To get started with electronic claims processing, contact your software vendor or practice management vendor for more information. If you would like more information from Delta Dental on processing claims and special requirements, please feel free to view or print out the "Electronic Claims Submission" guide from the link below. You may also call our Customer Service Center at 1-800-328-1188 and request a paper copy.
To ensure electronic claims are processed accurately and efficiently:
- Submit the correct ID number as printed on the ID card and the subscriber's date of birth. Delta Dental uses this information to ensure the claim is processed under the correct member.
- For Medica, submit the 9-digit ID number printed on the dental ID card. Note: Some members may have a 16-digit ID number printed on their medical/dental ID cards. In this case, the first five (5) digits are the group number and the next nine (9) digits are the ID number to be used for dental claims.
- For Public Programs, be sure to submit the patient's ID number, which is the state-issued Person Master Index (PMI) number, not the subscriber's SSN.
- If you have questions regarding the Electronic Claims Submission guide, contact Delta Dental's Customer Service Center. Review your response reports forwarded by your clearinghouse to determine if there are any errors on claims.
- Secondary Coordination of Benefits (COB) claims should include the primary paid amount on the electronically submitted claim. If this amount is not listed on the claim, you will receive a follow-up letter requesting this information, which will in turn delay processing.
- To submit x-rays* or other claim related materials, two options allow faster claim resolution. The best option is to use National Electronic Attachment, Inc. (NEA). The second option is Web submission via this Web site, which will be available in Fall 2009. Other submission methods are email, fax or mail. When not using NEA to submit attachments or X-rays*, a Claim Attachment Cover Sheet must be used in order to match the attachments to the electronic claim.
* X-rays are rarely required; before sending, check your Dental Office Administrative Manual.
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