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edbaublitz
Canine II

Re: Why won't my claims go through

Good morning Heidi.

The reason why the payer ID does not match what the insurance company gave you is because Carestream has its own list. The reason we have our own list is because many of the insurance companies out there have Alpha Characters in their Payer IDs. SoftDent is not capable of taking letters in the Payer ID field.

Therefore, we created our own payer list and we tabled them. In the back end of our system, when we receive your claims with our Payer IDs on them, our system converts them to the correct payer id that is tabled and it is forwarded on with their payer id.

Please email me some recent (Within the last 90 days)  examples of claims that the insurance company is saying they did not receive and I will be happy to assist you. I just need the patient's name and the Date of Service please.

My email is Edward.baublitz@csdental.com.

Please put your office telephone number or account number in the subject line of the email so that I am able to locate your account.

Thank you and I look forward to assisting you further in this matter.

Ed

rbsmiles
Canine II

Re: Why won't my claims go through

I have spoken to CS the claims did show in your system as "rec'd" by

delta. The problem is as follows, The dates of service go back to the

start of the year. This now mid February. If that company does NOT have

alpha in their ID you should be using their ID. We have not been paid yet

for those dates of service. My A/R is now almost at 35 days for those

claims.

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edbaublitz
Canine II

Re: Why won't my claims go through

Heidi:

If the reports are showing information from Delta Dental that they were accepted, that basically means they got the claims. This does not mean that they were definitely getting paid. They may have rejected at Delta for some reason.

Not all insurance companies return electronic responses of rejections. Also, sometimes when the Insurance Company's system rejects a claim, it gets kicked out of their system, and their Customer Service Reps do not see it anymore. Then they tell you they did not receive the claims, which is false information. So you have to speak with their EDI Dept.

However, if the electronic report is coming from them, saying it was accepted, that means the payer id you used is correct. The Payer ID is basically an electronic address.. It's only function is to route the claim to the insurance company. Therefore, if they received the claim, it was correct. Our best option is to send me some examples and your account number so that I can look into this. If I need to call Delta Dental to sort this out I will but, I need information to go on.

Thanks,

Ed

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rbsmiles
Canine II

Re: Why won't my claims go through

this is just too much work. The length of time for processing is being

impeded by not using their requested ID. I am curious WHY you aren't using

their ID if it does not contain alpha?

On Thu, Feb 15, 2018 at 10:11 AM, edbaublitz <exchange@carestream.com>

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edbaublitz
Canine II

Re: Why won't my claims go through

Heidi:

I have located your account and have looked at some of the examples from your call on 2/13/18. The Electronic Report was in fact from the insurance company "Information from: MINNESOTA DELTA DENTAL/DELTA USA". Their response was " CLAIM HAS BEEN ACCEPTED FOR ADJUDICATION." I removed the patient name for obvious reasons.

Therefore, the Payer ID you used was correct and did not delay the claims. I will call Delta Dental and find out  what happened to these claims for you.

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