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Clearinghouse Setup 

If sending E-claims to a clearinghouse, you must first set up the clearinghouse. In the main menu, click Setup, Family/Insurance, Clearinghouses.

Clearinghouses are listed alphabetically. If using Clinics, you can override some information by clinic (e.g. login credentials, export path). See Clinic Clearinghouse Setup. To view a clinic's Export Path overrides for all clearinghouses listed on the E-Claims window, select the clinic in the upper right.

Set a default clearinghouse:

  • For dental claims: Single click on a clearinghouse, then click Dental.
  • For medical claims: Single click on a clearinghouse, then click Medical.
  • For eligibility requests: Single click on a clearinghouse, then click Eligibility. Note: If no eligibility default is set, the default for eligibility will be the chosen dental default. If no eligibility default is set and there is no dental default, the eligibility default will be the chosen medical default.

Enter clearinghouse or direct carrier settings: Double click the clearinghouse. For set up instructions by individual clearinghouse, see E-Claims

Add a clearinghouse that isn't listed: Click Add.

Clearinghouse reports: These settings affect the automatic download of clearinghouse reports (e.g. Electronic EOBs (ERAs), acknowledgement reports, text reports).

  • Receive Reports by Service: Determines the method used to receive reports.
    • Unchecked: The computer specified will receive the reports. This is the original method used by Open Dental.
    • Checked: Receive reports using the OpenDentalService. This method is recommended for remote app users.
  • Computer to Receive Reports Automatically: Specify one computer which will download reports automatically from the clearinghouse server to the Report Path. Enter the IP address or computer/server name or click This Computer to use the computer you are currently on. If you enter a server name and leave Open Dental open on the server, the computer will automatically check the server for new reports according to the interval. If this field is blank, this feature is disabled.
  • Report Receive Interval: Set the time, in minutes, to automatically check the clearinghouse server and download new reports. Only values between 5 and 60 are allowed. 30 is the default.

Note: Only some clearinghouses currently support automatic download of reports:

Change Healthcare (formerly Emdeon and WebMD) supports medical automatic downloads only.

To troubleshoot e-claims, see Clearinghouse Error Messages.

 

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