Creating primary claims

You should create an insurance claim each time an insured patient receives treatment. You can create a claim immediately after a patient checks out, or you can create a batch of insurance claims at the end of the day.

From the Insurance menu in the Ledger, you can create claims using any 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.

Note: When you create a claim, clinical note and claim attachments are checked for and attached to the claim automatically.

To create a primary claim

1.   Do one of the following:

·        With a patient selected and to create a claim for all procedures posted on the current date for that patient, from the Insurance menu, click Today's Procedures.

·        With a patient selected in the Ledger, select the procedures that you want to create a claim for, and then from the Insurance menu, click Selected Procedures.

Tip: Selecting any of the other options in the Insurance menu creates a claim and either sends it electronically, to the Batch Processor, or to the printer without opening the claim window to allow you to edit the claim information. Do not select any of these other options for claims that require special handling, such as the addition of a narrative or X-rays, before being batched, sent, or printed.

Note: The Insurance menu may be unavailable for the following reasons:

·        The selected patient has not been assigned insurance in the Family File. If the patient is covered by insurance, delete any posted procedures that are covered, add the patient insurance, and then re-post the procedures.

·        The selected patient has insurance, but the All (with running balance) option is selected in the View menu. Clear the option.

The Primary Dental Insurance Claim window appears.

2.   Edit the claim information as needed.

3.   On the menu bar, click Submit.

The Submit Claim dialog box appears.

4.   Click one of the following:

·        Send to batch – Sends the claim to the Batch Processor.

·        Send Electronically – Sends the claim electronically.

·        Print – Prints the claim.

Important: Avoid exiting the Primary Dental Insurance Claim window without batching, sending, or printing a claim to prevent the claim from staying on the account without getting submitted.