Canada Claims

For Canada users, in the Account Module, click New Claim, or double-click an existing claim to edit.

To send electronic claims, setup the ITRANS 2.0 or Claimstream (TELUS) clearinghouse first.

Edit Claim Window

Buttons and fields in this window match what is found in the Edit Claim window for the U.S. version. Differences are noted below.

Procedures: Displays procedures attached to the claim. Up to seven procedures can be included on a claim, per CDA limitations. If sending more than seven procedures, create multiple claims.

Send: Send the claim. This button is grayed out if the claim was sent and the carrier returned a transaction reference number.

Resend: Click to resend the claim. Can be used even when the Send button is grayed out as noted above. When prompted to select a reason for resending the claim, select either option as the choices do not affect claims in Canada.

History: Click to view the history of the last action taken on the claim. See Canada Etrans Edit for details on claim responses.

Canadian Tab

The Canadian tab contains specific Canadian information.

Referring Provider

Accident Date: Used to indicate that dental treatment was needed as the result of an accident. If a value is entered, the Is Accident field on the printed claim is automatically marked.

Trans Ref Num: When a claim is sent electronically, this box is automatically filled with a unique transaction reference number composed of letters and numbers.

Reverse: Click to reverse or unsend a claim. Claims can only be reversed on the same day, by carriers that support claim reversal, and when a Transaction Reference Number is generated.

Materials Forwarded (E-mail, Correspondence, Models, X-rays, Images): Indicate the types of supporting documents which have been physically mailed to the insurance carrier. These boxes can be checked/unchecked independently.

Treatment Required for Ortho: Only used for Ortho claims. If checked, the ortho flag is sent.

Ortho Treatment (Predetermination Only): Only for predetermination claims, not regular claims.

Maxillary Prosthesis: All information entered here is sent on electronic claims when needed. Only the Initial placement upper is sent on printed claims.

Mandibular Prosthesis: All information entered here is sent on electronic claims when needed. Only the Initial placement lower is sent on printed claims.

Extracted Teeth: This box is empty until something other than Not a... is selected in the Maxillary or Mandibular Prosthesis dropdowns. When an option is selected, any extracted teeth with a status of Complete, Existing Other, or Existing Current and a valid procedure date list. This information is sent on all electronic claims, regardless of the Maxillary or Mandibular selections.

Missing Teeth: List of the patient's missing teeth. For display only. Change the missing status of teeth from the Chart Module, Missing/Primary Teeth tab.


If a carrier substitutes a code, the substitution code is added as a new row in the Edit Claim window and displayed at the end of the procedure list on the response printout. Substitute codes always list lab amounts (usually $0.00). This allows the user to view all details regarding the submitted code as well as the substituted code.


Primary electronic preauthorizations are available for carriers that accept them. On the CDA claim form, Predetermination only. displays in the Remarks field.

Open Dental does not support the electronic sending of secondary preauthorizations (COB predeterminations).

If a patient has dual insurances from the same carrier (i.e., blue-on-blue), the carrier may coordinate secondary coverage estimates automatically and send two responses to Open Dental. These display one after the other.

Electronic Attachments

Some carriers accept electronic attachments. See Canada Attachments for details.

To add a note to a claim, use the Remarks field in the Edit Claim - General Tab for printed claims, or add a text file as an attachment for electronic claims.

Secondary Claims

If a patient has primary and secondary insurance:


If insurance is requiring the student school and status, enter information in the Edit Patient Information window under Name of School and Eligibility Excep. Code.

Electronic Claims and Sunlife

When sending electronic claims, both the treating dentist and billing dentist are submitted. If sending to Sunlife, the treating dentist receives the payment instead of the billing dentist. This is a decision made by Sunlife.