We do not return x-rays or other documentation submitted with paper claims; however, we will make an exception when we receive a stamped, self-addressed envelope with the claim. Perks at Work: Discounts and special offers on products and services to help reduce your overhead expenses and save time, for Delta Dental PPOSM and DeltaCare® USA dentists. Check with your software vendor to determine how you will receive the ERAs. Enter the information in the “Remarks” or “Comments” field. What if I am receiving Electronic Remittance Advice (ERA/835)? With Provider Tools, patient information is entered for you. Can I still receive paper? Depending on the ZIP code range in which your office falls, you might have to wait several weeks before you receive your payment. We also will enroll you for our electronic remittance advice (ERA), which replaces the paper version of your explanation of remittance (EOR). Review questions and answers about EFT and ERA here, too. If you don’t know if you use Emdeon or Secure EDI, contact your current software vendor or your own clearinghouse for more information. For more information about electronic encounter form submission, please email our A copy of the pathology report is needed for hard and soft tissue biopsies: D7285-D7286. Claim payment checks and EOBs are mailed weekly to dental offices within a specific ZIP code range. Pre-treatment estimates” for more information. Direct deposit is a free service only available to participating dentists. (The enrollee is the person who has the dental plan through his/her employment. To enroll in the Electronic Funds Transfer (EFT) and Electronic Remittance Advice (ERA) service, please complete the enrollment form below and include a voided check. We will accept duplicate films and paper copies of digital images. From the Provider Tools screen, transmit claims, digitized attachments and pre-treatment estimates with either of these tools: “Submit Claim” – transmission is quick and efficient. Northeast Delta Dental will submit the claim for payment processing on Wednesdays and Fridays. DeltaCare USA's payer identification number for encounter forms is DDCA3. See processed claims in minutes (when clinical review isn’t necessary), including Delta Dental’s payment and the patient’s payment portion (maximums and deductibles are updated in real-time, too). In dual coverage cases, there will usually be two different enrollees within a family.) Inform your local Dentist Network Administration and Contracting department if your TIN or the name associated with that TIN changes. 835/Electronic Remittance Advice (ERA) is an electronic version of the provider Explanation of Benefits (EOB). When benefits and copays have been determined, the claim becomes a remittance advice document and is sent to your dental office. A copy of the operative report is needed for procedures D7490-D7521, D7610-D7780, D7910-D7912, D7980-D7983 and D7998. Check eligibility, benefits and claims status. Submit your completed form and voided check or bank letter to: You can log in to your online account to find claim forms. A laser printer with black ink (if not transmitting electronically), A 10 point font and all capital letters (Courier is a good font choice), Eight-digit dates with no spaces, slashes or dashes (for example, 05032014 for May 3, 2014), Standard size paper (8.5 x 11 inch) for claims and written documentation, Fees with decimal points (for example, 100.00; not 100), Use free-form text — use the “Tooth number or letter” field to indicate quadrant or arch (UR or L, for example), Use ditto marks or arrows to indicate duplicate information, Allow stray marks in spaces that should be left blank, Write on top of lines or outside of boxes, Use correction fluid or a highlighter pen, Use photocopied claims that are blurred or skewed. Avoid lost or stolen checks 4. Electronic funds transfer and electronic remittance advice. Username or X-ray copies submitted with paper claims must be of diagnostic quality. You can get free pre-treatment estimates often within minutes (when clinical review isn’t necessary) with Provider Tools. Reference Code, Adjustment Notice or Process Policies: Explains any limitation on your insurance coverage for the procedure you received. If you are a Minnesota provider, you must comply with the MN Statute 62J requiring all … Connect with your Delta Dental to learn more. Dental consultants look for reasons to approve your claims. Electronic remittance explanation codes. Any owed balance will carry over to the next week’s claim payment. See “, X-rays for your for your Delta Dental Premier, Restorative: D2710-D2794, crowns — laboratory processed, and D2950, core buildup, including any pins, Implant services: D6055-D6077, implant supported prosthetics, Prosthodontics, fixed: D6710-D6794, fixed partial denture retainers, crowns. You will receive this from the same clearinghouse used to submit your claims electronically. A. As a HIPAA Covered Entity, Delta Dental of New Jersey (DDNJ) is required to comply with the CAQH Phase III CORE EFT and ERA Operating Rule Set. Orthodontics” for more information. Delta Dental of Oregon Medicare Advantage Provider Attestation; Claims and payments. Participation in Dental Electronic Remittance Advice (ERA) is limited to those providers whose practice management software vendor is participating in ERA with Emdeon or to those providers who have a Dental Provider Services (DPS) account. “My Patients” – your current patients are listed here and we add new patients as their claims are processed. Network dentists can opt in to direct deposit, allowing for quicker and safer electronic payment of Delta Dental claims. Send a new claim for payment after services are provided (do not date and return the pre-treatment estimate). Download the claim form for your Delta Dental plan. You will receive this from the same clearinghouse used to submit your claims electronically. Emdeon EDI 835 Registration form may be used by providers using Emdeon EDI as a clearinghouse. You’ll see Delta Dental’s payment and the patient portion when the claim or pre-treatment estimate processes, often within moments (when clinical review is not necessary). You may request Direct Deposit solely from Delta Dental of Massachusetts (DDMA) 1, or from all Delta Dentals with EFT Direct deposit – your payments made better: 1. Not in one of these networks? Emdeon EDI 835 Registration form may be used by providers using Emdeon EDI as a clearinghouse.