Claims Processing Updates

As you are likely aware, Henry Schein One's prior clearinghouse partner, Change Healthcare (CHC), experienced a criminal cyberattack in February of this year. While Henry Schein One systems were not compromised, CHC has indicated that patient data has been exfiltrated from its environment. Based on CHC's analysis to date, a small percentage of Henry Schein One customer's patient data was affected (at this time, less than 1%), but because CHC is not able to tie affected individuals to practices we are providing this notice to all Henry Schein One practice management customers that utilized claims or eligibility services through CHC.

CHC has provided a HIPAA substitute notice with additional information here: https://www.changehealthcare.com/hipaa-substitute-notice. The notice includes a description of information which may have been involved based on CHC's review to date, a toll-free call center number, and information on complimentary credit monitoring and identity protection services available to all individuals. CHC recommends that covered entities post a link to the substitute notice on their home page for at least 90 consecutive days.

Beginning in late July, CHC has informed us that CHC will send direct notice (written letters) to affected individuals for whom CHC has a sufficient address. CHC will make HIPAA and state attorney general notifications as required by state law on behalf of covered entities as a delegate. You do not need to do anything for CHC to process required notifications. CHC will proceed as a delegate on your behalf to provide the following notifications:

• HIPAA substitute notice;
• HIPAA media notice;
• OCR report, when data review is completed;
• Individual notifications under HIPAA and state law, for impacted individuals with sufficient information;
• Impacted individuals with an unknown or insufficient address will be provided notice via substitute notice; and
• Notice to state attorneys general as appropriate.

If your patients would like additional information regarding the cyberattack or the complimentary credit monitoring and identity protection services, you can refer them to the CHC substitute notice at the link above. If you have any questions, please contact CHC directly as set forth in the notice.

As you are likely aware, Henry Schein One's prior clearinghouse partner, Change Healthcare (CHC), experienced a criminal cyberattack in February of this year. While Henry Schein One systems were not compromised, CHC has indicated that patient data has been exfiltrated from its environment. Based on CHC's analysis to date, a small percentage of Henry Schein One customer's patient data was affected (at this time, less than 1%), but because CHC is not able to tie affected individuals to practices we are providing this notice to all Henry Schein One practice management customers that utilized claims or eligibility services through CHC.

CHC has provided a HIPAA substitute notice with additional information here: https://www.changehealthcare.com/hipaa-substitute-notice. The notice includes a description of information which may have been involved based on CHC's review to date, a toll-free call center number, and information on complimentary credit monitoring and identity protection services available to all individuals. CHC recommends that covered entities post a link to the substitute notice on their home page for at least 90 consecutive days.

Beginning in late July, CHC has informed us that CHC will send direct notice (written letters) to affected individuals for whom CHC has a sufficient address. CHC will make HIPAA and state attorney general notifications as required by state law on behalf of covered entities as a delegate. You do not need to do anything for CHC to process required notifications. CHC will proceed as a delegate on your behalf to provide the following notifications:

• HIPAA substitute notice;
• HIPAA media notice;
• OCR report, when data review is completed;
• Individual notifications under HIPAA and state law, for impacted individuals with sufficient information;
• Impacted individuals with an unknown or insufficient address will be provided notice via substitute notice; and
• Notice to state attorneys general as appropriate.

If your patients would like additional information regarding the cyberattack or the complimentary credit monitoring and identity protection services, you can refer them to the CHC substitute notice at the link above. If you have any questions, please contact CHC directly as set forth in the notice.

As you are likely aware, Henry Schein One's prior clearinghouse partner, Change Healthcare (CHC), experienced a criminal cyberattack in February of this year. While Henry Schein One systems were not compromised, CHC has indicated that patient data has been exfiltrated from its environment. Based on CHC's analysis to date, a small percentage of Henry Schein One customer's patient data was affected (at this time, less than 1%), but because CHC is not able to tie affected individuals to practices we are providing this notice to all Henry Schein One practice management customers that utilized claims or eligibility services through CHC.

CHC has provided a HIPAA substitute notice with additional information here: https://www.changehealthcare.com/hipaa-substitute-notice. The notice includes a description of information which may have been involved based on CHC's review to date, a toll-free call center number, and information on complimentary credit monitoring and identity protection services available to all individuals. CHC recommends that covered entities post a link to the substitute notice on their home page for at least 90 consecutive days.

Beginning in late July, CHC has informed us that CHC will send direct notice (written letters) to affected individuals for whom CHC has a sufficient address. CHC will make HIPAA and state attorney general notifications as required by state law on behalf of covered entities as a delegate. You do not need to do anything for CHC to process required notifications. CHC will proceed as a delegate on your behalf to provide the following notifications:

• HIPAA substitute notice;
• HIPAA media notice;
• OCR report, when data review is completed;
• Individual notifications under HIPAA and state law, for impacted individuals with sufficient information;
• Impacted individuals with an unknown or insufficient address will be provided notice via substitute notice; and
• Notice to state attorneys general as appropriate.

If your patients would like additional information regarding the cyberattack or the complimentary credit monitoring and identity protection services, you can refer them to the CHC substitute notice at the link above. If you have any questions, please contact CHC directly as set forth in the notice.

We are pleased to report that we’ve restored our electronic medical claim service (aka 837P- Professional claims).

If you are registered for our eClaims service and have purchased the Medical Cross Code Pack, you can send both dental and medical claims for your patients through the same service in a streamlined manner.

If you are not currently registered for our eClaims service and/or do not have the Medical Cross Code Pack, please contact your sales representative and they will be happy to assist you.

You can now view an updated list of payers who support medical claims.

On June 6, 2024, we discovered an issue that caused some Denti-Cal pre-determination claims to be rejected by the payer because they didn't include the original Provider Document Control Number (PDCN)and Document Control Number (DCN) from the notice of authorization (NOA).

We've been working aggressively with DentalXChange to implement a fix for these claim submissions. We're excited to share that we have fixed the issue, and you can again submit pre-determination claims electronically using your normal workflow.

We've made the appropriate changes to now include the original PDCN on the applicable claim submissions going forward. As a reminder, you should include the DCN number from your NOA on future claims as well. We are also diligently working to reprocess the affected claims you've previously submitted to Denti-Cal (Payer ID 94146). We anticipate those claims to be reprocessed over the next few days.

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 with DentalXChange and attachments with Vyne (NEA). 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. We're actively working with our clearinghouse partners and payors to restore medical claims processing.

We have now re-established connectivity for the majority of claims by volume. See the payor list below. We'll add updates to this site as we have them.

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. We're processing claims with those payors once you have completed the enrollment.

We recommend you contact the payors who send you EFTs and request paper checks in the mail.

Please be aware that some of your EFTs may have been in process with Change Healthcare when the outage occurred, and payors who process paper checks with Change Healthcare may be unable to send checks at this time. We're working with Change Healthcare to identify these payors, and we'll work with the payors to explore alternative options for paper check processing. Some payors have also indicated that they will be sending paper checks instead of EFTs during this incident.

In collaboration with our partners, Henry Schein One is offering practices multiple financial support options. Visit our financial services page at https://info.henryscheinone.com/financialservices for information about the financing options and links to apply.

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.

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.

Some payors require special enrollment before you can submit electronic claims through the new clearinghouse.

This special enrollment is required for Medicaid of AK, CA, FL, IA, KY, LA,ME, MI, MN, NV, NJ, NY, NC, UT, VT and WY, DC Medicaid, DMBA, and PEHP.

Visit the special enrollment page to register.

Effective 6/11/24, special enrollment with DentalXChange is no longer required for BCBS of TN or BCBS of MS. DentalXChange will no longer return a validation error when a provider is not enrolled and submits a claim.

If the provider on the claim has completed special enrollment through any EDI Clearinghouse, re-enrollment with DentalXChange is not required. The payor will receive the claim, recognize a previous enrollment with another EDI Clearinghouse, and update the enrollment record.

For providers who have never completed Special Enrollment through any EDI Clearinghouse, claims will be rejected, and DentalXChange will work with the provider to complete the electronic filing process.

Any claims that were previously pending enrollment (submission dates from the last 90 days) will be released as of 6/11/24.

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

1. Visit the enrollment page and click Enroll in ERAs. Fill out the online form to start your ERA enrollment process.
2. Wait for an email from a Zentist team member. There's a 3-to-5-day processing time after you submit the online form. You'll hear from a Zentist rep after that time.
3. Contact Zentist with questions and enrollment status checks by emailing hsone@zentist.io. In your email, include the name of your dental group, the practice(s) your inquiry pertains to, and the best phone number to reach you.

Please note these important items:

• 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.
• To help you get enrolled as quickly as possible and ensure all information is complete, all of the forms will be managed by Zentist. You must work with Zentist to submit your enrollment information. Zentist will be managing the communication between your office and the payors.
• This ERA enrollment doesn't change the way you receive payments. You'll still need to work with payors directly to set up EFT payments.
• Once your enrollment is complete, DentalXChange will deliver ERAs to your Henry Schein One practice management system multiple times a day. You'll receive ERAs the same way you received them previously.

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.

To help you get enrolled as quickly as possible and ensure all information is complete, all of the forms will be managed by Zentist. You must work with a Zentist rep to submit your enrollment information. Reps from Zentist will be managing the communication between your office and the payors.

Once your enrollment is complete, DentalXChange will deliver ERAs to your Henry Schein One practice management system multiple times a day. You'll receive ERAs the same way you received them previously.