Demanding Insurance (Dental)

We are assuming here that you have already gone through the "Enter a New Patient" tutorial. If you have not gone through the "Enter a New Patient" tutorial, please go through that tutorial before continuing on this one.

From the Main Menu (Physician) directory select number 3 Patient information (Enter, Change, Inquire). You can press the 3rd button with your mouse or enter the key combination ALT+3.

Next you will see a Lookup Patient Accounts screen that allows you to search for a patient using the account number (ID), last name, first name and social security number. For this tutorial enter '10001' in the text box labeled 'Lookup patient account ID' and press ENTER. You should see the patient appearing in the grid below. Click on the Patient in the grid then click on the 'Select' button to select this patient.

You are now in the Lookup Billing Accounts for this Patient screen. This lists all the billing accounts you have setup for the patient. You should see the: "DENTICAL" billing information appearing in the form's grid. Click on the "DENTICAL" billing information in the grid then click the 'Select' button. This takes you to the main Patient Account Information screen.

Let's demand an insurance for this patient. Press the '4 Demand Forms' button. You will get a menu with the following selections:

1 Demand Statements

2 Demand Insurance

3 Select Insurance

4 Eligibility

5 Select Reports

6 Label

7 Super bill

8 Custom

Click on "2 Demand Insurance". Now another menu will appear that shows the insurance currently setup for this patient. You should see the "DENTICAL" selection on this menu.

Click on the "DENTICAL" selection. Now the Patient Account Information screen will disappear and a screen will pop up with two fields: (the actual dates may vary)

These dates are used to determine which transaction that you want to appear on the insurance forms. Remember in the Charge Entry screen there was a date box next to the Procedure code field. This is the date of the transaction and will be used for demanding.

Lets start with an exercise; first click on the Beginning Date value and change the year to 2001. There are several ways you can change the year. First you must double click on the year so it's highlighted. Now you can:

Use the "Up" or "Down" arrow keys to increase or decrease the date.

Type in the year "2001"

Click on the little down arrow next to the year to get a calendar. To change the year at the top of the calendar click on it this will cause up and down arrows to appear that will allow you to adjust the year.

If you desire to change the month on the calendar you can click on it at the to and a menu will appear from which you can select the desired month.

After you have changed the year, click on the "Select these dates" button. This will create the insurance claims and bring you back to the Patient Account Information screen.

In the Patient Account Information screen, press the Escape key or click on the "Save and Exit" button to exit the screen. You should now be at the Main Menu (Physician).

You will noticed that you have more selections at the Main Menu (Physician). These new selections will be:

9 You have 1 file that has not been printed/processed

10 You have 2 audit files that have not been printed

Note: The "1 file" and the "2 audits" may change depending on how many audits and claims are created.

Click on " 9 You have 1 file that has not been printed/processed". A menu will appear with selections similar to:

M7D513.LST Demand Denti-Cal 1 Pages

Don't print/process any files

Click on the "M7D513.LST Demand Denti-Cal 1 Pages" selection. Another menu will appear with the following selections:

Print this file

View this file on the screen

Erase this file

Transmit this file

Note: You may not see the "Transmit this file" if you are not currently setup to send claims electronically.

Now click on the "Print this file" selection. The Main Menu (Physician) will disappear and the printing screen will appear. Click on the "Print" button to print the claims. Once the claims are printed you can click on the "Done" button to return back to the Main Menu (Physician) screen.

If the insurance form that gets printed is not lined up on the insurance or other claims form you can make adjustments by click on the Click here if the text on the form is not aligned. A screen will appear that will allow you to make adjustments.

Lets say the texts near the top of the insurance form need to moved .10 inch to the right and .15 inch down. You can click on the Right button until the number next to the right button shows .10. Now you can click on the Down button until the number next to the down button reaches .15. Once the adjusts are made you need to click on Apply. Then you need to click on Finish to go back to the print screen.

Once you are back at the print screen you can click on the print button again to see if the text is aligned correctly. Repeat the previous step if you need to make more adjustments.

NOTE: If the text on the top of the form is aligned correctly but the text on towards the button is still off, you need to make More or Less spacing. For example if the text towards the bottom of the form needs to be moved down, you can click on the More button once or twice. Click on Apply then Finish and print another copy of the form.

Another way to demand insurance claims.

Lets say you want to demand various "Denti-Cal" insurance claims for more than 1 patient. You might have noticed that it would be very tedious to go into each patient to demand multiple insurance claims. The software is setup so that it can demand all the "Denti-Cal" insurance claims for all the Denti-Cal patients This process will only create insurance claims with charges that haven't been previously demanded.

From the Main Menu (Physician) directory Select number 5 Insurance Claim Form Programs. You can press the 5th button with your mouse or press the key combination ALT+5.

You should then see the Insurance Directory menu.

As you might have notice there is a list of insurance types:

You can simply click on "2 DENTI_CAL FORM .." to demand all the Denti-Cal insurance claims. When you click on the "2 DENTI_CAL FORM .." a menu will appear with three selections:

Click on "1 Create claims" to demand all of the claims. To print the claims refer to selections 9 and 10 under the Main Menu (Physician). The new claims will be appended to the end of any old claims files if the old claim files are not deleted. This is only specific to the form type. For example, you have an old batch of DentiCal claims with patients 1,2, and 3 when you decide to demand more DentiCal(513) claims, say for patient 4,5,and 6 the result will be that the old batch of DentiCal claims will now contain patients 1,2,3,4,5,6.

This completes the how to demand insurance claims for a patient.