Entering pre-authorization estimates

After receiving a pre-authorization estimate from an insurance carrier, enter it in the Ledger.

To enter a pre-authorization estimate from an insurance carrier

1.   With a patient selected in the Ledger, click Options, and then click Treatment Plan.

The Ledger title bar now reflects that you are in the Treatment Plan view.

2.   From the transaction log, double-click the pre-authorization estimate that you want to enter an authorization number for.

The Primary (or Secondary) Dental Preauthorization Estimate window appears.

3.   From the Enter Estimate menu, click Itemize by Procedure or Total Estimate Only.

·        If you select Total Estimate Only, the Total Insurance Preauthorization dialog box appears. Skip to step 5.

·        If you selected Itemize by Procedure, the Itemize PreAuth dialog box appears.

·        The estimated insurance portion is entered automatically in the Amount Paid field. If the amount is correct, click OK.

·        If the procedure was rejected, select the Rejected option under Procedure Status, then click OK.

·        If the estimate amount is different from what appears, enter the correct amount in the Payment Table field. Click OK.

Note: When you itemize estimates, update the Payment Table only when the estimate amount applies to all patients covered by that plan. For example, if the current coverage amount is different from the estimate amount because money will be withheld toward a deductible, do not update the Payment Table. Similarly, if a patient has exceeded his or her maximum benefit, do not update the Payment Table.

4.   Repeat this process for all other procedures attached to the estimate.

Once you have entered all the procedures, the Total Insurance Preauthorization dialog box appears.

5.   In the PreAuth Number field, type the pre-authorization number for the estimate.

6.   If you did not itemize payments, type the authorized amount in the Total Estimate field.

7.   To post the estimate and return to the Itemize PreAuth dialog box, click OK/Post.

8.   To return to the Ledger, click File, and then click Exit.