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Renaissance E-Claims

Renaissance is an E-claim Clearinghouse solution that uses Remote Lite software. It is offered by Renaissance Electronic Systems and Services. You can visit their website, but their explanation does not apply very well to Open Dental since we have a direct connection with them instead of using print capture. Website: www.rss-llc.com. To begin using Renaissance, call them at 1-866-712-9584 to set up an account.

Note: Renaissance uses its own unique format for claims (not X-12). We do not recommend using a a format that is not X-12 format. No validation is done on claims and not as much information can be sent. For example, Renaissance's unique format only allows sending information that can be printed on a claim form. X-12 format allows for 15 different places of service, but Renaissance only allows 4 particular places of service, which are Provider's Office, Hospital, ECF, and Other. Some insurance companies reject claims if the place of service is not properly set for specific procedure codes. Some offices choose to use Renaissance anyway. Please bear in mind that our support for Renaissance issues is minimal. To send in X-12 format, use TesiaBridge, also offered by Renaissance.

In the Main Menu, click Setup, Family/Insurance, Clearinghouses, double click on Renaissance, then set up as follows:

If using Renaissance Version 5 the Claim Export Path should be changed to C:\Users\Public\RES\DOTR\upload. 

Then, download and install the Remote Lite software: https://www.rss-llc.com/downloads.html. Click Open when given a choice. After installation, you should see the following window

It doesn't matter which option you select here since Open Dental does not use print capture templates to interface with Renaissance. Click OK to close this window. This is your main Remote Lite window

One thing to be aware of with this window is that if another window is covering it up, you will not be able to see an icon in your Windows task bar at the bottom of your screen like you would expect. Instead, to open the window back up, double click on the small icon in the system tray at the lower right of your screen. For the same reason, you may also frequently see this message:

Whenever you see this message, just click OK, then double click on the icon in the system tray.

Before you can send claims, you must go to the menu under File | Office Setup:

To actually send claims, see Managing Insurance Claims. When you click send claim to Renaissance from that window, the Remote Lite program will come up with a list of claims that have been created. Then, just click the Send Claims Button at the bottom of the Remote Lite window. On the other hand, if you see a claim that you don't actually want to send, you can highlight it and click the red X delete button. Then you would go back to the Open Dental send claims window and change the status of that claim back to Waiting so that it won't be marked as sent.

If you have more than 8 procedures on a claim, the claim will be rejected.  Make sure to send two separate claims in that case, with some procedures on each claim.

IMPORTANT !! Every single time you send claims, follow up by going to the report section using the fourth button at the bottom. You should see a report for the previous day's claims. Print and then delete this report. You MUST verify that all the claims were accepted by the insurance companies. This is the major advantage of using e-claims. The report does not just show that Renaissance accepted your claim, but it shows that the insurance company accepted your claim. So you know within 24 hours whether your claim was accepted or not, rather than waiting 1 or 2 months. Then, you MUST follow up on any claims that were not accepted by fixing and resending them.

 

Open Dental Software 1-503-363-5432