Best Provider for eClaims?

For users or potential users.
Post Reply
Joe Gordon
Posts: 64
Joined: Fri Jul 30, 2010 3:43 am

Best Provider for eClaims?

Post by Joe Gordon » Thu Aug 05, 2010 8:04 pm

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.

User avatar
Rickliftig
Posts: 764
Joined: Thu Jul 10, 2008 4:50 pm
Location: West Hartford, CT
Contact:

Re: Best Provider for eClaims?

Post by Rickliftig » Sat Aug 07, 2010 6:03 am

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
Another Happy Open Dental User!

Rick Liftig, DMD FAGD
University of CT 1979
West Hartford, CT 06110
srick@snet.net

User avatar
drtech
Posts: 1647
Joined: Wed Jun 20, 2007 8:44 am
Location: Springfield, MO
Contact:

Re: Best Provider for eClaims?

Post by drtech » Sat Aug 07, 2010 6:31 am

we use claim connect. Used them for about 3-4 years I think...works great
David Fuchs
Dentist - Springfield, MO
Smile Dental http://www.887-smile.com

Joe Gordon
Posts: 64
Joined: Fri Jul 30, 2010 3:43 am

Re: Best Provider for eClaims?

Post by Joe Gordon » Sat Aug 07, 2010 7:01 am

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.

User avatar
jordansparks
Site Admin
Posts: 5739
Joined: Sun Jun 17, 2007 3:59 pm
Location: Salem, Oregon
Contact:

Re: Best Provider for eClaims?

Post by jordansparks » Sat Aug 07, 2010 1:25 pm

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.
Jordan Sparks, DMD
http://www.opendental.com

Pruce Dental
Posts: 290
Joined: Tue Feb 09, 2010 2:39 pm
Contact:

Re: Best Provider for eClaims?

Post by Pruce Dental » Sat Aug 07, 2010 5:48 pm

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?
Robert L. Pruce, DMD
www.prucedental.com

Joe Gordon
Posts: 64
Joined: Fri Jul 30, 2010 3:43 am

Re: Best Provider for eClaims?

Post by Joe Gordon » Sun Aug 08, 2010 6:27 am

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

User avatar
jordansparks
Site Admin
Posts: 5739
Joined: Sun Jun 17, 2007 3:59 pm
Location: Salem, Oregon
Contact:

Re: Best Provider for eClaims?

Post by jordansparks » Mon Aug 09, 2010 11:33 am

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.
Jordan Sparks, DMD
http://www.opendental.com

DrDan
Posts: 4
Joined: Fri Feb 06, 2009 11:57 am

Re: Best Provider for eClaims?

Post by DrDan » Wed Apr 20, 2011 5:15 pm

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
Posts: 267
Joined: Sun Jul 29, 2007 12:39 am
Location: Visalia, CA
Contact:

Re: Best Provider for eClaims?

Post by teethdood » Wed Apr 20, 2011 8:19 pm

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.
Philip H. Doan, DDS
http://www.kaweahdental.com/

atd
Posts: 404
Joined: Thu Mar 27, 2008 2:28 pm
Location: Minneapolis, MN

Re: Best Provider for eClaims?

Post by atd » Thu Apr 21, 2011 12:09 pm

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
Posts: 4
Joined: Fri Feb 06, 2009 11:57 am

Re: Best Provider for eClaims?

Post by DrDan » Fri Apr 22, 2011 3:25 am

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

atd
Posts: 404
Joined: Thu Mar 27, 2008 2:28 pm
Location: Minneapolis, MN

Re: Best Provider for eClaims?

Post by atd » Fri Apr 22, 2011 8:20 am

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.

User avatar
irfan
Posts: 216
Joined: Thu Oct 21, 2010 9:09 am

Re: Best Provider for eClaims?

Post by irfan » Fri Apr 22, 2011 3:08 pm

call them and ask for $30 again

enamelrod
Posts: 462
Joined: Tue Jul 24, 2007 9:51 am

Re: Best Provider for eClaims?

Post by enamelrod » Thu Jul 14, 2011 4:39 am

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

sbgcd
Posts: 25
Joined: Wed Jul 27, 2011 10:04 am
Location: NY
Contact:

Re: Best Provider for eClaims?

Post by sbgcd » Sun Aug 14, 2011 8:51 am

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

User avatar
jordansparks
Site Admin
Posts: 5739
Joined: Sun Jun 17, 2007 3:59 pm
Location: Salem, Oregon
Contact:

Re: Best Provider for eClaims?

Post by jordansparks » Sun Aug 14, 2011 1:25 pm

Attachments will always cost extra, no matter which clearinghouse.
Jordan Sparks, DMD
http://www.opendental.com

bralli
Posts: 7
Joined: Tue Mar 13, 2012 2:30 pm

Re: Best Provider for eClaims?

Post by bralli » Tue Mar 13, 2012 5:45 pm

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?

User avatar
jordansparks
Site Admin
Posts: 5739
Joined: Sun Jun 17, 2007 3:59 pm
Location: Salem, Oregon
Contact:

Re: Best Provider for eClaims?

Post by jordansparks » Wed Mar 14, 2012 7:24 pm

ClaimConnect.
Jordan Sparks, DMD
http://www.opendental.com

Cheryl Stern
Posts: 24
Joined: Fri Jan 22, 2010 6:30 am

Re: Best Provider for eClaims?

Post by Cheryl Stern » Thu Mar 15, 2012 10:02 am

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.

User avatar
jordansparks
Site Admin
Posts: 5739
Joined: Sun Jun 17, 2007 3:59 pm
Location: Salem, Oregon
Contact:

Re: Best Provider for eClaims?

Post by jordansparks » Sat Mar 17, 2012 4:38 pm

That's fine.
Jordan Sparks, DMD
http://www.opendental.com

stjames70
Posts: 101
Joined: Fri Dec 18, 2009 3:24 am

Re: Best Provider for eClaims?

Post by stjames70 » Wed Mar 21, 2012 8:50 am

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.

User avatar
jordansparks
Site Admin
Posts: 5739
Joined: Sun Jun 17, 2007 3:59 pm
Location: Salem, Oregon
Contact:

Re: Best Provider for eClaims?

Post by jordansparks » Wed Mar 21, 2012 10:57 am

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.
Jordan Sparks, DMD
http://www.opendental.com

ForrestGumpDDS
Posts: 177
Joined: Fri Oct 14, 2011 3:31 pm

Re: Best Provider for eClaims?

Post by ForrestGumpDDS » Sun Feb 23, 2014 6:35 pm

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?

User avatar
wjstarck
Posts: 935
Joined: Tue Jul 31, 2007 7:18 am
Location: Keller, TX
Contact:

Re: Best Provider for eClaims?

Post by wjstarck » Sun Feb 23, 2014 7:34 pm

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).
Cheers,

Bill Starck, DDS
Big Idea Software, LLC
Developer, EASy(Electronic Anesthesia System) for Open Dental
817-807-1709
TX, USA

ForrestGumpDDS
Posts: 177
Joined: Fri Oct 14, 2011 3:31 pm

Re: Best Provider for eClaims?

Post by ForrestGumpDDS » Mon Feb 24, 2014 2:26 pm

wjstarck wrote: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.

Post Reply