Tips for efficient electronic claims submission

Completing your electronic claim

• When submitting an electronic claim to Delta Dental, the payer ID number must be on the form.
  
  Electronic payer ID numbers or claim office ID numbers are used by clearinghouses to correctly route your electronically submitted claims. Check with your software vendor or clearinghouse for the correct way to submit electronic claims with your system.

• When submitting a procedure with a miscellaneous code (ending in 999) or non-Delta Dental code, you must include a detailed explanation in the comments/remarks field.

• You may transmit up to 16 procedures on one electronic claim to help speed the claims processing. If more than 16 procedures are provided for one patient, please transmit a second complete claim with the additional procedures.

• Enter eight numbers in the group number field of an electronic claim since Delta Dental groups are identified by an eight-digit group number.

  Group numbers for your Delta Dental patients can be found by using Delta Dental's online benefits and eligibility features on the web site. Enter the subscriber's social security or ID number and last name to access his or her records.

• Use the comments/remarks field to indicate attachment # (e.g. NEA # or NIS #) , student status, amount paid by prime carrier, dual coverage information and narratives for by-report procedures.
  
• Dual coverage claims can be sent electronically. Submit first to the primary carrier and include information about both coverages when transmitting the claim to the secondary carrier and submit the EOB. Include the prime payment amount in the comments field.

Responding to Requests for Additional Information

• Respond to Delta Dental's information requests within 60 days. When information is requested for a claim (such as x-rays or other documentation), the claim is pended for 60 days. If the requested information is not received within that time, we assume you will not be sending the requested data, and so the claim is deleted from the pending file. You will have to retransmit the claim and incur another transmission charge. Electronic claims specialists, who are available to answer questions with electronic claims submission, can be reached at 888-Delta90 (888-335-8290).

Submitting claims electronically may save you money

Find out with our Electronic Claims Submission (ECS) calculator. Compare the cost of paper claims submission to the cost of submitting electronically.