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eClaims Quick Start Guide

Learn how to send electronic claims, or eClaims, with Dentrix. Save time and money by taking advantage of your ability to submit claims electronically. Use these resources to get started with Dentrix eClaims.


To learn how to use Dentrix eClaims, click the topics below.

You can send all your claims with eClaims. eClaims is connected to a large list of payors for electronic claims and attachments.

Watch this video to learn how to set up Dentrix for electronic claim submission. (Duration 1:00)


Key Information

Help and Documentation



Before you can send electronics claims, you must make sure your practice information in the Office Manager includes all the information required to identify and validate your submissions. A key piece of information is specifying the administrative contact.

Watch this video to learn how to define your practice's administrative contact for claim submission. Duration (1:31)

Key Information

Help and Documentation

Configuring your practice information



You'll need to make sure insurance information for each carrier is set up correctly in Dentrix in order to successfully send electronic claims and avoid claim rejections.

Watch this video to learn how to set up insurance plans in Dentrix to include all the information that is required for electronic claims submission. (Duration 2:48)


Key Information

Help and Documentation



You can create claims individually in each patient's Ledger, or all at once through the Office Manager module.

Creating Claims Individually

You should create a dental insurance claim each time an insured patient receives treatment.

Watch this video to learn how to create primary claims individually. Duration (1:12)


Key Information

Creating Claims at the Same Time

Some offices choose to create all insurance claims for a given day at the same time instead of one patient at a time throughout the day. The Office Manager allows you to create all primary insurance claims for procedures posted within the selected date range and for selected providers and Billing Types.

Important: If you follow these instructions to create claims as a batch, carefully review the created claims to ensure all required attachments are included!

To batch claims:

  1. In the Office Manager, click File, and then click Batch Ins Claims.
  2. If necessary, change the date range.
    • The date range will default to today's date.
    • If you change the date range to include history, be aware that Dentrix will create insurance claims for patients based on their current insurance—even if that insurance wasn't active at the time of the visit.
  3. Choose the providers and billing types to include.
  4. Choose a method to process the claims.
    • Click Print to create the claims within the ledgers, send them to the batch processor, and immediately send them to the default printer.
    • Press Send to Batch to create the claims within the ledgers and send them to the batch processor. They will automatically be selected, making it convenient for you to choose the next action (such as printing or sending electronically).
    • Press Send Electronically to create the claims within the ledgers, send them to the batch processor, and begin the send electronically process.

Help and Documentation



After you create and batch claims throughout the day, you can send them electronically to the clearinghouse through the Office Manager.

Watch this video to learn how to submit claims electronically. Duration (2:08)


Key Information

Help and Documentation



You can attach images or other information before sending a claim to the Batch Processor.

Watch this video to learn how to add attachments to claims. (Duration 3:37)


Key Information

Help and Documentation




After you send your claims, the eClaims Transmission Report will appear in your batch processor. The transmission report includes several important pieces of information.

Watch this video to learn how to view and interpret the transmission reports that accompany a claims submission. (Duration 2:33)


Key Information

Help and Documentation



Creating secondary claims manually

  1. With a patient selected in the Ledger, double-click the primary insurance claim.
  2. Click Create Secondary.

Creating secondary claims automatically

An option can be enabled to remind you to create secondary claims after you post a primary insurance claim payment.

To create a secondary claim automatically

  1. In the Ledger, click File, and then click Insurance Payment Setup.
  2. Under Additional Options, select Auto-Create Secondary Claim with Primary Payment.
    Image of the Insurance Payment Setup window with two secondary options annotated

Claim Adjustment Segment (CAS)/Coordination of Benefits (COB)

Before submitting secondary claims electronically, our claims clearinghouse requires you to complete the Claim Adjustment Segment (CAS)/Coordination of Benefits (COB) portion for secondary insurance claims.

If you submit secondary insurance claims without completing the CAS/COB portion for the primary claim, they may be rejected, and you will receive a message similar to the following:

Receipt of a rejection message results from the absence of, or invalid information in, the Claim Adjustment Segment, which represents primary insurance claim adjustments. Adjustment information helps the secondary provider balance the remittance information. Adjustment amounts should fully explain the difference between the submitted charges and the amount paid by the primary insurance carrier. Claims submitters must use the Claim Adjustment Segment to report the primary carrier's claim level adjustments that caused the amount paid to differ from the amount originally charged.

  1. With a patient selected in the Ledger, double-click the primary insurance claim.
  2. Click View Secondary, and then double-click the Claim Information box.
  3. Under Other Subscriber Information, click Primary Claim Adjustment Reason(s).
  4. Complete the following information about the adjustment:
    • Group Codes
      • PR - Patient Responsibility - Is the adjusted amount in the segment the patient's responsibility?
      • CO - Contractual Obligation - Is the adjusted amount not the patient's responsibility due to a contractual obligation between the provider and the payer or a regulatory requirement? For example, a participating provider agreement might be considered a contractual agreement.
      • PI - Payer Initiated - In the payer's opinion, is the amount in this segment not the patient's responsibility without a supporting contract between the provider and the payer?
      • OA - Other Adjustment - Use if no other category is appropriate.
      • CR - Correction and Reversals - Is the claim a reversal of a previously reported claim or claim payment?
      • Reason Codes - The reason code appears on the ERA/EOB/EEOB that is returned from the payer after you first submit the claim. If necessary, you can use that reason code to resubmit the primary and the secondary claim.
        • Reason Codes 01-03 - Always use with PR - Patient Responsibility.
          Note: Always enter Reason Codes 01-09 as double digits, not 1-9.
        • Reason Code 18 - Use only with OA - Other Adjustment unless the state workers' compensation regulations require CO - Contractual Obligation.
        • Reason Code 23 - Use only with QA - Other Adjustment.
        • Reason Code 45 - Use only with PR - Patient Responsibility or CO - Contractual Obligation depending on liability.
        • Reason Code 85 - Use only with PR - Patient Responsibility.
        • Reason Code 133 - Use only with QA - Other Adjustment.
        • Reason Code 136 - Use only with QA - Other Adjustment.
        • Reason Code 201 - Use only with PR - Patient Responsibility.
        • Reason Code 209 - Use only with QA - Other Adjustment.
        • Reason Code 229 - Use only with PR - Patient Responsibility.
        • Reason Code 238 - Use only with PR - Patient Responsibility.
        • Reason Code 249 - Use only with CO - Contractual Obligation.
        • Reason Code 255 - Use only with QA - Other Adjustment.
        • Reason Code 257 - Use only with QA - Other Adjustment.
        • Reason Code P3 - Use only with PR - Patient Responsibility.
        • Reason Code P11 - Use only with QA - Other Adjustment.
        • Reason Code P16 - Use only with CO - Contractual Obligation or QA - Other Adjustment.
        • Reason Code W5 - Use only with CO - Contractual Obligation or QA - Other Adjustment.
      • Amount - Amount of the adjustment.
  5. Click Close.
  6. In the Insurance Claim Information dialog box, in the Remaining Patient Liability Amount box, enter the patient portion from the ERA/EOB (primary claim amount minus the primary claim payment amount minus adjustments).

Creating Secondary Claims if the Information has been Added/Changed

If the secondary insurance information has been changed in the patient's Family File after the primary claim was created, do the following to update the secondary insurance information:

  1. Verify that the correct secondary insurance information in the Family File is correct. Update it as needed.
  2. In the Ledger, double-click the primary insurance claim.
  3. Double-click the Subscriber Information block.
  4. Select Update Secondary Insurance, and then click OK.
  5. Click Create Secondary.

Key Information

Automatic creation of secondary claims can only occur if

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