Claim Form Edit

In the Claim Forms window, double-click a custom claim form.

Claim forms can be customized or added as needed. Changes to claim forms only affect printed claims and do not affect electronic claims. 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:

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.

Options

Description: Name of the claim form.

Width / Height: Dimensions of the claim form when printed. Edit width and height when claim form is not printed on standard 8.5 in. x 11 in. paper.

Is Hidden: Hide a claim form so it no longer shows as an option in various drop downs.

Print Images: Set whether or not background images print.

Offset X / Offset Y: Change the alignment of the form when printing on a preprinted form. 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.

Items

The Items grid displays fields currently added to the claim form. When an item is highlighted, the corresponding field on the claim form displays in red.

Add: Open the Claim Form Item window to add additional items to the claim form. Alternatively, double-click a field to change it.

X / Y Pos: The X and Y coordinates of the selected field. Can be edited.

Width / Height: The width and height of the selected field. Can be edited.

Edit Claim Form Item

Click Add to create a new Claim Form Item or double-click an existing Claim Form Item on the claim form to edit.

Image File Name: When a background image is selected or being added, enter the file name here. The file must exist in the OpenDentImages Folder. When an image is entered here, no fields should be selected on the right.

Format String: When adding a field that includes a date, enter the date format here.

Field Name: If not using an Image File Name, select the field to be used on the claim form.

Click OK to save changes.

Add a New Claim Form

If adding a new claim form from scratch (i.e., not importing XML), do the following in order.

  1. Prepare a high resolution background image. Image must be GIF,JPEG, or EMF.
  2. Save the background image to the OpenDentImages folder.
  3. In the Claim Forms window, click Add to open the edit window.
  4. Add the background image. Click Add then enter the image file name in the Edit Claim Form Item window. Adjust the X and Y positions as needed.
  5. Click Add to add fields. When a field is added, move it to it's appropriate location on the claim form.
  6. Move items by clicking and dragging or by using the arrow keys.
    • To make the movement larger press Shift while pressing an arrow key.
    • To select groups of items to move as a unit, press Ctrl while clicking. When you have groups selected, any change you make in the four text boxes at the bottom will apply to all items in the group.
  7. Click OK to save the form.

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