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ClaimConnect E-Claims  

ClaimConnect is an E-Claims Clearinghouse.  To use ClaimConnect for electronic eligibility and benefits, see E-benefits.

Please use Open Dental version 13.2.15 or greater, or 13.1.52 or greater.  We have asked ClaimConnect to not troubleshoot any failed claims for earlier versions because the solution is nearly always to update Open Dental.

According to ClaimConnect, the advantages are:

  • HIPAA compliant X12 format.
  • Submits directly from Open Dental software via secure, HTTPS Internet protocol.  No third party program to download and install.
  • ClaimConnect offers direct connections to most major insurance companies meaning less “hops” in between you and the Payer and faster payments.
  • ClaimConnect is the only service that offers real-time claim processing for MetLife claims. You get an Estimate of Benefits back within moments of the claim submission.
  • Online claim management screens that allow you to view, track, edit and even resubmit claims with a few mouse clicks and keystrokes.
  • Other HIPAA compliant real-time services available include:
    • Eligibility and Plan Benefit information for selected Payers.
    • Claim Status Inquiry for selected Payers.
  • 30 Day Satisfaction Guarantee

Visit www.dentalxchange.com for more information about their other EDI services.

Contact DentalXChange at 800.576.6412 Ext 455 to learn more about their services and pricing.

Register with ClaimConnect

  1. Go to www.dentalxchange.com.
  2. Create a new account or edit your existing account.
  3. Select Open Dental as your Practice Management Software.
  4. Choose the services you are interested in.

Set up in Open Dental
In the Main Menu, click Setup, Family/Insurance, Clearinghouses, then double click on ClaimConnect. Set up as follows:

Note: If using e-statements or payments through DentalXChange and you updated your DentalXChange password, see below:
If using e-statements, see See E-Bills.
If using Payconnect, see Payconnect.

Also see Electronic Attachments.

Troubleshooting & Technical Details
DentalXChange sometimes uses payer ID 06126 as the default for insurance carriers that do not do e-claims.

The best troubleshooting approach to nearly any problem is to monitor the DentalXChange website.  It will show you which claims were successfully submitted, which ones have errors, and so on.  Use it regularly to stay on top of your claims.

Problem: When sending claims, receive 'authentication failed.authBadPwd' error.
Solution: This error is due to a bad password.

  1. Go to the DentalXChange website and verify that the user can login.
  2. Verify that the same password is entered for the clearinghouse in Open Dental.

Note: When claims are sent via Open Dental, DentalXChange passwords are case sensitive. However when logging in via the DentalXChange website, passwords are not case sensitive. Thus it is possible to login to the DentalXChange website successfully but still receive a password error while sending claims from Open Dental. For example, if the DentalXChange password is 'PASSword', you can login on the DentalXChange website using 'PASSword' or 'password' because it does not validate case. However, if 'password' is entered in Open Dental (instead of 'PASSword'), you will receive a password error when sending claims since DentalXChange will validate case. If you suspect a password case issue and are unable to correct it, try resetting the password then reentering it in Open Dental. Special characters (%, !, $, etc) are also not allowed in Open Dental.

Problem:  Soap Exception
Solution:  You may receive a "Soap Exception" from Claim Connect when attempting to send e-claims.  This is almost always because the Electronic ID entered for the carrier is wrong.  Go to the payer list on the DentalXchange website: http://www.dentalxchange.com/x/payerlist.jsp and look up the carrier to verify the Electronic ID shown in the Edit Insurance Plan window.  Fix the ID, and resend.  If the ID was correct, then you might need to enroll with the carrier for electronic submission.  Enrollment forms may be found here: http://www.dentalxchange.com/x/enrollmentpayers.jsp

Problem:  Claims Not Sending.  You send claims. There are no errors, but nothing gets sent. The claim files are still sitting in the out folder such as C:\ClaimConnect\Upload, or whatever your setting is in the window above.
Solution: The most likely explanation is that your Comm Bridge in the window above is set to None instead of ClaimConnect.

Problem:  Uploads Fail
Solution: After a failed upload, the next time that a user tries to send a claim, there is a warning, "A previous batch submission was found in an incomplete state." Resubmit the batch in question as well as the subsequent failed batch. Also, check the ClaimConnect website to make sure all claims went through.  This can be a particularly annoying problem because the user who gets the error message might click through it without reading it.  There will then be no further warning, and the office may not realize that the batch failed until they start following up on aging claims a few weeks later.  So, if you get a warning of some sort, start checking the DentalXChange website to verify that recent batches went through.

Problem:  The ERA-835 does not list in the Insurance Claims History grid.
Solution: In version 15.4 and earlier, to show in the grid, the ERA-835 must already be downloaded into the Report Path specified on the Edit Clearninghouse window. To manually download raw ERAs in x12 format. 
1. Login to your ClaimConnect account.
2. Go to Reports and select ERAs.
3. Click the download button next to a claim, then save the ERA to the Report Path. 

Problem:  Invalid authentication request.authNoGroupUserFound.
Solution:  This may be due to an interface change at ClaimConnect that requires an action on your part. You are required to either check package requirements or view must read messages and general announcements prior to logging in and sending claims. Please contact DentalXChange.

Problem: Error retrieving. Era request unsuccessful. Error message received directly from ClaimConnect: 150. Service Not Contracted.
Solution: This means you are not signed up for the ERA download service with ClaimConnect. You have two options:

  • To enable the service, contact ClaimConnect.
  • To stop the error message (and not enable the service), update to version 16.1.14 or greater.

 

Open Dental Software 1-503-363-5432