Best Provider for eClaims?

[Joe Gordon]

We will be converting to OD very soon and looking for the best eClaim service provider. We submit about 100-150 claims per week, and we rarely ever need attachments. Also, would love to have benefits data downloaded and autopopulated into OD. Is that even possible? Many thanks in advance.

[Rickliftig]

I've been using Emdeon for about five years with no issues. $0.24 per claim I believe. There was a thread on the forum about six months ago with the same topic.

viewtopic.php?f=1&t=2502&p=10522&hilit=claims#p10522

Rick

[drtech]

we use claim connect. Used them for about 3-4 years I think...works great

[Joe Gordon]

Thanks, Rick & David. I searched for previous posts and couldn't find any recent- I missed that one. Already spoke w/ Claim Connect last week- they were very helpful, but they told me that when accessing eligibilty, the coverage and benefits frequency will not auto import into OD. Are there any providers that will? If not, would this be a feature request? This would be much more efficient and accurate for the admin staff.

[jordansparks]

It's not a limitation of OD. When the insurance companies provide the benefits as text descriptions instead of as formalized fields like they are supposed to, there's nothing we can do about it. There's nothing to import.

[Pruce Dental]

While were are discussing Claim Connect for checking benefits can I ask about the Trojan services. Does Trojan and claim connect provide the same information? You would sign up with only one of these services right? or is there some benefit of using both companies? What are the pro's and con's of each service?

[Joe Gordon]

Thought OD has the capability. Under Insurance Plan Info window, when click on the Request button below, this message pops up:

Does this mean that ClaimConnect & CDAnet are configured to populate the info into the coverage table? This is what we are hoping for. Jordan, If not, it would seem that with ClaimConnect's excellent service, they could add this feature to provide benefit data in formalized fields? This would be a big selling point for them if no other eclaim provider has it. Kinda like how XCharge has seamless integration with Account module CC entries, right?

[jordansparks]

With ClaimConnect, yes, sometimes the info does get automatically populated into the coverage table. But due to insurance companies not supplying formalized data or not supplying any data, the service is spotty. It's useful, but certainly not seamless.

Trojan works by supplying a database to users. The database will usually contain good information that is automatically imported. However, they can't supply information about individual patients. Their service is very geographically dependent. Some areas of the country have great data, others none at all.

[DrDan]

Just got my annual renewal for Renaissance. They used to charge a flat $30/month or something like that but now they want about $450/year. (About $48/month)
Surely there has to be a better (less expensive) solution for OD that we can use.
So who's using what and what are you paying?

DrDan

[teethdood]

I locked in to Rennaisance's for 3 years at around $30/month, will expire in a year. They quoted me $450/year with a 2-year commitment for 10% off for my second office, so now I'm just doing paper claims since I barely have any patients in the second office. I'm also in the market for a new eclaims service.

[atd]

Tesia is $29.95/month for unlimited claims. If you have multiple offices under the same tax ID#, it's still only $29.95/month total.

[DrDan]

Thanks for the replay ATD....
Does anyone know how much extra Claim Connect charges for "Real Time Eligibility & Benefits"?

[atd]

Just got my annual renewal for Renaissance. They used to charge a flat $30/month or something like that but now they want about $450/year. (About $48/month)

If $450/year is the total, that would be $37.50/month, not $48. That's only an extra $90/year - it may not be worth the hassle of switching if you're happy with the service.

[irfan]

call them and ask for $30 again

[enamelrod]

has anyone been using real time insurance benefit services. suggestions, cons,pros?

[sbgcd]

With TESIA, how do you do attachment for pre-estimates? Is it part of 25/mo or any extras? Please advise. Thank you.

[jordansparks]

Attachments will always cost extra, no matter which clearinghouse.

[bralli]

This thread is a bit out of date. Any insight on recommended choices for Eclaims? We were considering Tesia in that it seems to give the most value. Has anyone had any problems bridging to this particular clearinghouse?

[jordansparks]

ClaimConnect.

[Cheryl Stern]

The Ohio Dental Association Services Corporation is endorsing ClaimX by Extradent. For ODA members the rate is 25 cents a claim. Has anyone tried them? I'm using Claim connect, but this is less expensive.

[jordansparks]

That's fine.

[stjames70]

I am with Jordan here, ClaimConnect.

I think if you research it carefully, all provider for eClaims eventually have to go through EDI which is the parent company for ClaimConnect.
Thus it would make sense that their claims response should be fractionally faster and better than all other 3rd party providers.

Just my two cents.

[jordansparks]

Not quite. The original clearinghouse was Envoy. It has become Emdeon. A certain number of claims undoubtedly still go through them. But many other companies have been working hard over many years to get direct connections in place. I've never seen exact numbers published, and it can be hard to judge who's making wild claims versus legit claims about direct connections.

But that's entirely separate from my suggestion. Open Dental was a very early adopter of X12 format. Clearinghouses were not necessarily prepared to accept X12 from us. I think that in the case of both Emdeon and ClaimConnect, we were their first vendor submitting X12. ClaimConnect was slightly ahead of Emdeon in the available interface at the time, so we ended up with a solid X12 interface that has served us well for many years. Emdeon made a similar interface available soon after that, and one of these days we will certainly do the work on our end to make that work. For Tesia, we seem to have customers on two different interfaces at the moment, neither of which is great. The one that especially worries me is the TesiaBridge that uses the ancient Renaissance format. It's a high priority for us to improve that interface.

[ForrestGumpDDS]

Looking to find an answer to the same question. With some companies developing faster, some slower the solutions become outdated sometimes. The last answer in this topic is 2 years old.
So what's the good and cost efficient service to process eClaims out there these days?
I signed up with Tesia, mainly because someone else recommended me Renaissance before and I read somewhere on this forum that Tesia is a successor of the Renaissance company and they do not use Renaissance format, instead they use X12 or something common.
2 things that turned me down while setting it up.
1. You can't expect to install and connect the Tesia Bridge to OD yourself. You have to call them, go through options and request an appointment within business days/hours. Their business hours. Even though the installation is click-click-agree-done.
2. This IS a Renaissance format. And they don't even go to edit the separate entry of Tesia (in OD clearinghouse setup) which resides separately from Renaissance. I asked the tech why he did this and he answered "This is the way it needs to be done".
The process of using eClaims with TesiaBridge is fairly simple, though eClaims is a very new thing for us. Their price is attractive (fixed $39/mo). However I want to go with format that OD is prepared to work with (like X12).
Do I have any good options there?

[wjstarck]

Can't speak for anything other than Emdeon 'cause that's all we've ever used.

No problems for going on at least 6 years now (maybe more).

[ForrestGumpDDS]

Can't speak for anything other than Emdeon 'cause that's all we've ever used.

No problems for going on at least 6 years now (maybe more).

Thanks. I gave them a call, will try them for $39.95/mo. No contract required.