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Five Considerations for Choosing the Ideal Dental Clearinghouse Partner


How are you managing the claims process? A dental clearinghouse ensures that claims are submitted electronically from your Open Dental practice management software to the correct payer. The ideal clearinghouse provides comprehensive products and secure and seamless data exchange. Here are a few things to consider when choosing a clearinghouse for your practice.

1 – Minimize risk by working with companies with deep industry and regulatory expertise.

Is the clearinghouse HIPAA Compliant?

Make sure that the clearinghouse you choose is HIPAA certified and fully understands HIPAA compliance. Clearinghouses provide remote access via a secure VPN to your dental practice computer or server. The VPN makes the connection HIPAA compliant. Once a connection is established, the clearinghouse works with your Open Dental software to process claims.

Is the clearinghouse HITRUST CSF Certified?

Consider a clearinghouse that has earned HITRUST certified status for information security. Certification means a company has passed a comprehensive security evaluation. In addition, the company has met all industry requirements and regulations and has correctly managed risk while maintaining high standards to prevent data loss.

2 – Reduce manual processes by choosing a clearinghouse with an extensive portfolio of solutions.

A robust portfolio of solutions should correlate to practice workflow and reflects a deep understanding of the challenges faced. An ideal clearinghouse should significantly reduce or eliminate manual processes by offering innovative solutions designed to lower costs and boost efficiency across the lifecycle of the claim. Starting from the moment a patient schedules an appointment until the last payment is received, your clearinghouse should make managing dental claims as smooth, seamless, and simple as possible.

3 – Realize a unified experience with integrated clearinghouse solutions.

In addition to an extensive portfolio, solution integration within Open Dental is a key attribute to consider when evaluating a potential clearinghouse partner. It creates a unified experience within the system your team already knows. The more integrated solutions offered, the more streamlined the payment process becomes.

For example, depending on the procedure, some claims may require attached documents such as intraoral photos, x-rays, or perio charting to establish the procedure’s necessity. An integrated attachment solution makes is easy to attach required documentation as the claim is created within Open Dental and increases the percentage of clean claim submissions. A good solution includes this functionality. A great solution includes alerts for missing attachments before the claim is submitted.

4 – Scale and streamline workflows by accessing a vast network.

Does the clearinghouse have connectivity with all the dental payers utilized by your practice? Inclusive connectivity enables ease of claim submission reducing time and enabling providers to get paid faster. Deep connectivity instantly answers eligibility and benefit plan questions and allows claims processing to be done in real time.

5 – Get answers fast and support when needed.

The ideal partner provides thorough staff training and highly-trained and responsive customer support answering calls in a timely manner. A knowledgeable customer support team is essential to building trust and reliability. Working with a clearinghouse can help you streamline your day-to-day processes and boost your cash flow.

When searching for a clearinghouse, ask for referrals from current customers or ask your fellow dental professionals about the clearinghouse they use. The Open Dental User Facebook Group is an active community of clients that can offer advice based on their experience.

The ideal clearinghouse partner should bring peace of mind in knowing that all data exchanged is secured to the highest level and that dental payments are processed simply and efficiently from start to finish.

As a leader in the industry for more than 30 years, DentalXChange brings innovation and expertise to the dental payment market. DentalXChange services and supporting infrastructure are HIPAA compliant and HITRUST certified. DentalXChange has partnered with Open Dental since 2013 to create a portfolio of fully integrated solutions, including:

  • Insurance Verification
  • Claims Processing
  • Attachments
  • Electronic Remittance Advice
  • Merchant Services including online payments
  • Electronic Patient Statements

To learn more about how DentalXChange supports more than 7,000 Open Dental clients, visit DentalXChange or call 800.576.6412 Ext 455.

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