This topic answers frequently asked question about eClaims. Read these questions and answers before contacting eServices Support.
Q: When can I send claims?
A: Claims can be sent 24 hours a day, seven days a week. However, the high-peak transmission time is from 2:00 P.M. to 6:00 P.M. Mountain Time, Tuesday through Thursday. To avoid connection difficulties, you may want to schedule your claims submission for the early morning hours.
Note: Occasionally, enhancements and maintenance are performed on our computers and other systems that may cause you to be unable to send claims. You will be notified in advance when this will occur. Maintenance will be done during non-peak hours.
Q: How do I send a claim that requires X-rays or other documentation?
A: You can submit your attachments to the eServices department electronically along with the claim. The Dentrix Enterprise Help provides instructions on how to include an attachment with a claim.
Q: How many claims can/should I send at any given time?
A: You can submit up to 100 claims per batch. The eServices department suggests that you submit all of your claims for any given day in one large batch, either at the end of your work day or at the beginning of the following work day. Offices who submit one claim at a time frequently experience duplicate claim problems and confusion trying to match up reports. Submitting one large batch per day keeps your reports consolidated and easy to manage.
Q: How do I know if a claim was submitted successfully?
A: The status of each claim you send is listed on the Confirmation Report (part of the eTrans Transmission Report) that is delivered to the Batch Processor immediately following your transmission. If you do not receive this report, please contact eServices Customer Support at 800.734.5561, option 1.
Q: How do I resubmit a claim?
A: To resubmit a claim, you need to correct any erroneous information, delete and recreate the claim in the Ledger, and re-send it to the Batch Processor to go with your daily batch of electronic claims. The eServices department does not have the ability to resubmit claims for your office.
Q: How do I cancel or delete a claim once it has been transmitted?
A: Claims are processed in "real-time." That means as soon as your claim is received by the eServices department, processing begins. Therefore, we are unable to delete claims. Review your eClaims Pre-Submission Summary carefully before transmitting your claims to eliminate the possibility of sending claims you did not intend to send.
Q: Can I still submit a claim electronically if the insurance company is not found using the Payor Search Tool?
A: Yes. If a particular carrier does not accept claims electronically, use payor ID 06126 and the eServices department will print the claims to paper and mail it to them for you.
Q: Now that I send claims electronically, does that mean I don't have to follow up with insurance companies?
A: We recommend that you follow up with insurance companies after 30-45 days about outstanding claims that have been submitted but not settled. eTrans claim submission is a service that provides you with faster claim submission and tracking information. The insurance companies are still responsible for processing and paying your claims.
Q: Do I need to notify anyone if I have a new address, telephone number, or tax identification number?
A: Yes! It is extremely important that our records be as accurate as possible. So, it is important that you relay any changes made to your account to the eServices Enrollment department at 800.734.5561, option 4. Changes to your tax identification number must also be communicated directly to all insurance companies to whom you submit claims through eTrans. Changes made to your eTrans enrollment are not necessarily picked up by the insurance companies. Therefore, they must be notified directly. Any changes not properly communicated to the eServices Enrollment department and/or the insurance companies can result in claim delays and/or rejections.
Q: What does it mean when "Special Enrollment" is selected next to an insurance company found using the Payor Search Tool?
A: Those insurance companies require notification that you are going to be submitting claims to them electronically. Therefore, it is vital that you complete the proper paperwork before submitting claims to these companies.
Q: Am I charged for all claims transmitted? What claims am I charged for?
A: You are not charged for any claims that are marked as Rejected on the eClaims Pre-submission Summary Report, Confirmation Report, or Clearinghouse Report.
Q: How often do I receive billing statements?
A: Once a month, you will receive a billing statement as part of your eTrans Submission Report. This billing statement will list the method of payment you selected when you signed up for electronic claims (draft from checking or charge to credit card). If checking or charge are noted on your billing statement, you will be billed automatically on or around the 15th of the month.
Q: What if an insurance company says they never received my claim?
A: Verify the claim information (name, Social Security Number, date of birth, group ID, and so forth) with the insurance company. If the correct information was submitted and the claim was submitted through eTrans, contact eServices Customer Support at 800.734.5561, option 1.
Note: The eServices department is unable to research any claim that is older than six months from the submission date. Please run an Insurance Aging Report from Dentrix Enterprise on a regular basis to ensure that claims are not aging more than 45-60 days.
Q: Who do I call if I have questions or concerns?
A: Depending on the type of question you have, you can contact one of the Support teams listed below:
eServices Customer Support is available at 800.734.5561, option 1 to help you with installation and setup problems and software-related troubleshooting.
If you have questions regarding a charge to your account or any of the Henry Schein One eServices, contact the Billing department at 800.734.5561, option 3.
If you have claims which are rejected because the "provider is not registered for ECS or is invalid," or if you know you are going to need to request special enrollment with an insurance company, contact the eServices Enrollment department at 800.734.5561, option 4.
Henry Schein One hours of operation are Monday through Thursday from 6:00 A.M. to 6:00 P.M. Mountain Standard/Daylight Time, and Friday from 6:00 A.M. to 5:00 P.M. Mountain Standard/Daylight Time.
Q: What other services are available through the eServices department?
A: Henry Schein One constantly reviews, updates, and creates services that can assist your office. For more information, visit https://www.dentrixenterprise.com/products/addons/eclaims or contact the eServices Sales department at 800.734.5561, option 2.
Q: When running the eTrans installation, I get the message, "Setup could not detect an installed TCP/IP protocol. Your computer does not appear to be set up to connect to the Internet. Please make sure to get an Internet connection before trying to send claims."
A: When you tell the installation program that you want to send claims over the Internet, it tries to determine whether or not your computer can connect to the Internet. If it can't verify the connection, you get this warning. If you know that you have an Internet connection, you can safely ignore this message.
Q: Why is my dial-up networking or Internet connection suddenly unable to connect to the eTrans server to transmit my claims?
A: If you are trying to submit claims during a high-peak time (between 2:00 P.M. and 6:00 P.M. Mountain Time, Tuesdays through Thursdays) and receive an "unable to connect" message, you may be calling during an extremely busy time. Early morning is the best time to transmit easily and quickly.