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Denti-Cal 

Open Dental includes a paper Denti-Cal Claim Form.

The Denti-Cal website is
http://www.denti-cal.ca.gov/WSI/Prov.jsp?fname=EDI

Most Denti-Cal users submit claims to a clearinghouse, which then submits to Denti-Cal.  Open Dental users have been able to submit claims to Denti-Cal in this manner for many years.  But because there is a fee per claim when using a clearinghouse, larger offices have always wanted to submit directly to Denti-Cal.  As explained on the E-Claims page, our X-12 format is already the same format that is accepted by Denti-Cal, but Denti-Cal also requires a testing process before direct e-claims will be allowed.  The following still needs to be done:

1. We need to finish the testing process with Denti-Cal. On 1/17/2012, they responded to our submitted test file, indicating half a dozen changes that we needed to make.  We are working hard on making those changes, and then we will submit another test file.  So we're making good progress.

2. The dental office will need to be on Version 12.0 or later of Open Dental.

3. Each dental office that wishes to submit directly to Denti-Cal will also need to go through their own testing process with Denti-Cal.  We will provide instructions and guidelines here for that testing process, including how to set up the Clearinghouse

Instructions

If a Service Office Number must be sent in order to supplement an NPI, then enter that number at the bottom of the Provider Edit window, with a type of SiteNumber.  That number will be sent in loop 2010BB with a qualifier of LU.


 

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