Commercial Coordination of Benefits 837D Electronic Claims Transactions

Date Issued: 11/17/2016

We are pleased to announce that EmblemHealth is accepting electronically submitted dental claims for payment as a secondary insurance carrier. This applies to services rendered by health care professionals, including the 837D for dental practitioners in which payment responsibility is apportioned between the primary insurance carrier and a second carrier.

Our ability to accept Coordination of Benefit (COB) claims electronically improves the overall processing of claims payments. Electronic COB claims will:

  • Allow for prompt review and payment
  • Ensure fewer claims are denied for missing COB information
  • Reduce human error
  • Be available to HMO and PPO providers at all levels of technological readiness

EmblemHealth recognizes the importance to your practice of accurate claims payment and works diligently to upgrade our claims processing procedures. Accepting electronic COB submissions is another means to improve the efficacy of our claims adjudication. Correct submission of electronic claims to EmblemHealth will also ensure we can process your claims more quickly and accurately. Commercial COB electronic claims that do not meet the requirements or are submitted without the necessary information about the other payer may be rejected for missing, incomplete or invalid information.

Submitting Electronic Claims
For those dental professionals still submitting paper claims to EmblemHealth, this is a great opportunity to reduce costs and speed up claims processing for your office. We recommend you investigate electronic claims submissions. EmblemHealth has information available to assist in the transition from paper to electronic claims. If you are interested, we suggest you review the Claims Corner article EDI Transactions, What to Know to Make Them Work For You.

And finally, EmblemHealth engaged PNC Remittance Advantage to provide electronic funds transfers and electronic remittance advices to further streamline your billing and accounts receivables procedures.