Which is the best E-claim service w/ OpenDental

[qberry]

We are ready to send claims electronically now that we are using digital xrays. What are you other OpenDental users, using? We don't want the cheapest or the most expensive, we want the best.

[jordansparks]

Claim Connect. That will give you the option of electronic attachments if you decide to go that route.

[nathansparks]

They also have great customer service, they go the extra mile, never any passing of the buck when they should not.

[katraum]

My only experience with Claims Connect is running Aetna patient eligibility. The results from that are very confusing and not easy to read/interpret. Is this a function of Aetna or Claims Connect? Does Claims Connect return clearer, easier to read eligibility info for Metlife or Delta TN (who provide great detailed results on their own websites)? I am very interested in automating our eligibility verification....but it has to give us as much detail as the ins websites, not just eligible, deductible, max and basic, major, preventative %.


Thanks!
Katherine

[jordansparks]

It's a function of Aetna I think. I don't have a specific example of Aetna to refer to, but I have seen a number of these raw eligibility reports as they come back from the insurance companies. The data is supposed to be "computer readable" so that software can process it, clean it up, and present it well. It is more typical that the results are instead a series of "human readable" comment rows. That is completely useless to a programmer. What am I supposed to do with a comment that says "IN NETWORK ONLY MAX 1200 ORTHO"? The insurance company could have passed such information in a coded format instead so that, for example, if we know that the office is out of network, we can remove that info, or so that we could put it in a nice grid. I could go into a lot more detail, but I will spare you. Let's just say that eligibility is turning out to be a much more painful process than anyone envisioned. It could be a long long time before we get reliable info from the insurance companies. I think they are pushing their web-based human readable solutions more because that gets the information to the most people even though it lacks automation features.