FAQs for AttachmentConnect
Updated
by Lindsey Schurman
What is AttachmentConnect?
AttachmentConnect allows providers using ClaimConnect to create attachments within ClaimConnect. Images may be acquired by a screen capture, file upload, or archive of previously sent images.
Is there a Payer List?
Yes, the list of attachment payers for DentalXChange Attachment Services is displayed on the Payer List upon log in.
My claim didn’t stop for an attachment but I received a letter in the mail asking for an attachment – why is that?
DentalXChange validations are given to us by the payers based on their claim submission guidelines. Many payers will periodically request additional attachments based on other criteria. Offices may create a solicited attachment to respond to these requests for additional information or customize the attachment rules and determine which codes will stop for attachments.
What is the criteria for defining a patient for the Archive feature?
The criteria of the patient archive is Patient First Name, Patient Last Name, and Date of Birth within your account.
What is a Solicited Attachment?
A solicited attachment is an attachment requested from the payer during the claims review process.
What are Claims Submission Guidelines?
Claims Submission Guidelines are the sets of rules that tell a provider when a payer will require an attachment. Most commercial plans refer to these sets of rules as Claim Submission Guidelines because there may be exceptions to the guidelines where attachments may or may not be needed. DentalXChange calls a payer's Claim Submission Guidelines our "Validation Rules".
What is an Unsolicited Attachment?
An unsolicited attachment is an attachment sent to the payer before the claim is in the payer's claim review process. In this case, even if the payer has claim submission guidelines or DentalXChange has claim validation rules that indicate an attachment is required. If the attachment is sent at the same times as the claim, the attachment is considered "unsolicited".
Can more than one payer be added at a time in the rules section?
Yes, you can add multiple payers, providers, and codes – even to multiple locations! DentalXChange has adaptable rules that can be configured by the user.
Are you able to see who created an attachment validation rule?
You may see who created a rule by selecting the ‘clock’ icon in the Action section of the Manage Attachment Rules. If the rule has only “Created on” data and not “Created by” data, that means the rule was created or updated by the insurance company on that date.
How can I see what attachment validation rules applied to my claim?
Selecting the View Attachment Rules button will show the validation rules for the procedures on your specific claim. If you wish to see all the rules for the specific payer, you may then select View All Rules. If you wish to see rules for any other payer, or you wish to modify any validation rule for any payer, you may select the Manage Rules button. DentalXChange obtains the validation rules from the payers, but allows providers to modify the rules at will.
What is an attachment ID?
An attachment ID is a reference number that refers to the collection of images and narrative data to support a claim. A claim can have only one unsolicited attachment, but that attachment may contain more than one image and/or a narrative.
Once a claim bypasses the attachment requirements, can I still add an attachment to the claim?
If you are sending claims and there are no validation errors or attachment rules that apply, the claim is delivered to the payer without the ability to make changes. If there were any validation errors, or you are doing a Direct Data Entry claim, you will have the opportunity to add an attachment even if the validation rules do not indicate an attachment is needed.
Why do claims require attachments in the first place?
Not all claims require attachments. Insurance companies have established rules to keep practices from committing Fraud, Waste, and Abuse. If the procedure is medically necessary as in the case where a patient goes to have a root canal done by an endodontist, the payer will not require attachments. Should this procedure be completed by a general dentist, rather than specialists, the payer may want to ensure the procedure was medically necessary.
What is the difference between "Upload an Image" and "Capture an Image"?
Both functions allow you to add an image to an attachment. Capture an Image is a screencapture function where you bring the image on the screen and selects an area of the image to capture. Upload an Image is a file upload feature where the user selects a file to add to the attachment.
What happens if DentalXChange is not electronically connected to the payer or health plan I need to submit to?
DentalXChange delivers most attachments electronically. If DentalXChange does not have an electronic connection with a payer, the claim and attachment(s) will be delivered by paper. As additional payers become electronically integrated, your claims and attachments will change to electronic submission.
