eClaims with Rejected by Clearing House Status

At times, Tops Support will need to intervene to assist you with rejected claims. See below to find out when you can address these claims on your own, and when you should reach out to Tops Support.

1. Go to Matrix > Claims.
2. Open the dropdown menu on the top left and select Unpaid Claims.
3. Open the dropdown menu on the top right and select the Rejected by Clearing House status filter.
4. Each claim will display a yellow caution sign icon; hover your mouse over the caution sign icon to reveal the reason for the rejection.

• If the message states Operation Successful with validation errors and the explanation is displayed, note the error and correct it in the Tops Ortho chart. Refresh the Claims Matrix; a new error may appear, depending on how many errors the claim contains. Once you have corrected all the errors, the claim's status will change from Rejected by Clearing House to Open. Once it is in Open status, submit it again!

If you edit a claim and need to re-submit it, we strongly recommend adding a note to the claim in the Internal Notes for this claim section. Begin the note with "DXC" - this will allow you to sort your Unpaid Claims list and easily find these claims.

• If the message states DXC eClaim Group ID, then your Group ID in TopsOrtho > Practice Setup > eClaim is not valid. The Group ID is also referred to as the Account # in DentalXChange. It should be preceded by a – which Tops auto-populates. Make sure to tab out of the GroupID field to populate the hyphen. Example: -12345

• If the message states Invalid User i.e. ( ); verify your Login ID and Password in TopsOrtho > Practice Setup > eClaim. The Login ID is your DentalXChange username. The Password is your DentalXChange password.

• If the message states Operation Failed but does not display a reason for the rejection, this means the claim never made it to DentalXChange. In this situation, please contact Tops Support at 770.627.2527 for assistance.

• If the message states Malformed Document Sent, it means that the claim did not match DentalXChange's required formatting. Ensure that the format is correct and all required data is present. One example of a malformed document error is too many characters in a field. If you cannot make the necessary edits in the Tops Ortho chart, please contact Tops Support at 770.627.2527 for assistance.

• If the message states Operation Successful, Validation Errors <No additional detail> it means that the claim reached DentalXChange without any general formatting errors, but DentalXChange identified errors regarding the payer requirements. Since no explanation is given, please contact Tops Support at 770.627.2527 for assistance.

• If the message states Invalid PMS i.e ( ); it means that the username and password for the DentalXChange account is associated with more than one account number. In this case, your practice will need to create a new username and password associated with the account. To do this, DentalXChange will need to allow permissions. A ticket, call or email will need to be submitted to DentalXChange to start this process.