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rbsmiles
Canine II

Why won't my claims go through

I have claims to Delta of MN. They say our payor ID is incorrect.  It should be 07000.  They haven't rec'd my claims and when I change the SD to their claim number the claim won't validate.  PLEASE fix this

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14 Replies
Moderator
Moderator

Re: Why won't my claims go through

Hey Heidi , SoftDent uses different type of payer IDs than the one insurance companies usually have 
you can use payer ID 26004 for Delta Dental of Minnesota 
here is a link for the "internal" payer Ids in SoftDent 

http://www.carestreamdental.com/ImagesFileShare/.sitecore.media_library.Files.Practice_Management.eS... 

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rbsmiles
Canine II

Re: Why won't my claims go through

They told me on the phone, they want 07000 not 26004.

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rbsmiles
Canine II

Re: Why won't my claims go through

using your 26004 delays our claims. We still have not been paid on claims

going back to the beginning of January

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Moderator
Moderator

Re: Why won't my claims go through

looking at our system i found that t total of 10 claims\Pre-auth were sent to payer 26004 since January , and they were all received by insurance company 
i would advise you to take a look at claim status report in E-services as you might need to follow up with insurance company for any rejections or adjudication 

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rbsmiles
Canine II

Re: Why won't my claims go through

yes, I did and spoke with your support. i canceled the claims to try to

"fix" the claims. I spoke with Delta twice. they want the claims to go to

07000. Can you update it or no?

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drcavola
Premolar III

Re: Why won't my claims go through

FWIW - my observation is that DD is so, so, so, so, confusing.  We have many claims "supposed" to go to DD of MN, but they instead go here in Atlanta.

Heidi, try to change the  number yourself and see what happens.  You're likely to get ECS errors, but since you canceled the claims, it's worth a try.  

Myself, personally, I'd trust ECS moreso that some rep from Delta Dental.  But ... that's just me

rbsmiles
Canine II

Re: Why won't my claims go through

I did try it. And called delta twice. As well as checked their website.

This seems to be a problem SD.

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drcavola
Premolar III

Re: Why won't my claims go through

You're saying that you tried the eclaims with the payer ID DD provided, then called DD twice and check their website to see if the claims have been received?  Then, the answer was no?

Heidi, are you sure EVERYTHING else on the claim form/eclaims is correct?  Sounds like more than the payer number to me ... Eservices said that the claims were received, but DD says no.  

Have you been able to everify the insurance thru the Patient Screen in Softdent?  If so, then yes, you do have all the information entered into Softdent correct.  If not, then there's more investigating to go.

Sorry ... just trying to help.  Sometimes it takes a lot of detective work with those electronic claims....

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rbsmiles
Canine II

Re: Why won't my claims go through

I sent the claims w 26004. Called delta on 2 different claims 2 different

times. Both reps and their website said use 07000. I reprocessed the

claims with the 07000. SD failed the validation. So I had to go back to

the 26004. It's SD using the 26004. It's delaying the claims by weeks.

I'm unclear at this point what is unclear.

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