when plan requires that secondary claims are mailed with a copy of the primary EOB).
Don't Send Claims Electronically: Do not allow sending e-claims for this plan (e.g.Send Claims Electronically: Allow sending e-claims for this plan.Defaults to the setting for the carrier (see Carriers) but can be changed by insurance plan. Send Electronically: Determines whether e-claims can be sent electronically for this insurance plan. Select a don't send electronically option for Send Electronically (see below).If the clearinghouse cannot match the insurance carrier name with a known name, the claim will be printed by the clearinghouse and mailed. Leave the ID blank and submit the claims electronically anyway.If the carrier does not accept electronic claims, you have two choices. Enter the ID manually or click Search ID to search the Payor ID list. Also, if another user has a plan open with the same carrier, and carrier information is edited by a user with the Insurance Plan Edit permission, a new carrier is created.Įlectronic ID/Payer ID: Provided by the insurance company if they accept E-Claims. Note: If you have the Insurance Plan Edit permission and change information in any carrier field, a new carrier is created. If you manually enter carrier information that doesn't exactly match an existing carrier, or if you change carrier information, a new entry is automatically added in the insurance carrier list. Click to pick an existing carrier from the Carriers list or enter carrier information manually. Will also be added to the Employers.Ĭarrier: Required. Only visible if Medical Insurance is turned on.Įmployer: Optional. Medical Insurance: Check this box if this is Medical Insurance rather than dental. Insurance Plan ID: A system generated unique identifier that is useful for third party reporting and to filter the Insurance Plan List. Alternately, drop the insurance plan before picking a new plan. Requires the Change existing Ins Plan using Pick List security permission. Pick From List: Select an existing insurance plan from the Insurance Plans list. This audit trail is accessible to all users. This information is specific to the insurance plan and can only be edited by users with the Insurance Plan Edit security permission.Īudit Trail: View changes made to the insurance carrier, insurance plan, benefits, or employer. Plan Info Tab (Insurance Plan Information) The amount automatically clears when a new benefit year begins. Click Add to adjust benefits for amounts used so far. if the patient had treatment done at another office, or if you have just had a data conversion). Defaults to a date based on the last auto-created claim and the frequency (Auto Proc Period).Īdjustments to Insurance Benefits: Enter any benefit amounts that have already been used this year (e.g. Next Claim Date: The date the next claim will be created using the Auto Ortho Tool.To override it for the next claim only, uncheck Use Default Fee, then enter the new fee. Fee: Defaults to the fee set on the Ortho Tab.Ortho: View patient-specific information about the next time an orthodontic claim will be automatically generated when using Ortho Auto Claims. This is useful when tracking insurance frequencies. Hist: View history for procedures completed outside of the office. If you don't even know the insurance company name, create a dummy carrier called Pending, check the Pending box, then come back later and fix it. Identifies insurance information that is incomplete or unverified.
#Open dental insurance verification
The number can be changed at any time.Įligibility Last Verified: The date that patient insurance eligibility was marked verified (manually or using the Insurance Verification List). Order: Determines the order this plan will show in the Family module (primary, secondary, or supplemental insurance). Patient Plan ID: A system generated unique identifier that is useful for third party reporting. Dropping an insurance plan does not delete the plan it will still appear in the Insurance Plans for Family window. If you plan to send e-claims in 5010 format, you may need to drop patients from their family's plan and recreate them with subscriber as self, using the patient ID instead of the subscriber ID.ĭrop: Remove a plan when a patient changes carriers or no longer has insurance coverage. Note: In 2012, most carriers switched to each patient being their own subscriber with a subscriber ID.
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