As we welcome the new year, we’d like to provide a few tips and reminders for an efficient claims process.
Enroll in EFT/ERA
For efficiency, and to streamline the payment process, enroll in Electronic Funds Transfer (EFT) and Electronic Remittance Advice (ERA). The digital process can reduce costs and save time by streamlining manual processes and speeding up revenue cycles. For new EFT/ERA enrollment, go to enroll.ach835.com/new.
Be sure your NPI Type 1 and Type 2 are in the correct field on the claim form
The current ADA Dental Claim Form provides space for the National Provider Identifier (NPI) Type 1 or business NPI, Type 2. If your office is registered for a business NPI Type 2, this should be populated in Box 49 on the ADA Dental Claim Form. If no business NPI is available, this box should be left blank. The provider’s individual NPI Type 1 should be populated in Box 54 on the ADA Dental Claim Form. Ensuring proper placement of these NPIs can prevent claims processing delays and denials.
Submit a new claim form with new documentation
As a reminder, a new claim is required when new documentation is submitted as a result of a denial or request for additional clinical documentation. When additional clinical documentation is needed to make a benefit determination, DDMO will indicate that on your ERA or EOB. Please attach x-rays, photos and any narratives to a new claim form and submit it to us for benefit determination.
Add new providers to the provider portal
If you have added another dentist to your practice, remember to add those providers to your existing profile through our provider portal. To add a dentist, log in to our portal, select Admin and then My Profile, and add all providers by license number, leaving off any preceding zeros and using numerical values only. It is important to have all providers in your practice added to your account, so you can access all your remittance advices through the portal.
Review the Delta Dental Handbook
You can access the Delta Dental Dentist Handbook online through our provider portal. The dentist handbook includes general policies and a complete list of current CDT codes, descriptors, and specific processing policies that apply to each code.
