Insurance Claims

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doperio
Posts: 6
Joined: Thu Apr 16, 2015 9:53 pm

Insurance Claims

Post by doperio » Mon Jan 18, 2016 8:43 am

Hello, I'm a periodontist and I started a new practice and I am starting to have some patients with insurance that I am out of network with. I need to submit possibly less than 10 claims a month. Is it worthwhile to sign up for a clearing house service? It may not be worth it now, but I expect the practice to grow and the number of claims I need to submit to increase. I only plan to contract with Delta Dental and bill other PPO's out of network. Is the best option currently ClaimConnect & NEA Fast Attach, or should I consider Tesia that also offer attachment? Or, should I just snail mail claim? Thanks for any advice! Jon

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Arna
Posts: 444
Joined: Tue Jul 09, 2013 3:16 pm

Re: Insurance Claims

Post by Arna » Mon Jan 18, 2016 9:21 am

Snail mail will probably end up costing you more than the cost of a clearinghouse in the long run. A Forever stamp is 49c. Envelopes, paper, staff time to stuff all adds up too. Most clearinghouses charge per claim, and it's lower than the cost of a postage stamp. Using a clearinghouse also expedites the processing, as you're not reliant on the postal service to deliver, so with the right clearinghouse, you'll get paid quicker. It doesn't seem like much to begin with, but a couple of days delay on money can be a real game changer.
Claim Connect and NEA are by fair the most popular combination. Their services are outstanding, as is their support. There's no reason to not sign up with them.

You mention that you are going to bill PPO's out of network. That is a little contradictory, and I would like to know what you mean by that statement (I don't want you trying something that will get your claims rejected).
Entropy isn't what it used to be...

Arna Meyer

doperio
Posts: 6
Joined: Thu Apr 16, 2015 9:53 pm

Re: Insurance Claims

Post by doperio » Mon Jan 18, 2016 3:57 pm

This is what I have gathered so far:
ClaimConnect is $0.37/claim, $10 minimum?, requires NEA Fast Attach
Emdeon is $0.37/claim, no minimum, requires NEA Fast Attach
Tesia is $39.95 flat rate, attachment eligibility, first 30 days are free, NEA Fast Attach not needed. By the end of 2016, they will transition everyone over to Renaissance
Renaissance is $24.95 for the first 125 claims, over 125 claims, it's $49.95. Once you go $49.95, it stays $49.95 regardless of # of claims. NEA Fast Attach not needed.

NEA Fast Attach is $200 to register and $31 a month.

Is Renaissance Remote Lite still being not recommended with Open Dental?

Between Emdeon and ClaimConnect, what are people's experience and what do people recommend?

Is there anyway to get around the $200 NEA registration fee?

Thank you!

@arna: for PPO plans that I am not contracted with, I still bill them for the patient and the patient assign the benefits to me

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Arna
Posts: 444
Joined: Tue Jul 09, 2013 3:16 pm

Re: Insurance Claims

Post by Arna » Tue Jan 19, 2016 10:36 am

NEA is required if you will be sending attachments alongside electronic claims. Some users simply choose to mail those claims that require a narrative, xray or perio chart.
Thanks for clarifying what you meant by out of network insurance. Most insurance companies are more than happy to comply with the assignment of benefits.
Entropy isn't what it used to be...

Arna Meyer

doperio
Posts: 6
Joined: Thu Apr 16, 2015 9:53 pm

Re: Insurance Claims

Post by doperio » Sun Jan 24, 2016 7:09 am

I signed up with ClaimConnect and NEA mainly because I called and got connected with someone right away. There was no $200 fee to sign up for NEA through DentalXchange. They also told me that since I was paying $31 per month for NEA, I have already met the $10 minimum requirement for ClaimConnect.

Emdeon was straight up $0.37/claim with no minimum, but there was a $200 sign up fee with NEA.

Renaissance was attractive at $25/150 claims/month and NEA is not needed for attachment. However, it took multiple calls and each with long wait time to get a hold of customer service, who can only take and forward information to the sales rep. Customer service is not allowed to give out the sales rep email or number since she works at home. So I passed on Renaissance/Tesia.

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