Edit Claim - General Tab
The Edit Claim window, General tab, has fields for prosthetics, orthodontic work, claim referrals, and claim note.
Crown, Bridge or Denture: For bridges, dentures, and partials, Missing Teeth must have been correctly entered in the Chart module. If Replacement is selected, a Prior Date is required. This information only shows on printed claims and is not sent electronically. To send this information electronically, enter on the Procedure Edit window (Prothesis Replacement, Original Date).
Place of Service: The service location. Defaults to the Place of Service on the last procedure in the claim (as set on the Procedures - Misc Tab). If Public Health is turned on, the default is based on the Site's default place of service.
Accident: Used to indicate that dental treatment was needed as the result of an accident.
Ortho: Only used for Orthodontic claims.
Claim Referral: Only enter a referring provider and referral number if it is required by your insurance carrier.
Note: For a Referring Provider on a claim, the Not Person checkbox must be unchecked and the Is Doctor checkbox checked. See Referral List for checkboxes. The information will not send otherwise.
Claim Note: Shows on printed claims and e-claims. This note is a claim level note. The claim note and attachment ID Number together are limited to 255 characters on a printed claim, or 80 characters for e-claims. If a procedure in the claim has a default claim note, it will automatically copy to this field when the claim is created. If multiple procedures have default claim notes, each note will added. Enter a procedure's default claim notes on the Procedure Code Edit window.
Note: There is also a procedure level note which only goes out on e-claims. There is no place on a printed claim form to put a procedure level note. Add procedure level note in the Procedure Edit window.
For more technical details, see E-Claim Complexities.
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