ODS. Healthcare from your head to your toes.

Filing claims

Tips for reducing claims processing time

Submit claims electronically. ODS processes electronic claims first each day. See below for a list of electronic claims processing providers.
If submitting paper claims, please use the standard ADA form, either typed or legibly printed.
Verify the patient's relationship to the subscriber, and make sure plan information is correct before submitting claims.
Include all pertinent information: subscriber ID or recipient ID (if OHP), patient name and date of birth, tooth number(s) or quadrant and current ADA codes. Your office can call the ADA at 800-947-4746 to order the most current CDT codebook.
Please do not send X-rays unless requested by ODS. In some instances, clinical information may assist in determining benefits.
If a patient is covered by more than one ODS program, submit one claim form indicating the name of the subscriber, subscriber ID number, employer (if applicable) and the ODS group number for both plans. If the patient is covered by another carrier, please indicate the above information plus the name, address and policy number of the other carrier. If a patient has primary insurance through a carrier other than ODS, the EOB of primary payment amount from the other insurance company will need to accompany the claim for consideration of payment.
Be aware that ODS makes payments weekly.
Please contact us before submitting duplicate claims:

Check Dental Benefit Tracker to see the status of a claim. If you haven't registered for this free online service, you can register online.
If you receive a PDR indicating that your claim has already been processed before you receive a check, this indicates that your rebill was unnecessary — the claim was processed and is pending for the next scheduled payment date.
Rebilling without contacting us slows our turnaround time and delays payment.

Use miscellaneous codes appropriately with clinical information.
Code "R6, 9A6, 9A8" on the Payment Disbursement Register are for charges exceeding the amount allowed. This is a provider discount and should not be billed to the patient.
DO NOT USE HIGHLIGHTER ON PAPER CLAIMS.

Electronic claims filing

ODS is committed to receiving claims electronically. Advantages for your office include greatly enhanced service and dramatically lower administrative costs.

Below is a list of dental electronic claims providers for ODS. Please contact one of these providers to set up an account to make your claims-filing easier.

Clearinghouses

Emdeon (formerly WebMD)
220 Burnham St.
South Windsor, CT 06074
888-255-7293
Payor ID = CDOR1

APEXEDI Inc.
174 S 1000 East
American Folk, UT 84003
801-642-0285
Payor ID = CDOR1

EDI Health Group Inc. (EHG)
2201 Dupont Dr. #650
Irvine, CA 92614
949-852-0825

TESIA – PCI Corporation
3500 Sunrise Hwy #T-208b
Great River, NY 11739
630-922-6317

Practice management systems that submit directly to ODS

Dentists Management Corporation
10505 SE 17th Ave.
Milwaukie, OR 97222
503-243-3966

Quality Systems Inc.
18111 Von Karman #600
Irvine, CA 92612
949-255-2600

First Pacific Corp.
5121 Skyline Village Loop
Salem, OR 97306
503-588-1411

Direct connection to ODS

ODS also supports direct connections between offices and ODS if the dentist prefers this method. Transaction standard is the 837 Dental Claim required by HIPAA Administrative Simplification.