Tips for reducing claims processing time

• Submit claims electronically. Delta Dental of OregonAlaska processes electronic claims first each day. See below for a list of electronic claims processing providers.
• If submitting paper claims, please use the standard ADA form, either typed or legibly printed.
• Verify the patient's relationship to the subscriber, and make sure plan information is correct before submitting claims.
• Include all pertinent information: subscriber ID or recipient ID (if OHP), patient name and date of birth, tooth number(s) or quadrant and current ADA codes. Your office can call the ADA at 800-947-4746 to order the most current CDT codebook.
• Please do not send X-rays unless requested by Delta Dental. In some instances, clinical information may assist in determining benefits.
• If a patient is covered by more than one Delta Dental program, submit one claim form indicating the name of the subscriber, subscriber ID number, employer (if applicable) and the Delta Dental group number for both plans. If the patient is covered by another carrier, please indicate the above information plus the name, address and policy number of the other carrier. If a patient has primary insurance through a carrier other than Delta Dental, the EOB of primary payment amount from the other insurance company will need to accompany the claim for consideration of payment.
• Be aware that Delta Dental makes payments weekly.
• Please contact us before submitting duplicate claims:
  • Check Dental Benefit Tracker to see the status of a claim. If you haven't registered for this free online service, you can register online.
  • If you receive a PDR indicating that your claim has already been processed before you receive a check, this indicates that your rebill was unnecessary — the claim was processed and is pending for the next scheduled payment date.
  • Rebilling without contacting us slows our turnaround time and delays payment.
• Use miscellaneous codes appropriately with clinical information.
• Code "R6, 9A6, 9A8" on the Payment Disbursement Register are for charges exceeding the amount allowed. This is a provider discount and should not be billed to the patient.
• DO NOT USE HIGHLIGHTER ON PAPER CLAIMS.

Electronic claims filing

Delta Dental is committed to receiving claims electronically. Advantages for your office include greatly enhanced service and dramatically lower administrative costs.

Below is a list of dental electronic claims providers for Delta Dental. Please contact one of these providers to set up an account to make your claims-filing easier.

Clearinghouses

• Emdeon (formerly WebMD)
  220 Burnham St.
  South Windsor, CT 06074
  888-255-7293
  Payor ID = CDOR1

• APEXEDI Inc.
  174 S 1000 East
  American Folk, UT 84003
  801-642-0285
  Payor ID = CDOR1

• EDI Health Group Inc. – DentalXchange (EHG)
  17701 Cowan St., Suite 250
  Irvine, CA 92614
  949-852-0825

• TESIA Clearinghouse, LLC
  1540 W. Edgewood Ave.
  Indianapolis, IN 46217
  800-724-7240

Practice management systems that submit directly to Delta Dental

• Dentists Management Corporation
  10505 SE 17th Ave.
  Milwaukie, OR 97222
  503-243-3966

• Quality Systems Inc.
  18111 Von Karman #600
  Irvine, CA 92612
  949-255-2600

Direct connection to Delta Dental

Delta Dental also supports direct connections between offices and Delta Dental if the dentist prefers this method. Transaction standard is the 837 Dental Claim required by HIPAA Administrative Simplification.

Delta Dental EDI transactions contacts

Email

Support for claims from other Delta Dental providers

For help with claims from other Delta Dental providers, please contact that provider directly.