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Set Up Dental EDI Claim Profile Rules

On the Dental tab of the EDI Claim Profile Maintenance window, you can determine how the details appear in referring provider full middle name, the rendering provider loop, and the service facility location loop for 837D Electronic Data Interchange (EDI) claim files of specific payers.

  1. In the EDI Claim Profile Maintenance window, select the Dental tab.

  2. To generate the full middle name instead of the middle initial of the referring provider in the EDI claim file, select the corresponding row in the Setting column for the Send 2310A Referring Provider Full Middle Name option.
  3. For the Send 2420A Rendering Provider Loop option, do one of the following in the Setting column:
    • To generate the 2420D loop with same claim and line-level rendering providers, select Always.
    • To generate the 2420D loop with different claim and line-level rendering providers, select Only if claim and line level renderings are different.
  4. For the Send 2420D Service Facility Location Loop option, do one of the following in the Setting column:
    • To generate the 2420C loop with same claim and line-level rendering providers, select Always.
    • To generate the 2420C loop with different claim and line-level rendering providers, select Only if claim and line level renderings are different.
  5. Select OK.