You can set up the claim form options for an insurance plan that uses the DX2012 or DX2019 claim format from the practice definitions.
Note: You can also save a default set of DX2012 or DX2019 claim form options that will be applied automatically to any new insurance plan that uses that claim format.
To set up dental claim form options for dental insurance plans
When you are adding a dental insurance plan or updating a dental insurance plan, in the Dental Insurance Plan Information dialog box, make sure that DX2012 or DX2019 is selected as the Claim Format, and then click Claim Setup.
Note: This button is available only if DX2012 or DX2019 is the selected Claim Format.
The Claim Setup dialog box appears.
Set up any of the following options as needed:
Formatting Options:
Font Size - The font size to use on the entire claim. From the list, either select a font size, or select Default.
Date Format - The format to use for dates on the entire claim. From the list, select MM/DD/YYYY or MM/DD/YY.
All Capital Letters - With this checkbox selected, all the letters of each word on the entire claim will be capitalized. With this checkbox clear, only the initial letter of each word on the entire claim will be capitalized, clear this checkbox.
No Special Characters - Generally speaking, a special character is any character that is not an uppercase or a lowercase letter or a number. With this checkbox selected, spaces appear in place of special characters, and unaccented letters appear in place of accented variants of letters (such as those for "a" and "n") on the entire claim. With this checkbox clear, special characters and accented variants of letters (such as those for "a" and "n") may appear on the entre claim.
Provider and Fee Options - The fee schedule to use for procedures on the entire claim. From the Fee Schedule list, select one of the following options:
Billing Provider - To use the fee schedule that is assigned to the billing provider.
Insurance - To use the fee schedule that is assigned to the insurance plan.
Default - To use the fee schedule that is assigned to the subscriber; or if one is not assigned to the subscriber, the fee schedule that is assigned to the billing provider; or if one is not assigned to the billing provider, the fee schedule that is assigned to the insurance plan.
Provider Addresses:
Billing Provider - The address to use for the billing provider on claims. From the list, select one of the following options: Billing Provider Address, Rendering Provider Address, Rendering Clinic Address, or Central Clinic Address.
Rendering Provider - The address to use for the rendering provider on claims. From the list, select one of the following options: Billing Provider Address, Rendering Provider Address, Rendering Clinic Address, or Central Clinic Address.
Advanced Settings:
Set Procedure Code Order - To set the order for specific procedures on DX2012 or DX2019 claim forms to align with payor requirements, click Set Procedure Code Order. The Set Procedure Code Order dialog box appears. Add, reorder, and delete procedures as needed, and then click OK.
Do any of the following as needed:
To add procedures, do the following:
Click the Add button 
.
The ADA Code Selection dialog box appears.
To search for procedure codes, do the following:
Click Search.
The options for searching appear.
Enter the first character or more of a procedure code category, abbreviated description, ADA code, and/or ADA description in the Category, User Code, ADA Code, and/or Description boxes, respectively.
Click Show Results to view a list of matching procedure codes.
Note: To return to viewing the list of all the procedure codes, click Search, click Clear Search to clear the search criteria that you entered, and then click Show Results.
In the upper list, select one or more procedure codes.
Note: To select multiple procedure codes, click a procedure code, and then, while pressing the Ctrl key, click the other desired procedure codes. To select a range of adjacent procedure codes, click the first procedure code of the desired range of procedure codes, and then, while pressing the Shift key, click the last procedure code of the desired range of procedure codes.
Click Add.
Repeat steps b-d as needed to add other procedure codes.
Note: To remove a procedure code that you added, select that procedure code in the lower list, and then click Remove.
Click OK.
To move a procedure up or down in the list, select that procedure, and then click the Up button 
or Down button 
as needed until the procedure is in the correct position. When you create a claim that includes any combination of these procedures posted in any order, those procedures will appear on the printed claim (or will be transmitted on the electronic claim) according to the specified order.
Important: Rate codes must appear on claims first.
To remove a procedure from the list, select that procedure, and then click Delete.
To remove all the procedures from the list, click Delete All.
Use Patient's SSN for ID Number in 8, 15 - With this checkbox selected, the patient's Social Security Number appears in boxes 8 and 15 on the claim. With this checkbox clear, the subscriber's ID number appears in boxes 8 and 15 on the claim.
Print Completion Date in Remarks in 35 - With this checkbox selected, the completion date of the procedures on the claim appear in box 35. With this checkbox clear the completion date of the procedures on the claim do not appear in box 35.
Print Primary Payment in "Other Fee" in 31a - With this checkbox selected, the payment that was received for the primary insurance claim appears in box 31a on the secondary claim. With this checkbox, the payment that was received for the primary insurance claim does not appear in box 31a on the secondary claim.
Use SSN for Chart Number in 23 - With this checkbox selected, the patient's Social Security Number appears in box 23 on the claim. With this checkbox clear, the patient's chart number appears in box 23 on the claim.
No Arch, Sextant or Quad in 27 - With this checkbox selected, box 27 for procedures on the claim can include tooth numbers and/or letters but cannot include letters for arches, sextants, and quadrants. With this checkbox clear, box 27 for procedures on the claim can include tooth numbers and/or letters and can include letters for arches, sextants, and quadrants.
Print Primary Payment in Remarks in 35 - With this checkbox selected, the payment that was received for the primary insurance claim appears in box 35 on the secondary claim. With this checkbox, the payment that was received for the primary insurance claim does not appear in box 35 on the secondary claim.
Print 'No' for claims without Assignment of Benefits in 37 - With this checkbox selected, the word "No" appears in box 37 if direct payments to the dentist or office are not authorized by the subscriber. With this checkbox clear, nothing appears in box 37 if direct payments to the dentist or office are not authorized by the subscriber.
Use Pre-Printed Form - With this checkbox selected, you must use a pre-printed claim form (a piece of paper that has all necessary lines, boxes, labels, and explanatory text already on it) to print the claim details on. With this checkbox clear, you can print the claim form and details on a blank piece of paper.
To copy the current settings to other plans, do the following:
Click Copy Settings.
The Copy Settings dialog box appears.
The plans that are using the same Claim Format that is currently selected for this plan appear in the list.
To list all insurance plans instead of only the plans that are using the same Claim Format that is currently selected for this plan, select the Show All Insurance Plans (without using Claim Format as filter) checkbox.
Note: If you copy the claim settings to a plan that does not have the same Claim Format as this plan, the Claim Format for the other plan is changed to the format that is currently selected for this plan.
To filter the list, enter all or part of the name of a carrier in the Filter box, and then press Enter.
The matching insurance plans appear in the list.
In the list, select one or more insurance plans.
Note: To select multiple plans, click a plan, and then, while pressing the Ctrl key, click the other desired plans. To select a range of adjacent plans, click the first plan of the desired range of plans, and then, while pressing the Shift key, click the last plan of the desired range of plans.
Click Copy Settings.
On the message that appears after the copying is complete, click OK.
You are returned to the Claims Setup dialog box.
Click OK.
You are returned to the Dental Insurance Plan Information dialog box.