Learn how to split an insurance claim in the Ledger so you can process a partial payment.
It’s Monday morning, and you’re going through the weekend mail to start catching up on your insurance payments. As you start posting your first EOB in the Dentrix Ledger, you notice that the insurance carrier paid for the exam and bitewings, but they need an updated perio chart before they will submit payment for the perio maintenance cleaning. Which one of the following do you do?
A. Apply the partial payment, close out the claim, and then print an extra copy so that you have something to refer to because the original claim will not show up on your Insurance Aging Report.
B. Resubmit the entire claim with the perio chart and hold the partial payment until you receive payment on the perio maintenance, and then post both checks together.
C. Put it off until later and call Dentrix Customer Support.
D. Split the claim into two parts, apply the partial payment to the exam and bitewings, and leave the perio maintenance open so it will show up on your Insurance Aging Report.
The correct answer is . . . D. Dentrix makes it easy for you to split an insurance claim in the Ledger so you can process partial payments. If you don’t know how to split an insurance claim, I’ll show you.
Splitting an Insurance Claim
From the Ledger, highlight the claim that you want to split. From the Insurance menu, click Split Primary Claim. In the Split Claim for… dialog box, highlight the perio maintenance procedure and click the down arrow to move it under Claim #2, as shown here:
Click OK. You now have two separate insurance claims. You can pay off the claim for the exam and bitewings with the check you received today, and you also have an open claim that you can attach the perio chart to and resend to the insurance company for payment. The perio claim will still show up on your Insurance Aging Report for easy tracking.
You can use this procedure for other situations such as rebilling when a crown buildup has been denied, when X-rays have been requested, or when other denials or partial payments require submission of a narrative to the insurance company.
To learn more about splitting insurance claims, see the Splitting primary insuranceclaims topic in the Dentrix Help.
For more tips designed for Dentrix Office Managers, subscribe to the Dentrix Office Manager blog at thedentrixofficemanager.blogspot.com.
By Dayna Johnson, Certified Dentrix Trainer
Dayna Johnson, founder and principal consultant of Rae Dental Management, helps dental offices improve patient care, increase collections and reduce staff headaches by implementing efficient management systems. With 19 years experience in the business and technical side of dental offices, Dayna’s passion for efficient systems is grounded in both personal understanding and professional expertise. Dayna can be reached at firstname.lastname@example.org or visit her website at www.raedentalmanagement.com.
Originally published in Dentrix Magazine Fall 2013