Creating primary medical claims

Before you can create a medical claim, you must cross-code at least one procedure for medical insurance. Once you have cross-coded a procedure, you can create and print a medical claim. Before printing a medical claim, you need to purchase HCFA pre-printed claim forms.

When creating claims, you can use Dentrix to do any of the following:

·        If you posted procedures that can be cross-coded but did not enter the cross-coding information, a dental claim is created for the procedures.

·        If you entered a combination of cross-coded and dental procedures for the day, two claims are created: a medical claim that includes all cross-coded procedures and a dental claim for procedures that are not cross-coded.

·        If you assigned more than four ICD-9-CM diagnostic codes to the cross-coded procedures, a warning appears. Click OK to assign some of the cross-coded procedures to additional medical claims.

To create a primary medical claim

1.   With a patient selected in the Ledger, select a transaction that you want to create a medical claim for.

2.   Click Insurance, and then click Today’s Procedures.

The Primary Medical Insurance Claim window appears.

3.   Edit the claim information as needed.

Note: For more information on the Primary Medical Insurance Claim window, click Changing medical claim information.

4.   In the menu bar, click Submit.

The Submit Claim dialog box appears.

5.   Click one of the following:

·        Batch to send the claim to the Batch Processor.

·        Send Electronically to send the claim electronically using eTrans.

·        Print to print the claim immediately.

Insurance - Today’s Procedures - Batch, Send Electronically, and Print

To create a claim using one of these options

·        With a patient selected in the Ledger, from the Insurance menu, click one of the following options:

·        Today's Procedures - Batch: Create a claim from today’s procedures and send it to the Batch Processor.

·        Selected Procedures - Batch: Create a claim from selected procedures and send it to the Batch Processor.

·        Today's Procedures - Send Electronically: Create a claim from today’s procedures and send it electronically. You must first set up an eServices account to use this feature.

·        Selected Procedures - Send Electronically: Create a claim from selected procedures and send it electronically. You must first set up an eServices account to use this feature.

·        Today's Procedures - Print: Create a claim from today’s procedures and print it.

·        Selected Procedures - Print: Create a claim from selected procedures and print it.