Printed Claim Form Setup
This page only contains information about claim forms that are printed.
To open the Claim Forms window, in the Main Menu, click Setup, Family/Insurance, Claim Forms.
Internal Claim Forms: The original claim form templates that come with Open Dental. Can only be copied.
Custom Claim Forms: Claim forms that can be customized, duplicated, imported, exported, or deleted.
The default claim form determines the default claim form on the Edit Insurance Plan Window, Other Ins Info tab when a new insurance plan is created.
If a new claim form is replacing an existing one, you can easily assign the new claim form to all insurance plans that use the old form.
To import most claim forms, you need two files: an XML file and the background image file (GIF or JPG). Some claim forms only require an XML file.
The new form will appear last in the Custom Claim Forms list. Once imported, the XML file is no longer needed by Open Dental, and you may delete it from your A to Z folder.
Claims forms are exported in XML format.
Advanced users only.
We recommend contacting Open Dental support if you need to make changes, as changes may affect claim submission and payment.
Possible reasons to modify a claim form:
To make changes to an existing claim form, double click the form in the Custom Claim Forms list. The left side of the window will show the items on the claim form. The right side of the window will have an edit panel.
To change a claim form name: Change the Description.
To hide a claim form so it no longer shows as an option in various drop downs: Check the Is Hidden box.
To set whether or not background images print: Check Print Images to print the background claim form image. Uncheck the box to not print the image (e.g. when printing on a preprinted form such as Denti-Cal).
To change the alignment of the form when printing on a preprinted form, change the Offset X, Offset Y values. Values can be positive or negative and will shift all elements on the page by the given number of pixels in hundredths of an inch.
You can add your own claim form from scratch, but it is very involved and takes a lot of time.
Step 1: Prepare a background image.
Hint: On the edit window, GIF image size can be easily adjusted by changing the width and height, but JPG image size cannot be changed. If you save as a JPG, set the compression and smoothing for as small a file size as possible without losing detail, somewhere between 200 and 500 Kb. The larger it is, the longer it will take to print.
Step 2: Create a new blank claim form.
Step 3: Add the background image.
Step 4: Add more items as needed.
Step 5: Click OK to save the form.
You can delete a custom claim form as long as it is not being used by any insurance plans. Highlight the claim form, then click Delete.
Does Open Dental have a New York State Medical Assistance Claim Form A (EMED 000201)?
No. You could create one, but it will require some effort. Another option would be to send these claims electronically using a clearinghouse or direct connection to payer.