Changing claim information

The Claim Information block displays information that is specific to a patient and an insurance claim. Those items are numbered 27 through 35 on a standard ADA insurance claim form. The standard information prints on the claim unless you have edited it.

Note: By default, "Standard" appears in the Claim Information block. If you have changed the standard information, "Non-Standard" appears.

To change claim information

1.   In the Ledger transaction log, double-click an insurance claim or payment or a pre-authorization estimate.

The Insurance Claim or Preauthorization Estimate window appears.

2.   Double-click the Claim Information block.

The Insurance Claim Information dialog box appears.

3.   Make changes to any of the information displayed in the Insurance Claim Information dialog box:

·        Place of Treatment - Select the location where treatment was performed. Edit the text in the box as necessary.

·        Preauthorization Number - If required, type the pre-authorization number provided by the patient's insurance carrier.

Note: If you received a pre-authorization and entered it in Dentrix, the pre-authorization number automatically prints on the insurance claim. If there is more than one number for the procedures on the claim, you must create a claim for each set of procedures with a different pre-authorization number.

·        First Visit Date Current Series - Type the appropriate date.

·        Original Reference Number - Type a valid number in the text box.

·        Student Status - Select the appropriate status for the patient. If the patient is a part- or full-time student, type the name of the school and the city where it is located.

·        Attachments -Click the arrows to select the appropriate number of attachments from the lists. Click Processing dental insurance claims to learn more about claim attachments.

·        Disabled - Select if the patient is disabled.

·        Occupational Illness or Injury - Select if treatment was necessary due to an on-the-job illness or injury. Type the relevant date and description.

·        Accident Information - Select Auto Accident or Other Accident if treatment was necessary as result of an accident. Type the relevant date and description.

·        Services Covered by Another Plan - Select this option if needed and type a relevant description.

·        Prosthesis - If the claim involves a prosthesis, select the appropriate option and type the Replace Reason, Order Date, and Prior Date. If the prior date is an estimate, select Prior Date Is Estimate.

·        Orthodontic Treatment - If the claim is for orthodontic treatment, select this option and type the Placement Date and Mos. Remain (months remaining) to complete the treatment.

·        For Special/Medicaid Claims - Select the reason for the pre-authorization, and then select the appropriate options.

·        Referring Physician - Click the search button to select a referral source, and then select an ID Number Type and type an ID Number.

·        Other Subscriber Information - Active for secondary insurance claims only. If the primary or secondary provider supplies this information, you can type it in the appropriate fields.

Note: To reset the Insurance Information options to the defaults, click Clear.

4.   Click OK to save your changes and return to the Primary Dental Insurance Claim window.

Note: When you enter or clear claim information in a Claim window, the changes only apply to the currently displayed claim and the associated primary, secondary, or medical claim. When you create a new claim, the claim information uses the defaults for the current patient. You can change the defaults for the patient through the Appointment Book. For more information, click Scheduling appointments.