Question 1

What does the dental claim extractor read?

Accepted Answer

The claim number and date, the claim type and claim status, the patient name, member ID, and date of birth, the dental provider name, NPI, and taxonomy (specialty) code, the payer name and payer ID, the plan name, and the service date range.

Question 2

Are the service lines returned as a table?

Accepted Answer

Yes. The service lines table returns each line with its CDT (Current Dental Terminology) procedure code, description, tooth number (FDI notation), tooth surface, oral cavity designation, quantity, unit price, line total, allowed and paid amounts, patient responsibility, and status.

Question 3

Which money and adjudication fields come out?

Accepted Answer

The billed, allowed, and paid amounts, the total amount, patient responsibility, deductible applied, coinsurance percentage, the diagnosis codes (ICD-10), the service authorization number, and the adjudication outcome, plus a patient benefits table with coverage percentage, annual maximum, used, and remaining per benefit category.

Question 4

How is a dental claim different from a CMS-1500 or UB-04 claim?

Accepted Answer

A dental (ADA) claim uses CDT procedure codes with tooth-number and tooth-surface designations. A professional (CMS-1500) claim uses CPT/HCPCS codes, and an institutional (UB-04) claim uses revenue codes. For those, use the professional claim or institutional claim extractor.

Question 5

Is it safe to upload a claim that contains patient data?

Accepted Answer

The claim is processed via the Talonic API for extraction only, is not retained for training, and is not shared. Redact the member ID and date of birth where you can; for BAA-covered workflows, ask about the Talonic platform. PDF only, up to 10MB and 100 pages.

Dental Claim (ADA) Extractor

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