Performing Insurance Functions > Processing Individual Claims
The Insurance feature enables you to automate your office’s repeat insurance claims, commonly known as Continuation of Treatment claims. You can generate and print insurance Continuation of Treatment claim forms for patients whose insurance companies require them. More...More...
Before you can generate Continuation of Treatment claims, you must set up a claim for each patient requiring Continuation of Treatment claims.
To create a Continuation of Treatment claim:
From the patient chart or a Financial Functions window, click the Claims button. The Claims window is displayed.
Select an optionoption.
Click Add. If there is more than one policy holder for this patient, the Policy Holders window is displayed. Select a policy holder and click OK. If the policy holder has more than one carrier, the Insurance Plans window is displayed. Select the carrier and click OK. The Add New Claim window is displayed. Select AAO Cont of Tx. The Adding Claim Form window is displayed.
Select the existing Actual claim and click Copy. The Copy New Claim window is displayed. Select AAO Cont of Tx. The original claim information is copied to the new claim; therefore, you must delete the Description of Services information. Select the new claim and click Change. The Editing Claim Form window is displayed. In the Description of Services section, select a line and click Delete Line to remove each entry.
Select the Actual claim and click Change. The Actual claim is displayed. To the right of the Cancel button at the bottom of the window, the type of claim is displayed. Click on the word Actual, and the claim type changes to Cont of Tx.
This method of creating the Continuation of Treatment claim deletes the Actual claim, so it is not usually recommended.
After using one of the above methods, the Adding Claim Form or Editing Claim Form window is displayed.
Scroll to the lower half of the form. Complete the information in the following fieldsfollowing fields, as applicable:
Date Appl. Placed — This field is automatically populated with the start date from the Patient Information window, if the date was entered there.
First Visit Date — Type the date of the first visit. If you copied the Continuation of Treatment claim from the Actual claim, this field is already populated.
Months Tx. Remaining — Type the number of months of treatment remaining. If you copied the Continuation of Treatment claim from the Actual claim, this field is already populated.
Description of Services — Leave this field blank, or delete the information in this section if you copied the Continuation of Treatment claim from the Actual claim. When you generate Continuation of Treatment claims each month, the software automatically adds the Description of Services information you set up on the Insurance Claim Options window.
Click History. The Claim History window is displayed.
Complete the information in the following fieldsfollowing fields.
Last Cont of Tx. — Type the last Continuation of Treatment date.
If this is a new claim,
type the patient's start date.
Press Tab. The software automatically
populates the Next Cont of Tx. field, depending on the frequency
for filing. Press Tab.
Monthly Charge — Type the amount charged per month.
Always enter the monthly amount, even if the frequency is quarterly.
Frequency — Defaults to the setting you entered in the Carrier Maintenance window for this insurance carrier. If None is displayed in the Frequency field, use the drop-down list to select a frequency, or tab to the field and use the arrows to select a frequency.
Click Close to close the Claim History window. Click OK to close the Adding Claim Form for <Name> window.