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.