Find a Payer ID

When efiling a claim, the PayerID for an insurance company is required.

Locating a Payer ID

Step 1: Locate the correct Payer ID, Payer Name and Address

Our recommendation is to locate and confirm the payer name, address, and payer ID exactly as provided by the insurance company, whether that information comes from the insurance card, the payer’s website, or directly from a representative.

Step 2: Update the Employer Policy with the correct Payer ID.

Within the patient's chart, locate the Employer Policy attached to the policy holder.   Alternatively, you can locate the Employer Policy using Command-Y or Matrix>Employer Policy.

Input the details exactly as they were provided by the insurance company for the specific Employer Policy, including the Payer Name, Address, Payer ID, and Group Number.

Reference the Navigate the Employer Policy article at the bottom of this page for more information on required field.

Clearinghouse Rejected - Insurer Not Found

There are situations where the payer ID provided by the insurance company may not match the payer ID DentalXChange uses for electronic routing.

Having an incorrect payer ID will result in a claim being rejected within Tops, reflecting a Clearinghouse Rejected status.  If your rejection reflects a validation error of “Insurer Not Found”, reviewing the DentalXChange payer list should be your next step.

Step 1: Locate the Claim

1. Right-click over the claim in question and select Open Employer Policy from the contextual menu.
2. When the Employer Policy window for the patient displays, click the blue link named e-Claim Insurance Payer List.

3. The DentalXChange website will open in a new browser tab.
4. Enter the name of the insurance company in the Name field.
5. Click Search.

6. Locate and note the necessary payer ID.

Note: Can't find the payer ID? Login to your DentalXChange account, click the Payer List link under the Claims menu. Scroll to the bottom of the payer list and click the blue link to search by the payer's address. Searching by the payer’s mailing address can help identify the most accurate payer ID to use, particularly when multiple payer IDs appear and it’s unclear which one is correct.

7. Return to the Employer Policy window.
8. Copy and paste the old payer ID in the Notes field of the Employer Policy window for future reference.
9. Enter the new payer ID in the Employer Policy window.
10. Return to Matrix > Claims > Unpaid>Rejected by Clearinghouse.
11. Refresh the list and if all validation errors have been resolved, the claim should no longer appear in Unpaid>Rejected by Clearinghouse.
12. Update your filters to Unsent Ready-to-File and No Submission Date.
13. Locate the claim and e-File it again.

Still can't find the payer ID?

If you still cannot locate the payer in the DentalXChange payer list and continue receiving an “Insurer Not Found” validation error, you can use the generic payer ID 06126. Make sure that you have the correct payer name and mailing address.

In these situations, DentalXChange will attempt to match the payer information to a valid electronic payer ID. If a match cannot be made electronically, the claim may be converted to print-and-mail on the practice’s behalf.

Need to mail a claim?

For specific mail-only payers: Enter DXPRT as the payer ID in your employer policy. 

DXPRT:

This is the dedicated payer ID to designate a claim for printing and mailing by DentalXChange. 

Why locking the details is important

Insurance Company details in the Employer Policy record - along with Employer details - should be locked once they are created or corrected.

Any changes made to the Employer Policy record will affect all patients who have ever used the policy. This includes patients whose policy is no longer active.

If an employee:

• Changes groups within the same insurance company
• Changes insurance providers within the same company
• Changes jobs and obtains new insurance

If an employee’s insurance changes, you must:

• Create a new Policy Holder record
• Either link the new policy holder to an existing Employer Policy record, or create a new Employer Policy record if one does not already exist

Think of the Policy Holder and linked Employer Policy record like an insurance card. When someone receives new insurance, they do not alter their old card — they receive a completely new one.

The original Policy Holder and Employer Policy relationship must remain unchanged to preserve historical accuracy. Existing claims are tied to the original policy details, and modifying those records can impact all past claims associated with that policy.

For more information, reference the article below Change Employer Policy.