Filing claims

Tips for reducing claims processing time

  • Submit claims electronically. Delta Dental of OregonAlaska processes electronic claims first each day. See below for a list of electronic claims processing providers.
  • If submitting paper claims, please use the standard ADA form, either typed or legibly printed.
  • Verify the patient's relationship to the subscriber, and make sure plan information is correct before submitting claims.
  • Include all pertinent information: subscriber ID or recipient ID (if OHP), patient name and date of birth, tooth number(s) or quadrant and current ADA codes. Your office can call the ADA at 800-947-4746 to order the most current CDT codebook.
  • Please do not send X-rays unless requested by Delta Dental. In some instances, clinical information may assist in determining benefits.
  • If a patient is covered by more than one Delta Dental program, submit one claim form indicating the name of the subscriber, subscriber ID number, employer (if applicable) and the Delta Dental group number for both plans. If the patient is covered by another carrier, please indicate the above information plus the name, address and policy number of the other carrier. If a patient has primary insurance through a carrier other than Delta Dental, the EOB of primary payment amount from the other insurance company will need to accompany the claim for consideration of payment.
  • Be aware that Delta Dental makes payments weekly.
  • Please contact us before submitting duplicate claims:
    • Check Dental Benefit Tracker to see the status of a claim. If you haven't registered for this free online service, you can register online.
    • If you receive a PDR indicating that your claim has already been processed before you receive a check, this indicates that your rebill was unnecessary — the claim was processed and is pending for the next scheduled payment date.
    • Rebilling without contacting us slows our turnaround time and delays payment.
  • Use miscellaneous codes appropriately with clinical information.
  • Code "R6, 9A6, 9A8" on the Payment Disbursement Register are for charges exceeding the amount allowed. This is a provider discount and should not be billed to the patient.
  • DO NOT USE HIGHLIGHTER ON PAPER CLAIMS.

Electronic claims filing

Delta Dental is committed to receiving claims electronically. Advantages for your office include greatly enhanced service and dramatically lower administrative costs.

Below is a list of dental electronic claims providers for Delta Dental. Please contact one of these providers to set up an account to make your claims-filing easier.

Clearinghouses

  • Emdeon (formerly WebMD)
    220 Burnham St.
    South Windsor, CT 06074
    888-255-7293
    Payor ID = CDOR1
  • APEXEDI Inc.
    174 S 1000 East
    American Folk, UT 84003
    801-642-0285
    Payor ID = CDOR1
  • EDI Health Group Inc. – DentalXchange (EHG)
    17701 Cowan St., Suite 250
    Irvine, CA 92614
    949-852-0825
  • TESIA Clearinghouse, LLC
    1540 W. Edgewood Ave.
    Indianapolis, IN 46217
    800-724-7240

Practice management systems that submit directly to Delta Dental

  • Dentists Management Corporation
    10505 SE 17th Ave.
    Milwaukie, OR 97222
    503-243-3966
  • Quality Systems Inc.
    18111 Von Karman #600
    Irvine, CA 92612
    949-255-2600

Direct connection to Delta Dental

Delta Dental also supports direct connections between offices and Delta Dental if the dentist prefers this method. Transaction standard is the 837 Dental Claim required by HIPAA Administrative Simplification.

Delta Dental EDI transactions contacts

Email

Support for claims from other Delta Dental providers

For help with claims from other Delta Dental providers, please contact that provider directly.

We're sorry, we don't currently offer dental plans in Washington. View our plans in Washington or use the dropdown at the top of the page to view dental plans in Oregon or Alaska.

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