Paper Claims
Claims with obvious omissions, such as signatures or dates of birth, are returned prior to processing along with a covering letter.
During processing, claims may be rejected for a variety of reasons. These reasons relate to the rules built into our payment system, which reflect the regulations for the delivery of general dental services. In such cases, you will receive a letter outlining the information from the claim form and the reason the claim has failed. View an explanation of the rejection messages.
Any amendment must be signed and dated, prior to returning it to us for re-processing.
Electronic Data Interchange (EDI) Claims
EDI files may fail for a number of reasons, such as invalid characters within the file. If you receive an error message, please contact our Helpdesk with your location (practice) number and file number.
Claims may also be rejected within our payment system. An electronic message, containing details of the error, will be sent back to you. You will be able to amend the claim and resubmit. View an explanation of the rejection messages.
If you require further assistance, contact our Helpdesk, quoting the claim case-id number. They will search our payment system to find out why the claim was rejected. The claim case-id number can be found on your payment schedule.