Ledger

Posting a batch of insurance payments manually

When an insurance carrier sends your office one check or electronic funds transfer (EFT) to cover multiple claims for multiple patients, with Dentrix Enterprise, you can post the large insurance check to multiple patients without having to switch back and forth between different accounts and insurance claims.

Note: Posting a batch of insurance payments requires the "Ins Payments, Enter" security right.

To post a batch of insurance payments manually

In Ledger, on the File menu, click Enter Batch Ins. Payment.

If applicable, do one of the following:

If the Password - Ins Payments, Enter dialog box appears, user verification has been assigned to the "Ins Payments, Enter" task. Do one of the following:

If your user account has been granted the "Ins Payments, Enter" security right, enter your credentials in the User ID and Password boxes, and then click OK.

If your user account has not been granted the "Ins Payments, Enter" security right, have a user with permission temporarily override this restriction so you can start a batch insurance payment session this one time. The overriding user enters his or her credentials in the User ID and Password boxes and then clicks OK.

If a message appears, informing you that you do not have rights to this operation, your user account has not been granted the "Ins Payments, Enter" security right. To have a user with permission temporarily override this restriction so you can start a batch insurance payment session this one time, do the following:

On the message, click Yes.

In the Password - Ins Payments, Enter dialog box, the overriding user enters his or her credentials in the User ID and Password boxes and then clicks OK.

The Batch Insurance Payment Entry dialog box appears.

Note: If you need to resume or delete a batch insurance payment entry session, under Pending Claims, click Pending Sessions. The Pending Sessions for Manual Batch Payments dialog box appears. Select a session, and then click OK to resume it (or you can click Delete to delete it).

Under Batch Entry Type, select the Manual option.

Set up the following options:

Pmt Type - The method of payment. Select one of the following options:

Check - If a check was mailed to the office.

Electronic - If payment was received through an EFT.

Ins Type - The type of insurance coverage. Select one of the following options: Dental or Medical.

Date - The date that the payment was collected. By default, today's date is entered, but you can specify a different date. To change the date, do one of the following:

To enter the correct month, day, and/or year in the box (which uses a mm/dd/yyyy format), do any of the following as needed:

To change the month, click the first date segment to select the number, and then enter the number (from 1-12) of the correct month.

To change the day, click the second date segment to select the number, and then enter the correct day of the month.

To change the year, click the third date segment to select the number, and then enter the correct 4-digit year.

To use a date selector to select the correct date, click the downward-pointing arrow to view a calendar, navigate to the correct year and month, and then click the correct day.

Click the downward-pointing arrow to view a month calendar.

Navigate to the correct month using the left and right arrows.

Note: To quickly change the year and month, click the month-year at the top of the calendar, navigate to the correct year using the left and right arrows, and then click the correct month.

Click the correct day.

Amount - The dollar amount of the payment. In the box, enter the paid amount on the check or in the electronic remittance.

Note: For a whole dollar amount, you can enter a number without adding the decimal point and two zeros. For example, if you type 36 and then press Tab, Dentrix Enterprise will change the amount to 36.00.

Check # and Bank/Branch # - If the insurance carrier is paying with a check, enter the check number (up to 25 characters in length) in the Check # box and the bank account number in the Bank/Branch # box.

Notes:

Check numbers and bank account numbers appear on deposit slips. Check numbers appear as part of payment descriptions on family walkouts (enhanced and plain forms), billing statements, family ledger reports, and patient ledger reports.

For walkouts and statements, if the check number is longer than 14 characters, an ellipsis (...) and the last 11 characters will be displayed.

For family and patient ledger reports, if the check number is longer than 13 characters, an ellipsis (...) and the last 10 characters are displayed.

Due to space limitations, the following reports, although they do list insurance payments, do not show payment check numbers: Day Sheet (Charges and Receipts), Payment Summary, Suspended Credits Report, and Receipts Day Sheet.

Collect. Clinic - The clinic where the payment was collected. By default, the clinic that you are currently logged in to is entered automatically, but you can specify a different clinic. To change the collecting clinic, do the following:

Click the search button .

The Select Clinic dialog box appears.

Note: If your user account has been granted the "View All Patients" security right for the Central clinic, the ID and name of all clinics appear in the list; otherwise, the ID and name of each clinic for which your user account has been granted the "My Clinics, View" security right (in the "Practice/Clinic Setup" category) appear in the list; however, if your user account has not been granted that right to any clinic, only the ID and name of the clinic that you are currently logged in to appear in the list.

In the list, select the correct clinic.

Click OK.

Encounter #: If a certain global setting has been enabled, this option is available. To specify the encounter number, do one of the following:

Enter an encounter number (numeric or alphanumeric, depending on a certain global setting).

Select an encounter number (if the applicable global setting is enabled).

Note: Depending on a certain global setting, the number may have to be unique for each patient, for each day, or for each patient per day.

Under Pending Claims, to search for an insurance plan or a patient, do one of the following:

For a dental insurance plan, do the following:

Click the Insurance Carrier Name search button .

The Select Dental Insurance Plan dialog box appears.

To search for plans that have particular insurance tags, do the following:

Under Insurance Tag Selection, click the search button .

The Insurance Tag Selection dialog box appears.

Note: If the upper list is long, to filter it by name, click Search, enter all or the first part of a tag name, and then click Show Results to view the matches.

In the upper list, select the desired tags.

Note: To select multiple tags, click a tag, and then, while pressing the Ctrl key, click the other desired tags. To select a range of adjacent tags, click the first tag of the desired range of tags, and then, while pressing the Shift key, click the last tag of the desired range of tags.

Click Add.

The selected tags now appear in the lower list.

Note: To remove a tag from the lower list, select it, and then click Remove.

Click OK.

Note: To clear all the selected insurance tags at one time, click Clear Selection.

Under Search By, select one of the following options:

Carrier Name to search by carrier name.

Employer to search by employer name.

Note: This option is available only if an employer has already been assigned to the current patient.

Group Plan to search by group plan name.

Group Number to search by group plan number.

In the In the Enter Carrier Name, Enter Employer Name, Enter Group Plan Name, or Enter Group Number box (the name varies according to the selected Search By option), enter all or part of a carrier name, employer name, group plan name, or group plan number, respectively.

Click the search button .

The matching insurance plans appear in the list.

Do one of the following:

Double-click the correct plan.

Select the correct plan, and then click OK.

For a medical insurance plan, do the following:

Click the Insurance Carrier Name search button .

The Select Medical Insurance Plan dialog box appears.

To search for plans that have particular insurance tags, do the following:

Under Insurance Tag Selection, click the search button .

The Insurance Tag Selection dialog box appears.

Note: If the upper list is long, to filter it by name, click Search, enter all or the first part of a tag name, and then click Show Results to view the matches.

In the upper list, select the desired tags.

Click Add.

The selected tags now appear in the lower list.

Note: To remove a tag from the lower list, select it, and then click Remove.

Click OK.

Note: To clear all the selected insurance tags at one time, click Clear Selection.

Under Search By, select one of the following options: Carrier Name to search by carrier name, Employer to search by employer name, Group Plan to search by group plan name, or Group Number to search by group plan number.

In the Enter [Carrier Name/Employer Name/Group Plan Name/Group Number] box (the name varies according to the selected Search By option), enter all or part of a carrier name, employer name, group plan name, or group plan number (depending on the selected Search By option).

Click the search button .

The matching insurance plans appear in the list.

Do one of the following:

Double-click the correct plan.

Select the correct plan, and then click OK.

For a patient, do the following:

Click the Select Patient search button .

The Select Patient dialog box appears.

In the Enter Last Name box, enter the last name of a patient.

Note: For information about all the search options that are available in the Select Patient dialog box, refer to the topic about selecting a patient.

Do one of the following:

Double-click the correct patient in the list of results.

Select the correct patient in the list of results, and then click OK.

A list of all outstanding insurance claims for specified plan or patient appears.

In the list under Pending Claims, select a claim.

Note: You can also perform any of the following tasks as needed:

To split a claim into two claims in order to post a partial insurance payment, with the claim selected, click Split Prim Claim.

To view a claim, edit claim information, or enter a dental or medical insurance payment, with the claim selected, click Edit Claim.

For the claim selected in step 6, under Enter Payment, perform any of the following tasks as needed:

To manually enter the credit adjustment for the claim, do the following:

Select the first procedure, click the box in the Cr Adj column and then click it again to allow editing of the amount, enter the correct amount, and then click the check mark (or press Enter).

The next procedure down is selected, and the next box down in the Cr Adj column is active to allow editing of the amount.

Continue entering the correct amount and clicking the check mark (or pressing Enter) for each procedure in succession until you have entered an amount for all applicable procedures.

The total amount of the credit adjustment appears in the Adj Amount box under Credit Adjustment (which is below the procedure list).

Under Credit Adjustment , set up the following options for the credit adjustment:

Adj Date - The date of the credit adjustment. By default, today's date is entered, but you can specify a different date. To change the date, do one of the following:

To enter the correct month, day, and/or year in the box (which uses a mm/dd/yyyy format), do any of the following as needed:

To change the month, click the first date segment to select the number, and then enter the number (from 1-12) of the correct month.

To change the day, click the second date segment to select the number, and then enter the correct day of the month.

To change the year, click the third date segment to select the number, and then enter the correct 4-digit year.

To use a date selector to select the correct date, click the downward-pointing arrow to view a calendar, navigate to the correct year and month, and then click the correct day.

Click the downward-pointing arrow to view a month calendar.

Navigate to the correct month using the left and right arrows.

Note: To quickly change the year and month, click the month-year at the top of the calendar, navigate to the correct year using the left and right arrows, and then click the correct month.

Click the correct day.

Adj Type - The type of credit adjustment (such as a professional discount or write-off). By default, the selection is determined by the setting in the Set Automatic Credit Allocation Options dialog box, but you can select a different credit adjustment type from the list.

Note - Details regarding or the reason for the credit adjustment. To enter a note, do one of the following:

Enter text in the box.

Click the search button to open the Adjustment Note dialog box, enter text, and then click OK.

Note: The credit adjustment is attached to the claim, has the claim ID associated with it, and is viewable from the insurance claim window.

To calculate the credit adjustment for the claim, do the following:

Under Credit Adjustment (which is below the procedure list), click Calculate.

For each procedure in the list with a positive amount in the Balance column, that balance is used to populate the amount in the Cr Adj column. The total amount of the credit adjustment appears in the Adj Amount box (next to the Calculate button).

Set up the following options for the credit adjustment:

Adj Date - The date of the credit adjustment. By default, today's date is entered, but you can specify a different date. To change the date, do one of the following:

To enter the correct month, day, and/or year in the box (which uses a mm/dd/yyyy format), do any of the following as needed:

To change the month, click the first date segment to select the number, and then enter the number (from 1-12) of the correct month.

To change the day, click the second date segment to select the number, and then enter the correct day of the month.

To change the year, click the third date segment to select the number, and then enter the correct 4-digit year.

To use a date selector to select the correct date, click the downward-pointing arrow to view a calendar, navigate to the correct year and month, and then click the correct day.

Click the downward-pointing arrow to view a month calendar.

Navigate to the correct month using the left and right arrows.

Note: To quickly change the year and month, click the month-year at the top of the calendar, navigate to the correct year using the left and right arrows, and then click the correct month.

Click the correct day.

Note - Details regarding or the reason for the credit adjustment. To enter a note, do one of the following:

Enter text in the box.

Click the search button to open the Adjustment Note dialog box, enter text, and then click OK.

Note: The credit adjustment is attached to the claim, has the claim ID associated with it, and is viewable from the insurance claim window.

To change the amount insurance is supposed to pay for each procedure (the actual insurance portion, not the estimated insurance portion), do the following:

Select the first procedure, click the box in the Ins Amt column and then click it again to allow editing of the amount, enter the correct amount, and then click the check mark (or press Enter).

The next procedure down is selected, and the next box down in the Ins Amt column is active to allow editing of the amount.

Continue entering the correct amount and clicking the check mark (or pressing Enter) for each procedure in succession until you have entered an amount for all applicable procedures.

To change the amount of the payment that is to be applied to each procedure, do the following:

Select the first procedure, click the box in the Applied column and then click it again to allow editing of the amount, enter the correct amount, and then click the check mark (or press Enter).

The next procedure down is selected, and the next box down in the Applied column is active to allow editing of the amount.

Continue entering the correct amount and clicking the check mark (or pressing Enter) for each procedure in succession until you have applied an amount to all applicable procedures.

To enter the amount of the deductible that is to be applied to each procedure, do the following:

Select the first procedure, click the box in the Deduct column and then click it again to allow editing of the amount, enter the correct amount, and then click the check mark (or press Enter).

The next procedure down is selected, and the next box down in the Deduct column is active to allow editing of the amount.

Continue entering the correct amount and clicking the check mark (or pressing Enter) for each procedure in succession until you have applied an amount to all applicable procedures.

To update the payment table for a procedure (only if a deductible is not being applied and if the maximum benefit has not been exceeded), in the Pmt Table column, select the Update checkbox.

To add one or more charge adjustments for the claim, under Charge Adjustment, do the following:

Set up the following options for the charge adjustment:

Adj Date - The date of the charge adjustment. By default, today's date is entered, but you can specify a different date. To change the date, do one of the following:

To enter the correct month, day, and/or year in the box (which uses a mm/dd/yyyy format), do any of the following as needed:

To change the month, click the first date segment to select the number, and then enter the number (from 1-12) of the correct month.

To change the day, click the second date segment to select the number, and then enter the correct day of the month.

To change the year, click the third date segment to select the number, and then enter the correct 4-digit year.

To use a date selector to select the correct date, click the downward-pointing arrow to view a calendar, navigate to the correct year and month, and then click the correct day.

Click the downward-pointing arrow to view a month calendar.

Navigate to the correct month using the left and right arrows.

Note: To quickly change the year and month, click the month-year at the top of the calendar, navigate to the correct year using the left and right arrows, and then click the correct month.

Click the correct day.

Adj Amount - The dollar amount of the charge adjustment.

Adj Type - The type of charge adjustment (such as a debit adjustment or patient refund).

Provider - The provider to associate with the charge adjustment. By default, the patient's preferred provider (Prov1 in Family File) is selected automatically, but you can specify a different provider. To change the provider, do the following:

Click the search button .

The Select Provider dialog box appears.

Either leave the ID and Last Name boxes empty to get a list of all providers, or enter all or part of a provider's ID or last name in the ID or Last Name box, respectively, to search for a provider.

Under Search By, select one of the following options: This Clinic, to search for the provider in the clinic that you are currently logged in to; All Clinics, to search for the provider in all clinics; or My Clinics, to search for the provider in the clinics to which you have been granted the "My Clinics, Select Provider " security right.

Notes:

The All Clinics option is available only if your user account has been granted the "View All Providers" security right for the Central clinic and if your user account has not been granted the "My Clinics, Select Provider" security right for the clinic that you are currently logged in to.

The My Clinics option is available only if your user account has been granted the "My Clinics, Select Provider" security right for at least one clinic and if your user account has not been granted the "View All Providers" security right for the Central clinic.

Either select the All Providers option to include providers who are associated with clinics (and who have a Log On User ID), or select the In ApptBook option to include providers who have been set up in Appointment Book.

Click the search button .

The matching primary and secondary providers appear in the list.

Select the correct provider.

Click OK.

Note - Details regarding or the reason for the charge adjustment. To enter a note, do one of the following:

Enter text in the box.

Click the search button to open the Adjustment Note dialog box, enter text, and then click OK.

Click Add.

Repeat steps a-b as needed to add other charge adjustments for the claim.

Note: The credit adjustments are attached to the claim, have the claim ID associated with them, and are viewable from the insurance claim window.

To edit a charge adjustment for the claim, under Charge Adjustment, do the following:

Select a charge adjustment in the list (the Date and Charge for each adjustment in the list appear for your reference).

Below the list, click Edit to populate the boxes to the left of the list with the details of the selected charge adjustment.

Change any of the following options for the selected charge adjustment as needed:

Adj Date - The date of the charge adjustment. To change the date, do one of the following:

To enter the correct month, day, and/or year in the box (which uses a mm/dd/yyyy format), do any of the following as needed:

To change the month, click the first date segment to select the number, and then enter the number (from 1-12) of the correct month.

To change the day, click the second date segment to select the number, and then enter the correct day of the month.

To change the year, click the third date segment to select the number, and then enter the correct 4-digit year.

To use a date selector to select the correct date, click the downward-pointing arrow to view a calendar, navigate to the correct year and month, and then click the correct day.

Click the downward-pointing arrow to view a month calendar.

Navigate to the correct month using the left and right arrows.

Note: To quickly change the year and month, click the month-year at the top of the calendar, navigate to the correct year using the left and right arrows, and then click the correct month.

Click the correct day.

Adj Amount - The dollar amount of the charge adjustment.

Adj Type - The type of charge adjustment (such as a debit adjustment or patient refund).

Provider - The provider that is associated with the charge adjustment. To change the provider, do the following:

Click the search button .

The Select Provider dialog box appears.

Either leave the ID and Last Name boxes empty to get a list of all providers, or enter all or part of a provider's ID or last name in the ID or Last Name box, respectively, to search for a provider.

Under Search By, select one of the following options:

This Clinic - To search for the provider in the clinic that you are currently logged in to.

All Clinics - To search for the provider in all clinics.

Note: This option is available only if your user account has been granted the "View All Providers" security right for the Central clinic and if your user account has not been granted the "My Clinics, Select Provider" security right for the clinic that you are currently logged in to.

My Clinics - To search for the provider in the clinics for which your user account has been granted the "My Clinics, Select Provider " security right.

Note: This option is available only if your user account has been granted the "My Clinics, Select Provider" security right for at least one clinic and if your user account has not been granted the "View All Providers" security right for the Central clinic.

Click the search button .

The matching primary and secondary providers appear in the list.

Select the correct provider.

Click OK.

Note - Details regarding or the reason for the charge adjustment. To enter a note, do one of the following:

Enter text in the box.

Click the search button to open the Adjustment Note dialog box, enter text, and then click OK.

Click OK. (The label of the Add button changed to OK when you selected the charge adjustment to edit it.)

To delete a charge adjustment for the claim, under Charge Adjustment, do the following:

Select a charge adjustment in the list (the Date and Charge for each adjustment in the list appear for your reference).

Click Delete. The adjustment is deleted without asking for confirmation.

To modify the deductibles that are being applied for the claim, under Deductible Applied for Claim, change the values in the Standard, Preventive, and/or Other boxes as needed.

If you have set up automatic adjustments for the insurance plan but do not want to post those adjustments, under Auto Adjs From Ins Plan Will Be Posted, select the Do Not Post Auto Adjustments checkbox. With this checkbox selected, only adjustments on the ERA will be posted automatically as applicable, according to the setting in the Set Automatic Credit Allocation Options dialog box.

To enter details regarding the insurance payment, do one of the following:

Enter text in the box.

Click the search button to open the Insurance Payment Note dialog box, enter text, and then click OK.

Note: The note is attached to the insurance payment, which is viewable in Ledger.

Click Post Claim.

Note: If you attempt to select another claim under Pending Claims, attempt to close the Batch Insurance Payment Entry dialog box, or click Next Check, after having made any changes to the amounts (such as Cr Adj and Applied) for any procedure under Enter Payment without clicking Post Claim, a message appears. To post the claim with the changes before switching to the other claim, closing the dialog box, or clearing the dialog box for the next check, click Post the Claim and Continue; to discard the changes for the claim and continue, click Continue without Posting; or to keep the changes and return to the dialog box with the claim still selected, click Cancel.

If the Balance for any procedure in the list under Enter Payment has a negative amount, the Procedures Overapplied on Insurance Payment dialog box appears; otherwise skip to step 10.

Do the following to resolve the undercharges/overpayments (or if you want to skip this step, click OK):

Clear the Automated Resolution checkbox.

For a procedure, select an option from the Action To Perform list:

Add Charge Adj to Claim and Apply Remaining - This option adds a charge adjustment to the claim and applies it to the remaining balance (up to the maximum allowed charge for the procedure).

Suspend Credit for Refund or Credit to Patient - This option adds offsetting adjustments to the claim to remove the balance, and posts a suspended credit to the patient’s Ledger for a refund or credit.

Allocate to Procedure with Remaining Balance - This option allows you to allocate the remaining amount to other procedures on the claim with a remaining balance. After you click Process, the Select Procedure dialog box appears. Select a procedure, and then click OK.

Allocate to Existing Charge Adjustment on Claim - This options allows you to allocate the remaining amount to any charge adjustments that were added to the claim previously (charges that appeared under Charge Adjustment in the Batch Insurance Payment Entry dialog box prior to opening the Procedures Undercharged or Overpaid dialog box). After you click Process, the Select Charge Adjustment on Claim dialog box appears. Select a charge adjustment, and then click OK.

Reduce Guarantor Credit Amt and Apply to Proc - This option applies the guarantor credit to the remaining balance without using an adjustment.

Click Process to perform the selected action.

If the Adj Type/Balance box is empty or has the incorrect adjustment type, to select the correct adjustment type, double-click the box, select an adjustment type, and then click OK.

To change the value in the Amount box, double-click the box; enter the correct amount; and then either click the check mark , or press Enter.

To change the selection in the Apply To box, select either Ins Payment or Credit Adj from the list to specify where to apply the Amount:

If the amount is being applied to the insurance payment, it reduces the Ins Pmt Applied and Amt Overapplied (this Proc) amounts and increases the Applied (Other) payment amount. If the amount that is being applied is from a guarantor credit, it also reduces the Guar Credit amount.

If the amount is being applied to the credit adjustment, it reduces the Credit Adj Applied and Amt Overapplied (this Proc) amounts and increases the Applied (Other) credit amount. If the amount that is being applied is from a guarantor credit, it also reduces the Guar Credit amount.

To view or edit the default text in the Note box, click the link, make any changes, and then click OK.

Repeat steps b-g as needed until the undercharge/overpayment for that procedure is resolved (RESOLVED! appears to the right of the Action To Perform list).

Repeat steps b-h as needed to resolve the undercharges/overpayments for other procedures.

Click OK.

If any procedures still have a negative balance when you click OK, a dialog box appears so that you can specify how you want to handle the undercharges/overpayments.

Repeat steps 6-9 as needed to enter insurance payments for other claims for the selected plan or patient.

Repeat steps 5-10 as needed to enter insurance payments for other claims for other plans and/or patients.

Notes:

If you attempt to close the Batch Insurance Payment Entry dialog box before you have finished posting claims for the insurance payment, a message appears. To save the batch entry session so that you can resume it later, click Yes, enter a Pending Session Name to help you identify the session later, and then click OK.

If you attempt to close the Batch Insurance Payment Entry dialog box, or click Next Check, while the Amount under Insurance Payment differs from the Paid Amt Posted under Posted Claims, a message appears. To return to the batch entry session so that you can reconcile the difference, click Cancel; to exit the batch entry session because you will return later to reconcile the difference, click Yes; or to exit the batch entry session and either complete or not complete the payment, click No. If you click No, on the next message that appears, select either No (if you will reconcile the payment later) or Yes (if you are done with the payment), and then click OK.

Any claims posted as explained in steps 4-11 appear in the list under Posted Claims. To edit the details of a claim, select the claim, and then click Edit Claim.

If you end the batch entry session before all claims for the check or EFT are posted, all payments posted prior to the closing of the Batch Insurance Payment Entry dialog box remain posted to the individual accounts.

To post insurance payments from another check or EFT, click Next Check, and then repeat steps 3-11.

Note: Insurance payments appear in the patients' ledgers, and the statuses of the insurance claims change to Received.