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Claims Processing Updates

Page last updated: 8/7/2025

We know insurance payments are vital to your business and want to make sure you have the cash flow you need. We'll update this page regularly as we have more information about claims, eligibilities, and ERAs.

Latest Updates

July 2025 Payor Connection Updates

We are happy to announce the following payor connections that Henry Schein One was able to obtain during the month of July 2025:

Claims
  • AultCare Health Plan (Payor ID DX052)
  • AultCare HMO (Payor ID DX052)
  • Aultra Administrative Services (Payor ID DX231)
  • Capital Health Life Pace (Payor ID 95112)
  • Central Health (Payor ID DCMAO)
  • Daniel H Cook Associates, LLC (Payor ID CHCDN)
  • DeltaCare Flagship (Payor ID DDNJF)
  • Edenbridge Pace (Payor ID R3491) 
  • ElderONE C/O Halos Systems LLC (Payor ID HALOS)
  • Hope PACE FL (Payor ID R3499)
  • Inspira LIFE Vineland (Payor ID R3482)
  • Kansas City Life C Insurance Company (Payor ID CX058)
  • McKinley Life Insurance Co. (AultCare Co.) (Payor ID DX052)
  • Mount Sinai Eldercare (Payor ID R3492)
  • My Place Health (Payor ID MPH01)
  • Pace Your Life (Payor ID 98472)
  • Point Comfort Correctional Care (Payor ID PCG05)
  • Seen Health (Payor ID NMM01)
  • St. Paul's PACE (Payor ID SPPCA)
Attachments
  • Daniel H Cook Associates, Inc (Payor ID CHCDN)
  • Kansas City Life Insurance Company (Payor ID CX058)
ERA
  • AultCare Health Plan (Payor ID DX052)
  • AultCare HMO (Payor ID (DX052)
  • Aultra Administrative Services (Payor Id DX231)
  • Central Health (Payor ID DCMAP)
  • Delta Dental of Alaska (Payor ID DDAK1)
  • Delta Dental of Oregon (Payor ID CDOR1)
  • McKinley Life Insurance Co (AultCare Co.) (Payor ID DX052)
Eligibility Pro
  • Blue Cross Blue Shield Iowa-Wellmark (Payor ID CBIA2)
  • Delta Dental of Oklahoma (Payor ID DDPOK)
Additional Info
  • Central States / TEAMCARE has changed their Payor ID from 75177 to Payor ID 36215

For a full view of our Payor Connectivity, please visit our Payor Search Tool:

 

Important Notice from Metlife (Payor ID: 65978)

On August 1, 2025, MetLife will implement targeted improvements to streamline claim adjudication and reduce turnaround times for payments.  

Validating quadrant and arch information is now required for the following procedure codes:  

Quadrant Validation Required for Procedures: 1510, 1520, 1553, 1556, 1575, 4210, 4211, 7320, 7485, 4230, 4231, 4240, 4260, 4261, 4274, 4342, 7321, 9613, 5384, 8286, 6190. 7297, 7310, 7311, and  7473 

Arch Validation Required for Procedures: 5875, 5876, 6985, 7472, 7939, 9938, 9939, 9954, 9972, 9975. 

To be prepared for this change and reduce claim rejections, you should add point codes to your system.

 

Important News for First Dental Health (Payor ID: FDH01)

  • Effective June 3, 2025, First Dental Health no longer receives claims.
  • Please contact the plan administrator listed on your patient's ID card for updated submittal information, or contact the patient on record to received their updated insurance information, as these claims will no longer be covered by First Dental Health.
  • Claims that are delivered to Henry Schein One for Payor ID FDH01 will be rejected with the response of "Payer not supported."

 

Important News for Lincoln Financial Group (Payor ID: CX061 and 52133) and ProviDRs Care Network PPO Plan (Payor ID: 48100)

  • On 6/3/2025, ProviDRs Care Network PPO Plan split from Lincoln Financial. This plan will now be processed with Payor ID: 48100. Please check your patients' ID card to validate the plan.
  • While processing for this plan and those with Lincoln Financial Group, please select the correct Payor ID below:
    • ProviDRs Care Network Group (Payor ID: 48100), Address: PO Box 815 Arnold, MD 21012
    • Lincoln Financial Group | NE (Payor ID: CX061), Address: PO Box 3464, Omaha, NE 68103
    • Lincoln Financial Group | UT (Payor ID: 52133), Address: PO Box 30779, Salt Lake City, UT 84130

 

Important News for PacificSource (Payor ID: 93029) Taxonomy Rejection

Between April 10 and May 4, 2025  we are seeing a high volume of claim rejections from PacificSource Health Plans (Payer ID: 93029), with rejections stating "THE BILLING PROVIDER TAXONOMY CODE IS REQUIRED WHEN THE RENDERING PROVIDER IS ALSO THE BILLING PROVIDER".

Important News for Medicaid of Massachusetts and Health Safety Net (HSN): Payor ID CKMA1

Update 5/6/2025: Claim attachments for Medicaid of Massachusetts and Health Safety Net (HSN): Payor ID CKMA1 has been reactivated. Claims with attachments to this payor will be printed and mailed to the processor Benecare for processing.

Important News for Delta Dental of Arkansas Individual Plan Providers

Delta Dental of Arkansas -  Individual (under Payor ID: ARIND) is currently undergoing a TPA migration. This process began on 04/02 and their new TPA will be ready to intake claims for this plan on 04/15 under their new Payor ID: WDENC.

  • To minimize provider impact, the Henry Schein One clearinghouse partner is now holding these claims as of 04/10. If you have submitted claims between 04/02-04/10, we will be resubmitting these to the new TPA on 04/15 for processing. Any attachments that have been sent during this time will also be made available to the new TPA.
  • Starting April 15, 2025, please submit your claims under Payor ID: WDENC.
  • If you were previously approved for WDENC ERAs, these should continue without interruption. If you were previously enrolled for Delta Dental of Michigan ERAs but are not enrolled for WDENC ERAs, please complete the enrollment process to continue receiving ERAs for Delta Dental of Arkansas – Individual. 

 

"The Payor Does Not Support Attachments” Rejection Message 

If you receive attachment rejections with a message stating, "The Payor Does Not Support Attachments", make sure to check the Payer ID you are using for the claim and compare it to the Henry Schein One Payer List: 

Payor IDs do change periodically, and several were updated as a result of the Change Healthcare Cyber Incident with the legacy Payor ID being deactivated on the Henry Schein One end.

When a Payor ID not supported by Henry Schein One is received (either an ID that has never been supported or has been deactivated by Henry Schein One), an attempt is made to 'map' the submitted Payor ID to the Supported Payor ID.

If this is unsuccessful, the Payor ID will be changed from the Submitted Payor ID to our "generic" Payor ID 06126. Payor ID 06126 does not support attachments and as a result, attachments on any claim associated with Payor ID 06126 will be rejected. 

 

Important Updates

As of 1/1/2025, GEHA (Commercial) Payer ID 44054 and GEHA (FEP) Payer ID 57254 have moved to UMR Payer ID 39026 for processing.

 

Claim and Attachments Processing to Horizon

When processing claims to Horizon, be sure you are verifying your patient insurance card and selecting the correct payer ID for delivery.

  • Payer ID 22099
    • DeCare - Horizon Blue Cross Blue Shield (Commercial)
    • Horizon BCBSNJ
    • Horizon Commercial
    • Horizon (Subscriber ID with prefix YHV, YKI, & YHZ)
  • Payer ID HNJ01 (PO Box 299 Milwaukee WI 53201)
    • Scion – Horizon NJ Health
    • Horizon NJ Health (Scion)
  • Payer ID HZFEP
    • Horizon FEP (Subscriber ID with prefix R)

Claims and Attachments Processing to United Concordia

Be sure you are verifying your patient insurance card and selecting the correct payer ID for delivery.

  • Payer ID 89070
    • United Concordia Companies, Inc.
    • Blue Cross Blue Shield of Delaware (UCCI)
    • Sun Life Financial (United Concordia) DOS Prior to 1/1/2018
    • Minnesota Blue Cross Dental (UCCI)
    • TRICARE Dental Program (TDP)
    • Blue Cross Blue Shield of North Dakota (UCCI)
    • Blue Cross Blue Shield of North Dakota FEP (UCCI)
    • DE (Delaware) Adult Medicaid
    • Highmark West Virginia (UCCI)
    • Blue Cross Blue Shield of Western New York
    • Blue Shield of Northeastern New York (UCCI)
    • HealthNow Federal (UCCI)
    • Tricare Active Duty Dental Program (UCCI)
  • Payer ID TLY26: Blue Advantage
  • Payer ID UCCAP: Blue Cross Blue Shield of Louisiana Advantage Plus Network
  • Payer ID UCCDP: United Concordia – Dental Plus – PA Blue Shield
  • Payer ID UCCEN: United Concordia (Encounters)
  • Payer ID UCCTR: United Concordia – Tricare Dental Plan

Resources

Frequently Asked Questions

Claims Processing

I'm receiving claim statuses I've never seen before. What do they mean?

Henry Schein One is currently processing claims with DentalXChange, and you may be seeing some new or unfamiliar claim statuses. Use our updated Tips for Resolving Claim Statuses and Avoiding Claim Rejections document to get info about the most common claim statuses you'll see, what they mean, and what action you can take to resolve them and get tips about things you can do to avoid claim rejections in the future.

Is there anything I can do to help avoid claim rejections?

Yes! We want to help you get paid as fast as possible, so we've developed a few claim tips you can use to help avoid rejections. Follow our tips for avoiding claim rejections to help your claims get to the payors faster.

Clearinghouse Information

How is a clearinghouse involved in the claims process? What does that process look like?

We've created an infographic to illustrate the journey of a claim and explain important points along the way. View the infographic to get a better understanding of the claim process.

What clearinghouse is Henry Schein One using to process my claims?

We'll continue to process claims in the way that's best for our customers. We're always monitoring the landscape, and we have options for claims partners. We're currently processing claims and ERAs with DentalXChange. We'll monitor the situation and make adjustments to our process as necessary to best serve you.

You don't need to change the way you process dental claims. We'll make adjustments for you. We've matched payors and payor IDs on our side so that you can continue processing with the claim and payor settings you already have.

Payor Enrollment

I've heard that some payors have special enrollment requirements. How can I find out if a payor I work with has these requirements?

If a payor you work with is not listed, they may require special enrollment. We've added a Special Enrollment Forms page to help you enroll with payors who have special requirements for claims and/or ERAs.

Please note: You must follow all the instructions on the special enrollment forms. Some payors, including Denti-Cal, require you to notify DentalXChange when you receive your payor approval. When you receive confirmation from the payor that your enrollment was received, email hs1enrollment@dentalxchange.com and include the approval message from the payor as an attachment.

I'm getting a claim status that says "Payer requests enrollment for EDI submission." What does that mean?

This error means that the payer on that claim requires special enrollment that isn't complete. This happens for one of three reasons:

  • Your practice hasn't completed the special enrollment forms.
  • The payer hasn't approved your enrollment. (Timeline for approval varies by payer from as little as 1-3 days to a maximum of 3 months.)
  • DentalXChange hasn't received your payer enrollment confirmation.

To fix this error you just need to complete the special enrollment steps for that payer.

  1. Visit the special enrollment site and click Enroll in Claims.
  2. Select the payer(s) you want to enroll with and follow the instructions.
  3. IMPORTANT: When you receive confirmation from the payer that your enrollment was received, email hs1enrollment@dentalxchange.com and include the approval message from the payer as an attachment.

Once DentalXChange has received your approval confirmation they'll be able to submit claims to that payer on your behalf.

For information about other common claims statuses and how to resolve them, read our Steps for Resolving Claims Statuses tip sheet.

ERAs (Electronic Remittance Advice)

How does the ERA enrollment process work?

We've set up a multi-payer ERA Enrollment Service powered by DentalXChange at no additional cost to you.

New to ERAs?

Dentrix users: Visit  https://www.dentrix.com/products/eservices/eclaims/eeob for information regarding the enrollment process via Henry Schein One and DentalXChange.

Dentrix Ascend users: Visit https://hsps.pro/DentrixAscend/Help/Enrolling_locations_in_the_ERA_service_for_the_first_time.htm for information regarding the enrollment process via Henry Schein One and DentalXChange.

Dentrix Enterprise users: Visit https://www.dentrixenterprise.com/products/addons/era for information regarding the enrollment process via Henry Schein One and DentalXChange.

Payor Enrollments

  • Each payor has a different turnaround time for processing ERA enrollments, which in some cases is up to 30 business days. This timeline is set by the payor. It’s important to start your enrollment as soon as possible. 
  • ERA enrollment doesn't change the way you recieve payments. You'll still need t owork with payors directly to set up EFT payments.
  • See which payors participate in the ERAs with our clearinghouse:
  • Visit the enrollment page and click Enroll in ERAs. Fill out the online form to start your ERA enrollment process.
  • Please do not select "All Payors" on the enrollment form as this will delay the enrollment steps. Only select the payors you are actually processing to and wish to receive ERAs from.
  • Once your enrollment is complete, DentalXChange will deliver ERAs to your Henry Schein One practice management system multiple times per day. You'll receive ERAs the same way you received them previously.