A repeatable setup checklist for every new PC: accounts, dental payer EFT enrollments, signers, bookkeeper access, invoicing, statements, and check stock.
Use this checklist for each new professional entity. A consistent sequence makes later setups easier to plan, review, and hand off.
Per payer, and each Delta Dental member company is its own payer, contracted per state, so the new state means a new Delta relationship:
Group contract executed by the PC’s officer; effective date recorded
Fee schedule obtained and reviewed before signing, including downgrade and network-leasing terms
Timely filing limit and appeal deadline recorded
Each dentist credentialed and linked; provider effective dates recorded
Retro-effective dates requested in writing
EDI enrollment approved (not merely submitted)
ERA enrollment pointing at your current clearinghouse
EFT enrollment pointing at the account authorized for the enrolled billing provider
Any VCC-paying payer converted to EFT
Test claim submitted and accepted at 277CA
First 835 received and posted
First EFT confirmed in the correct account, reassociating by TRN
Plus:
Medicaid: the applicable state enrollment plus each current plan, administrator, contracting, credentialing, or affiliation step required by the state’s delivery model
Medicare, only if applicable: Part B entity, dentist, and reassignment records completed through PECOS or the current CMS-855B/CMS-855I workflow; CMS-588 EFT and PTANs recorded; separate CMS-855S supplier enrollment completed for each applicable DMEPOS location
Entity configured in the PMS with its own Tax ID and group NPI
Separate submitter configuration at the clearinghouse, so claims cannot go out under another entity’s Tax ID
Attachment service configured for this entity (NEA/Vyne or clearinghouse-integrated), so required radiographs and narratives are transmitted with the appropriate claims
Fee schedules loaded, per payer, for underpayment and downgrade detection
Scrubber edits configured, including the preauthorization-required edit for Medicaid and DHMO work
ERA auto-posting configured, with group code mapping tested against a real 835
Confirm these four items before the entity begins billing:
Identity fields reconcile across source records; a legal-name, TIN, NPI, DBA, or account-holder mismatch can cause enrollment or payment failures
EFT to the account authorized for the enrolled billing provider, with the legal name, TIN, ownership, and control matching payer and bank records
ERA pointing at your current clearinghouse, otherwise you get money you cannot post
No unsupported unilateral manager control over a professional entity’s account; test the state’s rule, resolutions, online permissions, sweeps, and actual approvals together