Submitting and Tracking Claims

Submitting Dental and Medical Claims

If a patient is covered by both dental and medical insurance, you can submit procedures to both insurance carriers, provided you post ADA codes that are linked to CPT medical codes.
 

Example:ADA code 130 (emergency exam) might be linked to CPT code 99283 (emergency exam).

When you submit the claim, the software creates a dental and a medical claim and submits them in the order you specify.

If you are submitting medical claims, see Medical Cross-Coding.

To submit dental and medical claims:

1. After posting a linked ADA code in the patient’s Transactions window, click Submit Ins on the toolbar. If Ask to process or Automatically process is selected in the General System Settings window, a window prompting you to submit insurance, schedule an appointment, and print a walkout statement is displayed.

A message prompts you for the range of transaction dates to print on the claim. The first date defaults to the service date of the oldest procedure that has not been submitted, and the second date defaults to the most current date of unsubmitted transactions.

2. Click OK. A message is displayed that informs you that a linked claim is being processed.

3. Click OK. The Order of Submission For Linked Claims window is displayed. By default, the primary dental claim is submitted first and the primary medical claim second. You can change the order of submission.

When you post the insurance payment or denial to the dental claim, you are prompted to submit the claim to medical insurance, if the claim was not paid in full.

4. Click OK. The Claim window is displayed for the linked claim.

5. Verify that the information is correct and click OK. The First Sent field is not updated and the secondary insurance claims are not processed until you print the claim or submit it electronically.

6. When you post an insurance check payment for primary insurance to the patient’s Transactions window, a message that asks if this is the final payment is displayed.

7. Make sure you associate the payment with the claim number when posting, and click Yes. A message prompts you to submit the claim to secondary (medical) insurance.

8. Click Yes. A message asks you whether to update the insurance bluebook. When you post a check payment from the secondary insurance plan to the patient’s Transactions window, a message is displayed that asks if this is the final secondary insurance payment.

9. Click Yes. A message asks you whether to delete the claim.

10. To delete the claim, click Yes.