In the Main Menu, click Lists, Insurance Carriers.
Carriers are automatically added to the master list when you enter carrier information on an insurance plan, but you can also add carriers that are not attached to any plan
The number of plans a carrier is attached to is indicated in the Plans column. To narrow or sort the list of carriers, enter filter criteria:
- Carrier/Phone: As you type, only matching entries will list.
- ElectID: Filter by Electronic ID.
- Show Hidden: Include/exclude carriers that have been marked Hidden.
- CDAnet Only: Show only CDAnet carriers in the list. (Canadian Dental Association)
To update carrier information, double-click it.
If multiple entries for the same carrier exist due to data entry errors, you can combine them. See Combine Carriers.
Add a Carrier
Carrier ID: A system generated unique identifier that is useful for third party reporting.
Name, Phone, Address, Address2: Carrier name and mailing address.
Electronic ID: The electronic ID used when submitting e-claims. Insurance companies will provide you with the correct number.
Send Electronically: Determines the carrier's default setting for Send Electronically on the Insurance Plan.
- Send Claims Electronically: Allow sending E-Claims to this carrier.
- Don't Send Claims Electronically: Do not allow sending e-claims to this carrier (e.g. if you must print and mail).
- Don't Send Secondary Claims Electronically: Do not allow sending secondary e-claims to this carrier (e.g. when carrier requires that secondary claims are mailed with a copy of the primary EOB).
Send Paid By Other Insurance At: Determines how primary paid amounts are sent to secondary insurance claims.
- Default: Uses the default as set in Family Module Preferences.
- Claim Level: Send claim level paid amounts. (e.g. amount of the claim paid overall)
- Procedure Level : Send procedure level paid amounts. (e.g. amount of claim paid procedure by procedure)
- Both: Send both claim and procedure level paid amounts.
ERA Automation: Determines how ERAs for this carrier are processed.
- Use Global Preference: Uses the global preference set in Manage Module Preferences.
- Review All: All ERAs must be processed manually for this carrier.
- Semi-automatic: ERAs for this carrier can be processed with a single click of the Auto Process button on the ERA window. This will receive the claims associated with the ERA, and finalize the payment. They can also be processed manually, if needed.
- Fully-automatic: ERAs for this carrier will be automatically processed when imported, receiving the claims associated with the ERA and finalizing the payment. If an ERA does not get automatically processed while being imported for any reason, the user can still attempt to process them by clicking the Auto Process button on the ERA window, or process them manually.
Consolidate Ortho Ins Payments: Option to set plan level preference for Consolidate Ortho Ins Payments, or use Global Preference. See Ortho Setup.
Carrier Group: Only visible if carrier group names exist in Definitions: Carrier Group Names. Select a carrier group to associate to the carrier. Useful for queries.
Hidden: Hide this carrier so it is no longer available as a selection.
Is trusted for real-time eligibility: Check to enable to automated import of Electronic Eligibility and Benefits when using Scheduled Processes for this carrier.
Appt Text Back Color (black=none): Background color for the carrier's name in the appointment box when Insurance Color is added to the appointment view. See Appointment View Edit. Click None to clear current color selection.
Note: Selecting the color black is equivalent to having no color selected.
Import Benefit Coinsurance: When importing benefits using Electronic Eligibility, select how Open Dental imports received carrier benefit information. This affects insurance estimates.
- Carrier sends patient % (default): The carrier will send the percentage covered by the patient. Open Dental will import this as the percentage covered by insurance. For example, if patient pays 20%, Open Dental will import this as Insurance Pays 80%.
- Carrier sends insurance %: The carrier will send the percentage covered by insurance. Open Dental imports these benefits as they are.
Ins Plan Subscribers: Indicates how many insurance plan subscribers use this carrier. Click the dropdown to see all subscribers.
Delete: You can not delete a carrier that is in use, but you can combine carriers.