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New Jersey Prompt Pay Requirements - Good Faith Effort
 

New Jersey's Prompt Pay Law requires Delta Dental to make a good faith effort to obtain any missing information and diagnostics that are necessary to process a claim before sending a letter.

Under the requirements of the law, Delta Dental must first contact dental offices by phone, fax or e-mail about the missing information.

After contacting the dental office by phone, fax or e-mail, Delta Dental will, if necessary, send a follow-up letter or Explanation of Benefits that also details what information is missing.

Please note that dental offices don't need to wait for the follow-up letter or Explanation of Benefits before sending missing diagnostics or other information necessary for processing a claim. They may send that information at any time, making sure all diagnostics or other information are clearly labeled with the date, patient name, the dentist's name and address, and the claim number for identification purposes. The claim number will be provided on the phone, fax or e-mail.

To avoid most missing information delays, be sure claim forms are fully completed and necessary attachments are included on all claim submissions. Participating dentists should refer to Chapter 4 of the Dentist Handbook for form completion instructions or our Web site for the Required Documentation Charts.

 
 
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