Completing your Electronic Claim

Use the comments/remarks field to indicate student status, amount paid by prime carrier, dual coverage information, and narratives for by-report procedures.

Claims for procedures that require the routine submission of charting ONLY (D4210, D4211, D4220, D4240, D4270, D4271, and D4272), can also be submitted electronically using the comments field for pocket measurements.

Northeast Delta Dental can accept up to 240 characters in the comments field. Please note that not all software vendors and clearinghouses have the same capabilities. MedE America and Electronic Insurance Services (EIS) can accept and transmit all 240 characters. However, SoftRix and ENVOY-NEIC can only transmit 103 characters.

Dual coverage claims can be sent electronically. Submit to primary and secondary carriers, and record information about both coverages in one transmission. Include the prime payment amount in the prime paid or comments field.

Claim status reports that appear to have incomplete information may need to be printed with a horizontal orientation. You can ask your software vendor for assistance.

When submitting an electronic claim to Northeast Delta Dental, use the following ID numbers:

Payer ID Number: 02027 Carrier Type: 13

When submitting a procedure with a miscellaneous code (ending in 999), you must include an explanation in the comments/remarks field.

All requests for reconsideration must be sent by mail.