Product FAQs

 

Q: Where can I get a complete list of CDT codes?

A: A complete list is available at: https://www.ada.org/en/publications/ada-catalog/cdt-products.

 

Q: Do I need any special software to submit with ClaimConnect?

A: No. All you need is an Internet connection and a Browser. It supports major Internet Browsers including Microsoft Internet Explorer®, Safari, Firefox, Chrome and Microsoft Edge as long as they support 128-bit SSL transmissions. If you're reading this screen, you probably have everything you need to submit claims via ClaimConnect.

 

Q: What is the minimum system requirement to use ClaimConnect?

A: DentalXChange's minimum system recommendations are:

Microsoft Windows

Processor (CPU): 2 GHz or faster

Memory (RAM): 4 GB minimum, 8 GB preferred

Hard Drive Size: 500 GB storage

Monitor: 19" or greater LCD monitor, capable of resolutions of 1280 x 1024 and better

Software: Adobe Reader version 8.0 or later; latest version of JAVA

Broadband Internet Connection

• Microsoft Window's Operating System:
• Windows 10
• Windows 8.1
• Windows Server 2012 and 2012 (R2)
• Windows Server 2016
• Browsers Supported:
• Microsoft Internet Explorer 10 and 11
• Legacy Microsoft Edge 13 and above
• Google Chrome 83 and above
• Mozilla Firefox 76 and above
• Apple Macintosh
• Mac OS X 10.12 (Sierra) and above
• Browsers Supported:
• Google Chrome 83 and above
• Mozilla Firefox 76 and above
• Apple Safari 8 and above

 

Q: When can I send electronic claims?

A: Electronic claims can be sent 24 hours a day, seven days a week. ClaimConnect is a real-time environment that validates and processes claims as they are submitted. Our system exchanges claims and related transactions with payer systems and updates the status of your claims as the information arrives.

 

Q: How much does ClaimConnect cost?

A: Industry studies show that each paper claim you prepare manually costs somewhere between $1.50 and $5.00 though prices may vary. Call (800) 576-6412 for accurate pricing.

 

Q: Who do I call if I'm having problems or have questions or concerns?

A: If you cannot find the answer to your question here, feel free to contact our friendly and knowledgeable support staff at (800) 576-6412.

 

Q: Do I need to reenter patient, insured and provider information each time?

A: We store and maintain your patient and provider information in our highly secure state-of-the-art servers, provided the account subscribes to the Patient Storage Service.

 

Q: Can I still submit an electronic claim if the insurance company is not found on the payer list?

A: Yes. You can submit any dental claim via ClaimConnect. If a particular carrier does not accept claims electronically, we simply print them to paper and mail them for you.

 

Q: Do I need to notify ClaimConnect if I add a new dentist to my practice?

A: New providers are seamlessly added as you submit claims. You will have the opportunity to review the new provider information prior to releasing the claim for submission. It is extremely important however to register a new doctor with the insurance companies as some require the registration of their NPI number before submitting electronic claims for that provider. To add a new doctor before submission, simply go to the ClaimConnect main menu and follow the selections to modify your account.

 

Q: Do I need to notify ClaimConnect if I have a new address, telephone number, tax identification number, etc.?

A: Yes. Whenever any changes take place in your practice information, be sure to modify your account information in the ClaimConnect system. This is the only way we can insure that the most current information is sent to the insurance company. It is also your responsibility to also communicate these changes directly to each insurance company as well.

 

Q: Now that I send my claims electronically, does that mean I do not have to follow up with insurance companies?

A: We recommend that you follow up with insurance companies on any outstanding claims that have been submitted but not settled after 30-45 days. Many payers now offer automated claim status responses available in ClaimConnect.

 

Q: What if an insurance company says they never received my claim?

A: Verify the claim information (name, SSN, date of birth, group ID, etc.) with the insurance company. If the correct information was submitted and the claim was submitted through ClaimConnect, contact Customer Service. If the claim was: Electronic - ClaimConnect will research the claim to determine the status. This procedure usually takes one to three days depending upon how quickly the payer responds. Paper - ClaimConnect will verify the insurance company's mailing address with you and resubmit the claim for you.

 

Q: What if I accidentally submit an electronic claim twice?

A: ClaimConnect monitors your account to prevent duplicate claim submissions. A duplicate claim received within ten days will be rejected and the status set to duplicate at no charge. Duplicate claims submitted after ten days will be submitted to the insurance company, and you will be charged for processing both claims.

 

Q: Can I send claims electronically that might require x-rays or other attachments?

A: Yes. ClaimConnect has an integrated attachment service that will electronically attach all documentation required by a Payer to adjudicate a claim. Our attachment service alerts you to which claims require documentation on a payer by payer basis and requires no additional, third party software. Having one service to send claims and attachments will lead to fewer errors and expedites reimbursements.

 

Q: Do I need to register my NPI numbers with ClaimConnect?

A: Yes. If you are billing under a business name then you need a NPI number for the business and an individual number for the treating providers.

 

Provider Section Errors

Q: My claim has a provider section error. What do I do?

A: Scroll down the claim form to the Billing Provider or Rendering Provider section and select the Change Billing Provider or Change Rendering Provider button. The appropriate page will be displayed. Select the appropriate provider from the list of existing providers, make any necessary changes, and select the Save button to return to the claim form. Address any other validation errors, scroll to the bottom of the claim form and click Submit.

 

Q: The doctor whose name is on the claim is not listed as a provider in ClaimConnect. How do I add their name?

A: Scroll down the claim form to the Billing Provider or Rendering Provider section and select the Change Billing Provider or Change Rendering Provider button. The Change Billing Provider or Change Rendering Provider page will be displayed. Select the Add New Provider button and complete all information on the Add Billing Provider or Add Rendering Provider page. Be sure to include the correct Tax Identification Number or Social Security Number and License Number, including issuing state with month and year of expiration. Select the Save & Continue Button to return to the claim form. Address any other validation errors, scroll to the bottom of the claim form and Submit.

 

Q: Why do I have to select the billing and rendering provider when that information is already listed on the claim that I submitted from my practice management software (PMS)?

A: The first time that a claim is sent from a PMS, ClaimConnect must match the names on the claim form to the list of providers in the ClaimConnect account. This should only occur on the first claim for each provider in a practice. The next time a claim is submitted with the same billing and rendering provider, ClaimConnect will automatically match the information with the provider(s) that were selected on the first claim. Remember, if there are multiple providers in a practice, there will be a Provider Section Error on the first claim submitted for each provider.

 

Q: The doctor for whom I am sending the claim is already listed as a provider in my ClaimConnect account. I selected his name as billing and rendering provider, but the claim still has a provider section error. What do I need to do?

A: There may be information that is missing for that provider in ClaimConnect. Scroll down the claim form to the Billing Provider or Rendering Provider section and select the Change Billing Provider or Change Rendering Provider button. The Change Billing Provider or Change Rendering Provider page will be displayed. Select the Edit Provider button next to the provider's name and fill in any missing information. Be sure to include the correct Tax Identification Number or Social Security Number and License Number, including issuing state with month and year of expiration, and click Continue. On the next page, select the appropriate billing and rendering provider from the drop-down list. Select the Save & Continue Button to return to the claim form. Address any other validation errors, scroll to the bottom of the claim form and Submit.

 

Patient Section Errors

Q: My claim has a patient section error. What do I do?

A: This means that there is important information about the patient or subscriber that is missing from the claim form. Scroll down the claim form to the Patient or Subscriber Information section and select the Edit Patient or Edit Subscriber button. The appropriate page displays. The error message at the top will indicate which field is missing information. Fill in the required information. Select Save to return to the claim form. Address any other validation errors, scroll to the bottom of the claim form and Submit.

 

Q: My claim has a patient section error that states: “Required Field ‘Date of Birth’ - cannot be blank (mm/dd/yyyy).” Why isn't the date I entered being accepted?

A: Dates must be entered in the following standard date format: mm/dd/yyyy, including slashes. Select the Edit Patient or Edit Subscriber button in the Patient or Subscriber section of the Claim Form. The appropriate page displays. Correct the patient or subscriber’s date of birth according to the proper date format. Select Save to return to the claim form. Address any other validation errors, scroll to the bottom of the claim form and Submit.

 

Q: My claim has a patient section error that states: “Required Field "Group/Policy#" - cannot be blank.” I don't have a group number for this patient. What do I do?

A: A missing or incorrect group number is one of the most critical pieces of information that can trigger a rejection, regardless of how a claim is submitted. If at all possible, contact the patient to obtain the correct group number. If unsuccessful, enter 99999 in place of the actual group number and resubmit the claim.

Note: This generic number may only be used in conjunction with a valid Plan Name (employer) listed on the form. Be aware that the payer (insurance company) may still reject the claim.

Select the Edit Patient button in the Patient section of the Claim Form. The Edit Patient page displays. Add the Group/Policy. Select Save to return to the claim form. Address any other validation errors, scroll to the bottom of the claim form and Submit.

 

Q: My claim has a patient section error that states: “Required Field "SS# / ID#" - cannot be blank or invalid format (Example 123456789).” I entered the SS# or ID# but it is not being accepted. What do I do?

A: The SS# or ID# cannot include dashes. Select the Edit Patient button in the Patient section of the Claim Form. The Edit Patient page displays. Correct the information in the Member ID/SSN field of the Patient ID section, ensuring that any dashes have been removed. Select Save to return to the claim form. Address any other validation errors, scroll to the bottom of the claim form and Submit.

 

Q: My claim has a patient section error that states: “Invalid Zip Code for this city and state.” What do I do?

A: ClaimConnect recognizes 5-digit Zip Codes. We update our Zip Code database regularly, so the Zip Code you entered may no longer be current for the patient's address. Either verify the Zip Code with the patient or look up the most current ZIP Code for that address at the United States Postal Service website. Select the Edit Patient button in the Patient section of the Claim Form. The Edit Patient page displays. Add/Edit the Zip Code in the Zip field of the Address section. Select Save to return to the claim form. Address any other validation errors, scroll to the bottom of the claim form and Submit.

 

Q: My claim has a patient section error for a student that states: “School Name is required for full time student, School City is required for full time student, or School State is required for full time student.” Why do I have to add this information?

A: You will only receive this error if school information is missing for dependents who are age 19 or over. Payers require this information (regardless of how you submit the claim) so they can verify that the dependent patient is still eligible for coverage. Select the Edit Patient button in the Patient section of the Claim Form. The Edit Patient page displays. Add the required information. Select Save to return to the claim form. Address any other validation errors, scroll to the bottom of the claim form and Submit.

 

Claim Section Errors

Q: I have a claim section error. What do I do?

A: Scroll down the claim form to the Claim Information section and select the Edit Claim Information button. The Edit Claim Information page displays. Read the specific errors listed at the top of the page and scroll down the form to add/edit the required information. Select Save to return to the claim form. Address any other validation errors, scroll to the bottom of the claim form and Submit.

 

Q: I have a claim section error that states: “Claim Item (#): Field ‘Tooth’ - cannot be blank.” How do I fix this?

A: The most current ADA CDT-3 code manual requires that a tooth number be provided for this procedure code. To correct the Tooth value, select the Edit Claim Items button. The Edit Claim Items page will be displayed. Add the correct tooth number to the Tooth field for the indicated item/procedure. Select Save to return to the claim form. Address any other validation errors, scroll to the bottom of the claim form and Submit.

 

Q: I have a claim section error that states: “Claim Item (#): Invalid Tooth value entered for charge line.” How do I fix this?

A: Only specific tooth numbers may be used for this procedure code, as specified by the ADA CDT-3 code manual. Common errors include the use of an anterior tooth number with a posterior procedure code or vice versa. Also, check to make sure that the procedure code or tooth number is not specific to primary dentition. Hint: To add or replace a procedure code, search by code or category by selecting the Look-up Procedure Code (blue magnifying glass) button to the left of the Procedure Code field on the Edit Claim Items page. To correct the Tooth value, select the Edit Claim Items button. The Edit Claim Items page will be displayed. Enter the correct Tooth value in the Tooth field. Select Save to return to the claim form. Address any other validation errors, scroll to the bottom of the claim form and Submit.

 

Q: I have a claim section error that states: “Date for item (#) must be in this format: mm/dd/yyyy and the year must be greater than 1800.” How do I fix this?

A: Dates must be entered in the following standard date format: mm/dd/yyyy, including slashes. Select the appropriate button to edit the section containing the date format error. Enter the date in the correct format. Select Save to return to the claim form. Address any other validation errors, scroll to the bottom of the claim form and Submit.

 

Q: I have a claim section error that states: “Claim Item (#): Required Field ‘Fee’ - cannot be blank. How do I fix this?

A: Some offices like to include $0.00 procedures (such as patient education) on the claim form to reflect the total patient visit. However, the claim form isn't the proper place to track such information. Industry standards for electronic claims require that a dollar amount be submitted for each line item on the claim. If it is necessary to track $0.00 procedures, call a customer service representative for your practice management system (or read the user manual) to determine where such information should be entered. Any $0.00 items must be removed from the claim form. In the Claim Item Details section of the Claim Form page, select the Edit Claim Items button. The Edit Claim Items page will be displayed. Select the Delete (red trash can) button to delete any $0.00 line items from the claim form. Select Save to return to the claim form. Address any other validation errors, scroll to the bottom of the claim form and Submit.

 

Q: I have a claim section error that states: “Claim Item (#): Field ‘Quadrant’ - must be blank.” How do I fix this?

A: The procedure code specified for this claim pertains to a specific a quadrant or arch. The most current ADA CDT-3 code manual requires that no quadrant be submitted with this procedure code. In the Claim Item Details section of the Claim Form page, select the Edit Claim Items button. The Edit Claim Items page will be displayed. From the Quadrant drop-down, select the blank space option at the top of the menu. Select Save to return to the claim form. Address any other validation errors, scroll to the bottom of the claim form and Submit.

 

Q: I have a claim section error that states: “Claim Item (#): For a claim defined as an Actual Claim, there must be assigned dates of service for every charge line.” How do I fix this?

A: If this claim is a statement of services rendered, a properly formatted date for each line item must be entered. In the Claim Item Details section of the Claim Form page, select the Edit Claim Items button. The Edit Claim Items page will be displayed. Enter the date(s) for any line item(s) missing this information. Dates must be entered in the following standard date format: mm/dd/yyyy, including slashes. If this claim is a pretreatment estimate (also known as a predetermination), the Pretreatment Estimate option must be selected. In the Claim Information section of the Claim Form page, select the Edit Claim Information button. The Edit Claim Information page opens. Select the Pretreatment Estimate option in the Claim section of the page. Once this option is selected, the date fields for each proposed item/procedure must be left blank. Select Save to return to the claim form. Address any other validation errors, scroll to the bottom of the claim form and Submit.

 

Q: I have a claim section error that states: “Claim Item (#): For a Prosthesis code, Initial or Replacement must be selected.” How do I fix this?

A: All procedure codes for prostheses must be marked either as an initial placement or as a replacement with the original placement date. In the Claim Item Details section of the Claim Form page, select the Edit Claim Items button. The Edit Claim Items page will be displayed. From the Prosthesis drop-down, select Initial or Replacement in the Prosthesis field. For replacements, the replacement date is required to be entered in the standard date format: mm/dd/yyyy, including slashes. Select Save to return to the claim form. Address any other validation errors, scroll to the bottom of the claim form and Submit.

 

Q: I have a claim section error that states: “Claim Item (#): The code you entered was not found. Please correct the code # or search for it through the categories on the left side of the claim form.” How do I fix this?

A: There are many procedure codes that are specific to individual insurance companies. ClaimConnect only allows the submission of standard industry codes to reduce the number of denials. If the procedure code entered is not recognized, search for an equivalent code by category. In the Claim Item Details section of the Claim Form page, select the Edit Claim Items button. The Edit Claim Items page will be displayed. Enter the correct Procedure code or select the Look-up procedure code (blue magnifying glass) button to the right of the Procedure code box. First choose a procedure category, then select a procedure code from the list. Select Save to return to the claim form. Address any other validation errors, scroll to the bottom of the claim form and Submit.

 

Additional Claim Section Errors

Q: My claim has an Additional Insurance Coverage error. What does this mean?

A: This means that the claim included information about additional dental coverage for the patient but that some required fields were either blank or entered in an invalid format. In the Insurance Coverage section of the Claim Form page, select the Add Additional Insurance Coverage button. The Additional Insurance Coverage page will be displayed with error message(s) at the top indicating which field(s) are missing information or were improperly formatted. Fill in the required information and select Save to return to the claim form. Address any other validation errors, scroll to the bottom of the claim form and Submit.

Q: What is the DXC Attachment Service?

A: The DXC Attachment Services allows providers using ClaimConnect to create attachments within ClaimConnect. Images may be acquired by a screen capture, file upload, or archive of previously sent images.

 

Q: Is there a Payer List?

A: Yes, the list of attachment payers for DentalXChange Attachment Services is displayed on the Payer List after the user logs in.

 

Q: My claim didn’t stop for an attachment but I received a letter in the mail asking for an attachment – why is that?

A: DentalXChange applied the validations given to us by the payers as their claim submission guidelines. Many payers will periodically request additional attachments based on other criteria. Offices may create a solicited attachment to respond to these infrequent requests for additional information or customize the validations determining which codes will stop for attachments.

 

Q: What is the criteria for defining a patient for the Archive feature?

A: For a given provider group the criteria is: Patient First Name, Patient Last Name, and Date of Birth.

 

Q: What is a Solicited Attachment?

A solicited attachment is an attachment requested from the payer during the claims review process.

 

Q: What are Claims Submission Guidelines?

A: Claims Submission Guidelines are the sets of rules that tell a provider when a payer will require an attachment. Most commercial plans refer to these sets of rules as Claim Submission Guidelines because there may be exceptions to the guidelines where attachments may or may not be needed. DentalXChange calls a payer's Claim Submission Guidelines our "Validation Rules".

 

Q: What is an Unsolicited Attachment?

A: An unsolicited attachment is an attachment sent to the payer before the claim is in the payer's claim review process. In this case, even if the payer has claim submission guidelines or DentalXChange has claim validation rules that indicate an attachment is required. If the attachment is sent at the same times as the claim, the attachment is considered "unsolicited".

 

Q: Can more than one payer be added at a time in the rules section?

A: Yes, you can add multiple payer providers, and codes – even to multiple groups! DentalXChange has adaptable rules that can be configured by the user.

 

Q: Are you able to see who created an attachment validation rule?

A: You may see who created a rule by selecting the ‘clock’ icon in the Action section of the Manage Attachment Rules. If the rule has only “Created on” data and not “Created by” data, that means the rule was created or updated by the insurance company on that date.

 

Q: Are you able to see who deleted an attachment validation rule?

A: EHG staff can send a doing business as request to get this information – it is not currently available in DentalXChange’s interface at this time.

 

Q: How can I see what attachment validation rules applied to my claim?

A: Selecting the View Attachment Rules button will show the validation rules for the procedures on your specific claim. If you wish to see all the rules for the specific payer, you may then select View All Rules. If you wish to see rules for any other payer, or you wish to modify any validation rule for any payer, you may select the Manage Rules button. DentalXChange obtains the validation rules from the payers, but allows providers to modify the rules at will.

 

Q: What is an attachment ID?

A: An attachment ID is a reference number that refers to the collection of images and narrative data to support a claim. A claim can have only one unsolicited attachment, but that attachment may contain more than one image and/or a narrative.

 

Q: Once a claim bypasses the attachment requirements, can I still add an attachment to the claim?

A: If you are sending claims in batch and there are no validation errors, the claim is delivered to the payer without the ability to make changes. If there were any validation errors, or you are doing a Direct Data Entry claim, you will have the opportunity to add an attachment even if the validation rules do not indicate an attachment is needed.

 

Q: Why do claims require attachments in the first place?

A: Not all claims require attachments. Dental industry payers have established rules to keep practices from committing Fraud, Waste, and Abuse. If the procedure is medically necessary as in the case where a patient goes to have a root canal done by an endodontist, the payer will not require attachments. Should this procedure be completed by a general dentist, rather than specialists, the payer may want to ensure the procedure was medically necessary.

 

Q: Is a validation for an attachment a Validation error?

A: No, validation stating an attachment is required is not a validation error, but rather an alert that payer guidelines require an attachment to process the claim.

 

Q: What is the difference between "Upload an Image" and "Capture an Image"?

A: Capture Image is preferred whenever possible. To capture an image the user brings the image on the screen and selects an area of the image to capture. When uploading an image, the user selects a file with which it is possible to make errors or upload an image that is an inappropriate size.

 

Q: What security protocols does your claim attachment solution follow to ensure the security of Protected Health Information (PHI) managed by my practice?

A: DentalXChange Attachment Services fall under the same strict security protocols we must follow for all of our services. We are EHNAC and PCI level 1 compliant, and DentalXChange is not only a claims clearinghouse, but we also support banking transactions through our Merchant Services division, requiring enhanced security measures and practices.

 

Q: Will you sign a Business Associate Agreement (BAA)?

A: Yes, our BAA is available on the DentalXChange website, in the Account Settings section, and includes a time signature.

 

Q: What happens if you’re not electronically connected to the payer or health plan I need to submit to?

A: Based on our relationship with the payer, the claim and attachment(s) will be delivered by paper. As additional payers become electronically integrated, your claims and attachments will change to electronic submission.

 

Q: Do you charge for training? Technical support?

A: DentalXChange includes unlimited technical support and training, free of charge. Our dedicated support team provides demos and walk-throughs to assist and train you and your staff on our Attachment Services, and any of our other services or features. Additionally, we offer training videos on a wide range of topics, and our Attachment Services library continues to grow.

 

Q: What types of training and support resources are available for me and my staff?

A: DentalXChange includes unlimited technical support and training, free of charge. Our dedicated support team provides demos and walk-throughs to assist and train you and your staff on our Attachment Services, and any of our other services or features. Additionally, we offer training videos on a wide range of topics, and our Attachment Services library continues to grow.

 

Q: What happens if/when I have staff turn-over and need re-training on the software?

A: DentalXChange includes unlimited technical support and training, free of charge. Our dedicated support team provides demos and walk-throughs to assist and train you and your staff on our Attachment Services, and any of our other services or features. Whether you need a refresher or want to introduce the software to a new staff member, you may request a demo at any time. Additionally, we offer training videos on a wide range of topics, and our Attachment Services library continues to grow.

Registration

Q: Where do I go to register for Patient Credit Score Service?

A: The Patient Credit Score Services must be added to the DentalXChange account before registration can take place. Contact your Sales Executive at 800-576-6412 ext. 455 for more information on Patient Credit Score Service.

 

Q: How much does this service cost?

A: Patient Credit Score Service reports includes 5 transactions for a low monthly fee. A transaction fee will be assessed for any additional reports run. Pricing is subject to change. Contact your Sales Executive at (877) 932-2567 ext. 455 for more information on current pricing.

 

Q: How long does it take to get started?

A: TransUnion requires 7-10 business days for processing.

 

Application

Q: What information do I need to complete the application?

A: In addition to the practice’s contact information, please have the following business information ready to complete the application:

• Company or DBA Name
• The date the company was established
• Tax ID
• A listing of insurance companies that the signing provider is approved with
• The signing provider’s NPI number
• Tax Contact Information if it differs from the practice’s contact information
• A listing of insurance companies that the signing provider is a participating provider with
• The signing provider’s Medicaid Number (Optional)
• The signing provider’s State License Number (Optional)

 

Q: Can I save the application after I start and complete it at a later time?

A: No, the TransUnion application cannot be saved.

 

Q: Who is the referring vendor?

A: DentalXChange is the referring vendor.

 

Q: My practice doesn’t have three (3) officers. How do I complete this section of the application?

A: TransUnion requires a response to all fields on the application marked with an asterisk (*). If a required field does not apply, enter “not applicable” or “N/A” in the field.

 

Q: I am not a participating provider with any insurance companies. How do I complete this section of the application?

A: If the provider completing the application is not a participating provider with any insurance companies select the checkbox marked Other.

 

Q: Who signs the TransUnion Patient Financial Setup Form?

A: The TransUnion application should be signed by the person authorized to enter into contracts.

 

Q: The registration and application are complete. Can I use the service now?

A: No. TransUnion requires 7-10 business days for the approval process. Once the TransUnion approval process is complete DentalXChange must obtain additional information from TransUnion to complete the DentalXChange account setup. If you have received the TransUnion approval notice feel free to contact your PayConnect Specialist at 800-576-6412 ext. 472 to have this information applied to your account sooner.

 

Application Approval

Q: I want to do a report on a patient now. How can I speed up the process?

A: DentalXChange does not participate in the approval process and is unable to influence TransUnion’s processing time.

 

Q: My application was declined. Why did this happen?

A: TransUnion completes a detailed application process and it is possible to be declined for the service. Feel free to submit an inquiry to your PayConnect Specialist for further details. For disputes contact TransUnion at (800) 916-8800

 

Q: I received my password from TransUnion. How do I log into my account?

A: The DentalXChange account is used to access your Patient Credit Score Services. A PayConnect Specialist will contact you at the end of the TransUnion approval process to obtain information required to complete the DentalXChange account setup. Feel free to contact your PayConnect Specialist at 800-576-6412 ext. 472 to have this information applied to your account sooner.

 

Report

Q: What information is required to run a report?

A: To run a report, obtain the patient’s name and address at a minimum. Obtaining the patient’s date of birth and Social Security Number significantly increases the identification accuracy.

 

Q: Is there a form available to obtain the necessary patient information?

A: Neither TransUnion nor DentalXChange has a standard form available at this time.

 

Q: Will running a report affect the patient’s credit score?

A: The Patient Financial Assessment report provides the scores that are classified as a soft inquiries.

 

Q: What is a soft inquiry?

A: Soft inquiries typically occur when a person or company checks your credit report as part of a background check. Examples include employer background checks, getting preapproved for credit card offers and checking your own credit score. A soft inquiry may occur without your permission. Soft inquiries may be recorded in your credit report, depending on the credit bureau, but they won't affect your credit score.

 

Q: What is a hard inquiry?

A: Hard inquiries generally occur when a financial institution, such as a lender or credit card issuer, checks your credit report when making a lending decision. They commonly take place when you apply for a loan, credit card or mortgage, and you typically have to authorize them. Most important to note, hard inquiries might lower your credit score by a few points and they may remain on your credit report for two years. As time passes, damage to your credit score usually decreases or disappears, often even before the hard inquiry falls off your credit reports.

 

Q: Is the score provided a FICO credit score?

A: The Patient Financial Assessment report provides three different scores for review. The first score, the TransUnion New Account Score, enables lenders to better identify debtors who are most likely to become 90 or more delinquent within a 24 month period. The second score, the Recovery Score, evaluates each debtor based on the likelihood of recovering $50 or more within a 12 month period. The last score, the FICO score, helps lenders predict debtor behavior such as how likely someone is to pay their bills on time, or whether they are able to handle a larger credit line.

 

Q: What do these alerts mean?

A: The Identification Accuracy section of the report provides one (1) of five (5) possible alert messages:

1. Verify Demographics – No credit alerts exist for this patient, but the information provided in the inquiry is not a 100% match to the patient’s credit file.
2. Red Flags – A trigger has occurred on the patient’s credit file.
3. Investigate Warnings – Alerts or warnings are present on the patient’s credit file, but they are not serious enough to be flagged as Red Flag.
4. No Credit Found – No credit history was found for the patient.
5. Accurate – There are no discrepancies or alerts.

 

Q: Will DentalXChange support advise me on whether it’s a good idea to extend credit to a patient?

A: No. DentalXChange support staff is available to provide limited information on the Patient Financial Assessment report. The decision to extend credit ultimately lies with the responsible parties at the practice.

 

Q: Can I contact TransUnion with questions on the report?

A: No. DentalXChange support staff is available to provide limited information on the Patient Financial Assessment report.

 

Q: How many days do I have to review a report?

A: Patient Credit Score Services reports are viewable for 30 days.

 

Other Questions

Q: I sold my practice. What happens to my TransUnion account?

A: If your practice has been sold to a new owner the TransUnion account can also be reassigned to this new owner. Contact your PayConnect Specialist at 800-576-6412 ext. 472 to get the process started.

Checks Processing

Q. What does ACH mean?

A: ACH stands for Automated Clearing House, a U.S. financial network used for electronic payments and money transfers. Also known as “Direct Payments,” ACH payments are a way to transfer money from one bank account to another without using paper checks, credit card networks, wire transfers, or cash.

 

Q: What is the difference between an ACH transaction and credit card transaction?

A: Credit cards utilize a network (such as Visa and MasterCard) to verify whether somebody is within their credit limit and then, after the network approves the trade, those funds are guaranteed to the merchant. This is known as a “guaranteed funds” transaction. An ACH transaction is only a request for funds. The transactions are batched together and sent out for processing once a day.

 

Q: Are there regulations regarding collecting account & billing information?

A: Yes, contact PayConnect at 1-800-576-6412 Ext. 472 for further information.

 

Q: Am I able to get a list of authorization codes?

A: Yes, contact PayConnect at 1-800-576-6412 Ext. 472 for further information.

 

Q: Are ACH and routing numbers the same?

A: ABA routing numbers are used to identify financial institutions. Some banks choose to separate paper (checks) and electronic (ACH debits) transactions by using a different routing number for each. One should confirm with their institution what routing number to use.

 

Q: How long does an ACH transaction take to settle?

A: Processing ACH can take 3-5 days for the transaction to clear through the bank.

 

Q: What is the cutoff time for that day’s processing?

A: The cutoff time for the days transaction is 5:00 PM PST. Therefore, if an ACH is run at 6:00 PM PST that day, the transaction will be processed with the following day.

 

Q: When & how do void boxes appear?

A: This will depend on the time of day and when the transaction was run. The void box will appear during the same business day that a transaction is processed. Voids must be completed prior to 5:00 PM, PST. Once the transaction has settled, the refund box will usually appear up to 72 hours after processing the original transaction.

 

Q: How can I process a credit back to the originating institution?

A: Once the transaction settled, a refund box will appear and a credit may be initiated back to the account.

 

Q: Are you able to void a transaction?

A: Yes, transactions must be voided the same day prior to 5:00 PM PST. If a transaction is past this deadline, then refund box will appear usually after 72 hours.

 

Q: Are reoccurring payment plans able to be setup?

A: Yes, reoccurring transactions may be configured using ACH.

 

Europay Mastercard & Visa (EMV Chip Technology) Credit Card Processing

Q: What is EMV?

A: EMV stands for Europay, MasterCard and Visa. It is a global standard for cards equipped with computer chips and the technology used to authenticate chip-card transactions.

All of our credit card machines are enabled to read EMV chip credit cards, to help combat against counterfeit and fraud.

 

Q: Why are EMV Transaction credit/debit card transaction more secure?

A: EMV Secures the transaction within three areas; card authentication, cardholder verification and transaction authorization. EMV Cards store the payment information in a secure chip, rather than a magnetic stripe. Unlike a magnetic stripe card, it is virtually impossible to create a counterfeit EMV card.

 

Q: What should I do if a patient presents me with an EMV card today?

A: You do not need to make any changes. If you currently use a USB card swiper, you may continue to use the swiper to input the card data. If you currently key enter the card data directly into PayConnect, you may continue to keypunch the card data directly into PayConnect.

 

Q: Will I need special hardware to read EMV cards?

A: Yes, in order to process EMV transactions you will need to upgrade your equipment to an EMV capable POS device. Keep in mind, EMV cards will come with both the traditional magnetic trip and a chip. If you do not choose to upgrade you equipment to become EMV capable, you can continue processing credit cards how you usually do, by swiping the card or key entering the card information.

 

Q: What is the "EMV Liability Shift"?

A: In October 2015, the Card Brand (Visa, MasterCard, Discover, and American Express) will shift the liability for fraudulent, lost, stolen or counterfeit cards presented as “card present” transaction to you, the merchant. For example, if a patient provides you with an EMV credit/debit card, and you swipe the card using the magnetic strip on the back, and that credit card turns out to be a stolen credit card, then you will be responsible for absorbing the cost of the fraudulent transaction. If you upgrade your processing equipment to become EMV capable, then you will not be responsible for the fraudulent transaction.

 

Q: How do I update to an EMV solution?

A: If you currently process credit/debit cards via a dial up/Ethernet credit card machine, you can upgrade your credit card machine to an EMV capable one. Dial up/Ethernet transactions is the only form of transaction that can be processed using the EMV chip at this time. If you process credit/debit cards online (virtual, Practice Management Software, PayConnect Website), you do not need to take any action at this time.

 

Q: Does PayConnect offer dial up/Ethernet EMV compatible equipment?

A: Yes, PayConnect offers the most up to date EMV equipment on the market. You can contact us anytime so we can assist with the transition.

 

Other Questions

Q: Which bank cards does PayConnect accept?

A: PayConnect accepts Visa®, MasterCard®, American Express®, Discover/Novus®, Diners Club®, Reward, Health Flex Spending, debit cards and EBT (Electronic Benefit Transfer) cards.

 

Q: What do I need to process credit card payments?

A: A Merchant Account and processing equipment are needed to accept credit card payments (online, offline, anywhere).

 

Q: What other payment methods does PayConnect accept?

A: PayConnect supports check processing with the help of CrossCheck. By offering checks as a payment option, practices have the potential to greatly expand revenue. CrossCheck will provide a check reader and a merchant ID number. Contact PayConnect to get started.

 

Q: What pricing does PayConnect offer?

A: PayConnect provides the most competitive pricing in the industry. We offer all pricing models including Interchange, Tiered and ERR, and we help find the most suitable model for every business type. There are no setup fees and no monthly minimums. Contact PayConnect today for a free cost savings analysis.

 

Q: What equipment does PayConnect offer?

A: PayConnect offers a variety of processing equipment including VeriFone EMV devices, Clover Devices, MagTek devices and more. Pricing and functionality may vary.

 

Q: Can PayConnect integrate with my Practice Management Software?

A: PayConnect is compatible and can integrate with a variety of Practice Management Software. We have spent years improving those integrations and have added many dysfunctional and tools. Please contact PayConnect to determine if your Practice Management Software is compatible with PayConnect.

 

Q: What is the difference between "Card Present" and "Card Not Present"?

A: PayConnect works with both Card Present and Card Not Present transaction. There are two types of transactions in the credit card payment world:

1) Card Not Present - on-line transactions where the merchant is not presented with a physical card or a valid signature.

2) Card Present - almost all of the transactions in the retail world are Card Present transactions. In this setting, the merchant gets to swipe the card through a magnetic stripe reader which reads the track data from the back of the card and sends it off to the bank for verification. The merchants are also required to verify the signature on the receipt against the one on the back of the card.

If the card is NOT present, as in the case of a MOTO (mail order, telephone order) or online transaction, and the cardholder asks for a charge-back on the grounds of fraud, the merchant doesn't get the money. If the case is an Internet order, then additional fees and limits apply, besides a MOTO case.

On the other hand, in a Card Present transaction, if the merchant authorized the card and has a signature slip, the merchant keeps the money and the bank absorbs the cost (provided the merchant can dig up the receipt and present it to the bank when the charge-back dispute comes in). PayConnect offers a complete end-to-end solution for signature/receipt/check image capture and retrieval system that completely eliminates this problem.

 

Q: Do you have a web-based interface?

A: Yes, PayConnect offers a powerful, easy-to-use web-based interface that features merchant management, virtual terminals and extensive reports.

 

Q: Does PayConnect offer easy to use reporting?

A: Yes, along with the PayConnect Online Portal, PayConnect offers a state-of-the-art reporting and reconciliation portal. Advanced Merchant Portal allows you to track financial statistics, download and print your monthly statements, and get notified of important industry changes. We also offer custom reporting if requested. Sign up for PayConnect today and get Advanced Merchant Portal for free.

 

Q: Do you support Recurring Billing and why do I want it anyway?

A: PayConnect offers a complete recurring billing (sometimes known as "subscription billing") system. Merchants can store customer billing information on PayConnect. A contract identification number will be created, which merchants can then use to run transactions and schedule future billings or schedule billings, which will repeat at a regular interval.

Recurring billing is useful even to merchants that don't necessarily require subscription billing. It allows merchants to securely store customer information in the PayConnect database. The merchant need only keep track of the contract identification number.

 

Q: Am I protected from fraud as a merchant?

A: Consumers are well protected from online fraud by the zero-liability plans offered by their card issuers, but the merchant is not according to United States law. A few fraudulent purchases or charge-backs on a merchant account can lead to increased bank fees and even the revocation of a merchant account.

 

Q: What tools do you have to help me fight fraud?

Automatically included with all PayConnect accounts are basic fraud screening tools including AVS (address verification system), Visa's CVV2, Mastercard's CVC 2, and American Express' CID. These proven tools can filter out most online fraud, and are available at no extra cost. The ultimate fraud fighting device is our Card Present transactions combined with signature/receipts/check images capture and retrieval. This will help significantly reduce fraud and the risk of charge-back.

PayConnect also offers Dispute Manager, which is an easy-to-use tool to help manage chargebacks and disputes online. Dispute Manager allows merchants to receive and respond to chargebacks online, and track the progress of pending disputes. Please contact PayConnect sign up.

 

Q: How secure is your system?

A: Security is our highest priority and proper precautions are taken at all times. All communication between our client’s servers, PayConnect, the acquiring bank and the issuing bank are encrypted end-to-end with 1024-bit RSA public/private key-pairs assuring server authenticity and invulnerability to man-in-the-middle attacks.

 

Q: Does PayConnect use SSL encryption?

A: Yes. Our system runs in Secure Mode using SSL (Secure Sockets Layer) to encrypt all communication data.

 

Q: What is PCI Compliance?

A: PCI (Payment Card Industry) Compliance is a nationwide mandate across the industry requiring all merchants to become compliant with PCI Standards. As a merchant, steps must be taken to protect each customer’s credit card information. The PCI Compliance process ensures that security protocols are employed and procedures are put in place to limit any exposure of credit card information.

 

Q: Is PayConnect PCI compliant?

A: PayConnect is fully level 1 PCI compliant - the highest level of PCI privacy and security recognized by the Payment Card Industry Security Standards Council.

 

Q: How do I become PCI Compliant?

A: After signing up for PayConnect, merchants are provided information on how to become compliant. Our trusted PCI vendor, Clover Security, will activate each merchant’s PCI Account. Merchants will be required to register and complete the process, which consists of completing a questionnaire and possibly a network security scan to ensure there are no vulnerabilities within your network. PayConnect makes it a priority to help our merchants become PCI Compliant and will answer any questions or concerns that arise.

Q: What is the purpose of DentistUSA?

A: DentistUSA is a great way for a new or old practice to advertise themselves, allow patients make appointments, send email requests and connect with their dentist.

 

Q: How much does it cost to be enrolled into DentistUSA?

A: The basic DentistUSA profile is free. The DentistUSA profile with click to talk connectivity is $5 a month plus $.50 per incoming call.

 

Q: When filling out a provider’s profile, what does it mean when the area is shaded?

A shaded area means that field is required.

 

Q: How does a provider publish and unpublish their entire profile?

A: Click on Profile Manager and select either: Publish My Practice on DentistUSA or Remove My Practice from DentistUSA.

 

Q: Is a provider required to fill out all screens before publishing a profile?

A: No, only the Practice Information screen needs to be filled out before a profile can be published.

 

Q: How long does it take after publishing a profile for the information to update?

A: It only takes a few seconds for updating information to display on the providers profile.

Q: Where does one go to register for DDS Enroll Credentialing Services?
A: The DDS Enroll Credentialing Services must be added to your DentalXChange account before the registration can take place. See Add/Remove Packages or contact the Sales department at 1-800-576-6412 Ext. 471 for more information.

 

Q: What is DDS Enroll Credentialing Services?
A: DDS Enroll is a tool used to create, maintain, and distribute forms and communications to providers in order to obtain required documentation for the enrollment process. This innovative software streamlines the data gathering process and enables providers to track the application process from start to finish. Providers answer a series of questions covering topics of interest for each application type. This information is gathered through one easy to use application wizard and is used across multiple applications. DDS Enroll can be accessed by selecting appropriate links available in the Electronic Claims Services section of the Dashboard page.

 

Q: How is DDS Enroll Credentialing Services helping Practices?
A: DDS Enroll Credentialing is helping practices to keep all of their provider credentialing needs in a centralized online account. It is also helping practices save time creating applications as they can fill out applications for a provider and multiple payers at the same time.

 

Q: How does DDS Enroll Credentialing help payers?
A: Payers receive clean submissions with all required questions and certifications attached. Payers no longer have to reach out to the offices for additional information as submissions from DentalXChange are complete and ready for processing.

 

Q: What is credentialing?
A: Credentialing is primary source verification of a health care or dental practitioner’s education, training, work experience, licenses, etc. A variety of resources are used to verify the information provided by the practitioner is correct.

 

Q: Why would a provider want to credential with a payer?
A: Being a credentialed provider with a payer means you are able to see patients who have specific insurance plans and bill those insurance companies for the services you render. This can greatly increase the number of patients you can service.

 

Q: What is the process of getting credentialed with a payer?
A: You would need to complete your application and attach all required certifications within your DDS Enroll Credentialing account. Once your application is complete and you have completed all required fields, you are required to submit your completed application to DentalXChange for processing. Once DentalXChange reviews your submitted application it is then forwarded to the payer for further processing.

 

Q: What is recredentialing?
A: Recredentialing is the process of periodically re-viewing and re-verifying your professional credentials with a payer.

 

Q: Why do I have to recredential?
A: Recredentialing is required to ensure that the payer has the most up to date and accurate information about a practitioner. It is also an opportunity for you to update any changes in your practice location, phone number, name, etc.

 

Q: What are network maintenance forms?
A: Network maintenance forms are other types of forms sometimes required by payers in order to complete credentialing. Network Maintenance form types are: Add Associate, Add Location, Change Request Forms, Direct Deposit Forms, Practice Purchase Forms, Terminate Associate Forms and Terminate Location Forms.

Q: What information do I need to complete the applications?
A: In addition to practice and provider information, please have the following certification ready to complete the application: • W-9 • Dentist/Hygienist License • CPR Certification • DEA Certificate • Diploma/Degree • Board Certification/Specialty Certificate • Malpractice Insurance • Curriculum Vitae.

Q: Can I save applications after I start and complete them at a later time?
A: Yes, DDS Enroll will save any existing data in the question wizard and remember where you left off.

Q: What is currently client feedback about using DDS Enroll Credentialing?
A: Clients report that the application process takes minimal time to complete and that they are able to complete applications in under 5 minutes! Clients are extremely happy that they are able to keep all of their credentialing needs in a centralized account and that DDS Enroll reminds them of expired certifications and recredentialing due dates. Clients also report that using DDS Enroll is convenient as they no longer have to keep paper files and all credentialing history is stored within DDS Enroll.

Q: Why is Enrollment required?

A: Enrollment is required in order for the payer to direct the Electronic Remittances to the party of the provider’s choice.

 

Q: There are so many forms! Where should I start?

A: ERA Enrollment should be completed for each payer claims are submitted to. Attempting to enroll for payers that an office does not support will result in a denial and extra work for the office. It is also important to review the coversheet for additional information about a specific enrollment, such as approval time frame, additional steps or documents, and additional payers covered under one form.

 

Q: Is the provider notified once the enrollment is completed with the payer directly?

A: Yes, this step is required as DentalXChange needs to deliver ERAs to the providers account. Once the payer knows to send ERAs to DentalXChange, DentalXChange then needs to be able to set the location of those ERAs to the Provider’s particular office.

 

Q: What information is needed to enroll for ERAs?

A: For ERAs, The provider’s billing information is required. Each payer has slightly different requirements for ERA enrollment. For more detailed information, please review the DDS Enroll question wizard for a specific payer and the coversheet for further instructions.

 

Q: The provider uses the same NPI and TIN for multiple locations; can ERAs be divided out by address?

A: At this time, the information used to route ERAs is the TIN and NPI received from the payer. DentalXChange cannot route to multiple accounts for the same information. When using the same information, it is likely multiple claim payments from different locations will be included on the same ERA.

 

Q: How long does enrollment take?

A: Enrollment is payer dependent and can range from one to several days depending on the payer. This information is listed on the Enrollment form coversheet.

 

Q: How are the ERAs going to look in the provider’s account?

A: If there are no ERAs in the account, the provider should navigate to ERA search and use the help button [?] in the ERA section, which will bring up the DentalXChange help system specific to ERAs. There are also videos available for review.

 

Q: Why would the provider not get payments electronically?(EFT vs ERA)

A: Providers may believe they are signed up for ERAs when they complete the EFT process. The ERA enrollment process is still required as payers needs to know where to send the ERA reports. When the ERA and EFT application are on the same form, DDS Enroll will allow the provider to complete the EFT portion of the form. This process varies by payer.