Claim Types
In the Account Module toolbar, click the drop down arrow on New Claim.
There are five options when creating a claim:
Open Dental determines how claims are created based on the Insurance Plan order. The logic follows the table below.
Insurance Plan Situation (order listed in Family Module) |
New Claim | Primary | Secondary | Medical |
---|---|---|---|---|
1. Dental (Primary) | Claim type: Primary Med/Dent: Dental Insurance Plan: Dental Plan Other Coverage: Blank |
Claim type: Primary Med/Dent: Dental Insurance Plan: Dental Plan Other Coverage: Blank |
Message displays stating the patient does not have secondary insurance. | Message displays stating the patient does not have medical insurance. |
1. Medical | Claim type: Medical Med/Dent: Medical or Institutional Insurance Plan: Medical Plan Other Coverage: Blank |
Message displays stating the patient does not have any dental plans. | Message displays stating the patient does not have secondary insurance. | Claim type: Medical Med/Dent: Medical or Institutional Insurance Plan: Medical Plan Other Coverage: Blank |
1. Dental (Primary) 2. Dental (Secondary) |
Two claims are created (except for certain Canada Claims). Primary claim: Claim Type: Primary Med/Dent: Dental Insurance Plan: Dental plan with lowest ordinal Other Coverage: Dental plan with the second lowest ordinal Secondary Claim: Claim Type: Secondary Med/Dent: Dental Insurance Plan: Dental plan with the second lowest ordinal Other Coverage: Dental plan with lowest ordinal |
Claim Type: Primary Med/Dent: Dental Insurance plan: Dental plan with the lowest ordinal Other Coverage: Dental plan with the second lowest ordinal |
Claim Type: Secondary Med/Dent: Dental Insurance plan: Dental plan with the second lowest ordinal Other Coverage: Dental plan with the lowest ordinal. |
Message displays stating the patient does not have medical insurance. |
1. Dental (Primary) 2. Medical |
Same as Dental | Same as Dental | Message displays stating the patient does not have secondary dental insurance. | Same as Medical |
1. Medical 2. Dental (Primary) |
Same as Dental | Same as Dental | Message displays stating the patient does not have secondary dental insurance. | Same as Medical |
1. Medical 2. Medical |
Same as Medical | Message displays stating the patient does not have any dental plans. | Message displays stating the patient does not have secondary insurance. | Same as Medical |
1. Dental (Primary) 2. Dental (Secondary) 3. Medical |
Same as Dental Dental | Same as Dental Dental | Same as Dental Dental | Same as Medical |
1. Dental (Primary) 2. Medical 3. Dental (Secondary) |
Same as Dental Dental | Same as Dental Dental | Same as Dental Dental | Same as Medical |
1. Medical 2. Dental (Primary) 3. Dental (Secondary) |
Same as Dental Dental | Same as Dental Dental | Same as Dental Dental | Same as Medical |
When a patient has three or more dental insurance plans, create an Other type claim.
All plans the patient is currently subscribed to list. To list all insurance plans for the family, including inactive or dropped plans, check Show plans for family which are not in use by the current patient.
If a patient has an insurance set up with of:
Follow the steps below to create a claim for all insurance plans.