For the workflow processes and attention of your office staff, we would like to share the reminder that a new claim is required when new documentation is submitted as a result of a denial or request for additional clinical documentation. As we work together for efficiency, awareness of this process is appreciated.
Peer-to-peer program
For the situation of a denied claim, Delta Dental of South Carolina (DDSC) offers the peer-to-peer program as an opportunity for a professional exchange of information. With this program, dentists can converse with a dental consultant to understand why a claim was denied. The purpose and objective of a peer-to-peer call is to review a disputed claim or predetermination decision and to obtain any additional pertinent clinical information that may not have been available at the time the initial review was conducted. This is an opportunity for the dentist to provide additional information that may not have been submitted with the claim or may not have been apparent from the image or the narrative. Peer-to-peer call requests may be submitted through your professional relations representative, customer service representative, electronically or USPS.
EFT/ERA payment process
Also for efficiency, and to streamline the payment process, enroll for Electronic Funds Transfer (EFT) and Electronic Remittance Advice (ERA). The digital process can reduce costs and save time by streamlining manual processes and speeding up revenue cycles. For new EFT/ERA enrollment, go to https://enroll.ach835.com/new. If you already enjoy receiving virtual credit card (VCC) as your payment method from other carriers, that option will be available soon through DDSC. We look forward to providing this option for you and your practice.
