Creating primary dental insurance claims

You will 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. In Dentrix Enterprise, creating and sending a claim can be as simple as clicking one button. Create claims using the methods that fit into your office's workflow for handling claims.

Notes:

Also, you can create a batch of insurance claims from Office Manager.

Creating insurance claims requires the "Insurance Claims, Create New" security right.

Printing insurance claims directly from Ledger requires the "Batch Processor, Print/Display Reports" security right.

Viewing insurance claims requires the "Insurance Claims, Open" security right.

To create a primary dental insurance claim

With a patient selected in Ledger, do one of the following:

Create a claim for today's procedures. This option is the simplest way to create a claim. Use this method for creating a dental insurance claim that includes all the procedures that were posted today. Do one of the following:

Click the Ins. Today's Proc. button on the toolbar. The claim will be created and then batched or printed (according to the direct print option for insurance claims).

On the Insurance menu, click Today's Procedures. The claim will be created and then displayed, allowing you to edit information for the claim before it is sent. You need to edit the claim only if it requires special handling, such as adding a narrative or attaching X-rays.

On the Insurance menu, click Today's Procedures - Direct Print. The claim will be created and then printed.

On the Insurance menu, click Today's Procedures - Batch. The claim will be created and then batched.

Create a claim for specific procedures. Use this method for creating a dental insurance claim that includes specific procedures that were posted either today or on another date. Do the following:

Select the procedures for which you want to create a dental insurance claim.

Note: To select multiple procedures, click a procedure, and then, while pressing the Ctrl key, click the other desired procedures.

Do one of the following:

Click the Ins. Selected Proc. button on the toolbar. The claim will be created and then batched or printed (according to the direct print option for insurance claims).

On the Insurance menu, click Selected Procedures. The claim will be created and then displayed, allowing you to edit information for the claim before it is sent. You need to edit the claim only if it requires special handling, such as adding a narrative or attaching X-rays.

On the Insurance menu, click Selected Procedures - Direct Print. The claim will be created and then printed.

On the Insurance menu, click Selected Procedures - Batch. The claim will be created and then batched.

If applicable, do one of the following:

If the Password - Insurance Claims, Create New dialog box appears, user verification has been assigned to the "Insurance Claims, Create New" task. Do one of the following:

If your user account has been granted the "Insurance Claims, Create New" 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 "Insurance Claims, Create New" security right, have a user with permission temporarily override this restriction so you can create a claim 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 "Insurance Claims, Create New" security right. To have a user with permission temporarily override this restriction so you can create a claim this one time, do the following:

On the message, click Yes.

In the Password - Insurance Claims, Create New dialog box, the overriding user enters his or her credentials in the User ID and Password boxes and then clicks OK.

Dentrix Enterprise creates the claim.

Depending on which method you used to create the claim, do any of the following as applicable:

If you clicked the Ins. Today's Proc. button with the direct print option for insurance claims set to Print, or if you clicked Today's Procedures - Direct Print or Selected Procedures - Direct Print on the Insurance menu:

If the Password - Batch Processor, Print/Display Reports dialog box appears, user verification has been assigned to the "Batch Processor, Print/Display Reports" task. Do one of the following:

If your user account has been granted the "Batch Processor, Print/Display Reports" 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 "Batch Processor, Print/Display Reports" security right, have a user with permission temporarily override this restriction so you can print a claim 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 "Batch Processor, Print/Display Reports" security right. To have a user with permission temporarily override this restriction so you can print a claim this one time, do the following:

On the message, click Yes.

In the Password - Batch Processor, Print/Display Reports dialog box, the overriding user enters his or her credentials in the User ID and Password boxes and then clicks OK.

If you clicked Today's Procedures or Selected Procedures on the Insurance menu:

If the Password - Insurance Claims, Open dialog box appears, user verification has been assigned to the "Insurance Claims, Open" task. Do one of the following:

If your user account has been granted the "Insurance Claims, Open" 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 "Insurance Claims, Open" security right, have a user with permission temporarily override this restriction so you can view a claim 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 "Insurance Claims, Open" security right. To have a user with permission temporarily override this restriction so you can view a claim this one time, do the following:

On the message, click Yes.

In the Password - Insurance Claims, Open dialog box, the overriding user enters his or her credentials in the User ID and Password boxes and then clicks OK.

One of the following occurs:

Dentrix Enterprise sends the claim to the Batch Processor.

Dentrix Enterprise sends the claim to the default printer for Office Manager.

The Primary Dental Insurance Claim window appears.

Edit the claim.

Print or submit the claim.