Understanding Insurance Processing

There are three types of procedure types to use when processing insurance:

Dental-onlyDental-onlyBillable only to dental insurance.
Medical-onlyMedical-onlyBillable only to medical insurance.
Cross-codedCross-codedBillable to both dental and medical insurance, either an ADA code or a CPT code. These are billed first to medical insurance, and upon payment or denial, then automatically billed to dental. This default can be changed in the Bill Order field.

Procedures can be billed in the following ways:

To dental only
To medical only
To medical and then to dental
To dental and then to medical
To patient only

If a dental-only procedure is posted to a patient who only has medical insurance, only the patient is billed.

For each claim, up to eight insurance forms can be printed, showing the following:

Primary and secondary dental and medical coverage
Procedures that are strictly dental or medical
Procedures that are billed first to dental and then to medical
Procedures that are billed first to medical and then to dental

The remaining four forms are secondary forms to each of the primary forms, and are automatically generated upon receipt of payment by the primary insurance. They are submitted with the primary EOB attached.