Tips from Our New Insurance Workshop

New this fall! Our Insurance Billing & Collections Workshop is designed to give you an in-depth understanding of all the insurance claim tools and processes in Dentrix so you can correctly bill insurance and collect more quickly and easily. Here is a sneak peek into the Receiving Insurance Claims section of the workshop.

Splitting primary insurance claims

When you receive payment for some but not all of the procedures in an insurance claim, you can either split the claim or post multiple payments to it. Splitting the claim can make tracking the unpaid procedures easier by moving them into a new, separate claim. Now you can track the unpaid procedures using all the regular reports and options available for any unpaid claim.

TIP: Once any payment (even a partial one) has been posted to a claim, the claim is labeled “Received” and is no longer included in the pending insurance estimates for outstanding claims.

In the example below, the insurance carrier has paid on the exam and cleaning, but is requesting more information about the four-surface restoration you performed on tooth 6. You can split the claim in order to post the payment to the exam and cleaning and create a separate, unpaid claim for just tooth 6.

To split a claim:

  1. With a patient selected in the Ledger, from the transaction log, select the primary insurance claim that you want to split.
  2. From the Insurance menu, click Split Primary Claim. The Split Claim dialog box will appear.

    Screen Shot 1
  3. Under Claim #1, select the procedure that you want to move to the new claim. Click the Down Arrow button. Dentrix moves the selected procedure to the Claim #2 area.

    Screen Shot 1
  4. Click OK to exit. Two claims with the same date appear in the Ledger. You can now post the payment for the claim with the exam and cleaning.

TIP: You cannot split a claim if any of the following is true:

  • A payment has already been posted.
  • The claim is a secondary claim.
  • The claim is in history.
  • The claim is a primary claim with a secondary claim already created.
  • The claim is a pre-treatment authorization.

Author: Patty Reay
Published: 07/25/2012
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