Completing special enrollment forms for claims

Some insurance carriers, such as Blue Cross/Blue Shield and Medicaid, require a special enrollment form to be completed for processing electronic claims through Change Healthcare, the clearinghouse that is used by Dentrix Ascend. These payers will not accept or pay for electronic claims until the applicable form has been completed and processed. Henry Schein One provides a search tool to help you determine if a payer requires a special enrollment form and provides a link to the applicable form.

To complete a special enrollment form

1. Open the Dentrix Ascend Payor Search Tool page (www.dentrixascend.com/products/eservices/eclaims/payer-search).

   

2. In the Payer ID or Payer Name box, enter all or part of a payer ID or name, and then click Search Payers.

   The matching payers appear in the list.

3. If a payer requires a special enrollment form, a green check mark icon appears in the Special Enrollment column. To download the form, click that icon.

4. Open the form. Refer to the instructions that are included with the form to complete and submit the form.