Filing Denti-Cal claims using Open Dental

[tejasjani]

Hello,

My very first post here. We have recently been approved to accept Denti-Cal patients and I was wondering if anyone has prior experience setting up Open Dental to be able to file electronic claims for Denti-Cal. We are looking for any instructions or configurations needed in Open Dental to be able to start sending claims.

We have already been approved for EDI by Denti-Cal and we are planning to use ClaimConnect for routing the claims.

Thanks in advance

[jsalmon]

There shouldn't be any additional set up (other than on a per claim basis of course which is situational) to send claims to Denti-Cal.
You basically have two options:
Use a Clearinghouse

Most Denti-Cal users submit claims to a Clearinghouse, which then submits to Denti-Cal. Open Dental users have submitted claims to Denti-Cal in this manner for many years.

http://www.opendental.com/manual/dentical.html

Or directly submit to Denti-Cal by going through certification with Denti-Cal.

The general test certification steps are as follows:
Step 1: Fill out the Provider Service Office Electronic Data Interchange OSF and submit to Denti-Cal.
Step 2: Conduct a preliminary test with Denti-Cal. Submit one 837D claim transaction to Denti-Cal using Tumbleweed (a secure e-mail). Once successful, Denti-Cal 's EDI Support will request a formal project from the State.
Step 3: Denti-Cal will issue a Remote ID, username, and password when a provider enters the full testing phase (step 4). Use this information to set up the Denti-Cal clearinghouse.
Step 4: Complete the full testing phase by submitting test cases for certification.
Step 5: Wait for test verification.

http://www.opendental.com/manual/dentical.html

Once one of the two above is done you should be able to submit your claims like normal.