Sending claims to insurance is a big part of the day-to-day operations of your practice. Chances are, the majority of your claims are being sent electronically through a clearinghouse. In this post, we’ll discuss some of the common errors you may encounter when trying to send e-claims, and how to resolve them.
Can’t Send Claims Until Missing Data is Fixed
This e-claim error can show up for many reasons. Thankfully, it’s one of the easiest ones to resolve because it specifically tells you what data is missing! Below we will highlight some of the more common missing data errors.
Procedure DXXXX must indicate prosthesis Initial or Replacement
You may be thinking, I did enter that information! I put it in the General tab of the Edit Claim Window under Crown, Bridge or Denture. And while you may have already done that, it’s actually required on a procedure level as well. Simply double-click on the procedure from the Account Module (you can do this from the Chart Module too, but you’re already likely in the Account Module).
In the Prosthesis Replacement section, select Initial or Replacement. If it’s a Replacement, you’ll also need to enter the Original Date. It’s okay if it’s just an estimate, there’s a checkbox for that!
Create a new insurance plan instead of using the optional patient ID
In 2012, most carriers switched to each patient being their own subscriber with a subscriber ID. If you plan to send e-claims in 5010 format, you may need to drop patients from their family’s plan and recreate them with the subscriber as self, using the patient ID instead of the subscriber ID.
Wondering where the Optional Patient ID is? Navigate to the Family Module and double-click into the Insurance plan.
You’ll find the Optional Patient ID in the top green bar, specific to the patient you’re on. You can use the Drop button in the same section to Drop the insurance currently listed under a different subscriber, and then follow the normal process of adding insurance to the patient, this time selecting them as the subscriber.
We often see this error message when the Subscriber is a NonPatient, so not all pertinent information is collected when adding them to the system. Navigate to the Subscriber in the Family Module, and double click into the Patient Information ribbon on the left to pull up the Edit Patient Information Window. Add their date of birth, and try resending the claim.
One of the most common Clearinghouses we see offices use is ClaimConnect, through DentalXChange. Here are some of the common errors you may encounter when sending e-claims through this clearinghouse.
Authentication Failure. Please verify your login ID and password by visiting Setup | Family/Insurance | Clearinghouses | Claim Connect.
This is another one of those errors that gives us instructions on how to fix the error, right in the error message. Typically, you’ll see this happen after your DentalXChange password has been changed (and they frequent password changes). A quick browse to Setup > Family/Insurance > Clearinghouses, and double-clicking into ClaimConnect, you’ll find your current credentials saved near the bottom. Simply update the login and password to the new information, click ok and try to send your claim again to verify it worked.
TECH TIP: Type your password into Word or Notepad, then copy and paste it into the Clearinghouse Setup to make sure it’s typed correctly.
C:\ClaimConnect\Upload: Not Found
If you’ve never sent claims from this specific workstation, this is a common error that will need to be resolved before claims can be sent.
The easiest way to fix this is to navigate to Setup > Family/Insurance > Clearinghouses and double-click into ClaimConnect. If there is no Upload path listed, hitting OK will prompt the system to create one. Click yes on the popup asking if you’d like to attempt to create it. If created successfully, you can start sending claims on this workstation. Alternatively, you can manually path to the C:\ClaimConnect\ folder and create a subfolder called Upload.
Renaissance/Remote Lite Errors
File path “C:\Program Files (x86)\Renaissance\lite\RemoteLite.exe” does not exist.
This typically occurs when there are extra quotation marks in the Launch Client Program path. Navigate to Setup > Family/Insurance > Clearinghouses and double-click on Renaissance. In the Launch Client Program path, simply remove the ” around the path and hit OK to save your change.
Alternatively, verify that Renaissance is installed on every workstation that will be used to send claims.
If you have any questions or need help troubleshooting e-claims, please feel free to Contact Us and one of our technicians will be happy to pick up where you left off!