X12 Format from Insurance

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decastrat1
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Joined: Fri Apr 22, 2016 9:44 am
Location: Northeast Ohio

X12 Format from Insurance

Post by decastrat1 » Wed Oct 12, 2016 8:09 am

I am researching a lot into the X12 format for autoposting. I know that OD has the capability to Import Ins Plans with X12 format files. I have yet to received X12 format files from an insurance company. Has anybody been able to get one. We use Renaissance (Remote Life) and we received payment information from insurance companies but it comes over as a Rich Text Format. Renaissance tells me they send over whatever the insurance company sends them. Has anyone had any success or more knowledge of receiving X12 format files from insurance companies?

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jsalmon
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Re: X12 Format from Insurance

Post by jsalmon » Wed Oct 12, 2016 9:28 am

decastrat1 wrote:I know that OD has the capability to Import Ins Plans with X12 format files
EDIT: Open Dental DOES support importing ins plans via X12 format. See cmcgehee's post below!

Original Post
I'm pretty sure we don't. X12 is a format that can probably handle that type of information but we do not create insurance plans automatically based on X12s from external sources. We support the X12 format in regards to claims (4010, 5010, etc), ERAs, Benefits, etc. but we don't import entire insurance plans to my knowledge.

decastrat1 wrote:I have yet to received X12 format files from an insurance company. Has anybody been able to get one. We use Renaissance (Remote Life) and we received payment information from insurance companies but it comes over as a Rich Text Format.
Technically Renaissance doesn't support the X12 format. They have their own proprietary format which we do not recommend using a format that is not X12. The company that bought them out supports the X12 format so you're probably interested in TesiaBridge.
http://www.opendental.com/manual/eclaim ... sance.html
http://www.opendental.com/manual/eclaim ... ridge.html
The best thing about a boolean is even if you are wrong, you are only off by a bit.

Jason Salmon
Open Dental Software
http://www.opendental.com

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

Re: X12 Format from Insurance

Post by Arna » Wed Oct 12, 2016 10:49 am

Open Dental currently is programmed to automatically receive and process ERAs from ClaimConnect, Denti-Cal, Mercury DE and Emdeon (WebMD/Change Healthcare).
Entropy isn't what it used to be...

Arna Meyer

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cmcgehee
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Joined: Tue Aug 25, 2015 5:06 pm
Location: Salem, Oregon

Re: X12 Format from Insurance

Post by cmcgehee » Wed Oct 12, 2016 2:34 pm

Open Dental can import insurance plan information using the 834 version of the X12 format.
http://opendental.com/manual/importinsplans834.html

This is a fairly new feature (16.1) so not many people have used it yet. Perhaps other users of this forum can comment on how they obtained 834 files from their clearinghouse/carriers.
Chris McGehee
Open Dental Software
http://www.opendental.com

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