E-Claims 

In dentistry, most electronic claims are sent to a clearinghouse before being sent to the insurance company. 

ClaimConnect
Claim Connect should be used if you want to use Electronic Attachments, Electronic Eligibility and Benefits, or Electronic Bills. 

Tesia
Tesia.

Emdeon
Emdeon Former names include WebMD and Envoy

Others
Clearing houses differ greatly in size, infrastructure, and business model.  Some are small and tend to serve a local geographic area or focus on customer service.  Some are actively pursuing more direct connections with payers.  Some clearinghouses are more accurately described as aggregators, having a direct connection to only a few payers and sending the bulk of their claims to another clearinghouse.  We list some clearinghouses and aggregators below that are known to work well with Open Dental.

Apex
ClaimX
Renaissance (not X12 format)
RECS
Inmediata
AOS
PostNTrack
Lindsay Technical Consultants
Mercury Dental Exchange (not yet)

New 5010 Format
Starting 1/1/2012, clearinghouses started accepting the new 5010 format. Most clearinghouses will continue to accept the old 4010 format indefinitely, but carriers will increasingly insist on the 5010 format in order to have more complete information.  If you want to be an early adopter, you should:
1. Use version 11.1.16 or later (Inmediata users, use version 11.1.30 or later).
2. Edit your Clearinghouse to use the 5010 format.
3. Monitor your reports for dropped claims or other problems.

See E-claims Complexities at the very bottom for information about rejections due to Billing Provider PO Box.

Direct Connections to Payers
Most payers do not want to have to maintain direct connections with thousands of dental offices. They prefer to use clearinghouses instead. But some very big payers, like Medicaid, do offer direction connections. To use Open Dental for direct submission, there would be some work involved in contacting the payer, getting their implementation guide, setting up a partnership agreement, testing, and finally uploading claims. We do not provide implementation details, leaving that up to the individual offices. But it can still be useful for very large volume offices. The X-12 files will typically need to be manually uploaded to the carrier because there is no standard for transport.

BCBS Nebraska: Instructions for Open Dental setup: Providers must have supplemental provider ID added for BlueShield and Electronic ID 00760. Use the provider ID that they assigned you. Setup a clearinghouse with a Clearinghouse ID of NEBLUECONNECT. No CommBridge. Add payor 00760 to this 'clearinghouse', and uncheck the default box. Create a folder to accept your claims as they get created by Open Dental. Upload your claims to BCBS using their website. See http://www.bcbsneprovider.com/NEBLUEconnect/contacts.asp for contact information.

The carriers below are also known to accept X-12 claims. But we have not had time to do any testing with them yet. Remember that we have no timeline for this functionality and it might never even happen.

DentiCal (in progress)

BCBS of Georgia

ACS - Handles claims for Medicaid of Georgia and a few other states. Testing phase seems to be long.

Medicaid of NJ - Could take a few months since they require certification

Medicaid of TX

E-Claims Complexities
For more technical information about the information that goes out on e-claims, see E-claims Complexities.