Medical Insurance

Open Dental has good support for medical insurance making it useful in oral surgery and hospital settings. Below is information about how to use Open Dental's medical insurance features.

Turn on Medical Features: In the Main Menu, click Setup, Advanced Setup, Show Features, then select Medical Insurance. Restart Open Dental for the change to take effect.

Insurance Plans

Patients can have unlimited insurance plans. To designate an insurance plan as medical, select the following on the Edit Insurance Plan Window.

Medical Procedure Codes

Add medical codes (e.g. CPT Codes) as separate codes in the procedure code list. We recommend creating a Medical Code category in Definitions: Procedure Code Categories and assigning medical codes to it.

Cross code medical codes to procedure codes:

  1. Create the medical procedure code using a CPT code instead of a dental code. Leave the Medical Code field blank. See Adding a New Procedure Code.
  2. For the dental procedure code, enter the medical procedure code (CPT code) in the Medical Code field on the Edit Procedure Code Window.

Cross coding only affects medical claims. It does not affect what shows on EHR Continuity of Care Document (CCD).

Procedures

Medical information can also be entered on the Procedures - Medical Tab.

Claims

Create medical claims in the Account module. See Claim Types for details on how insurance setup affects claim type.

E-Claims

Use Change Healthcare Medical E-Claims for medical claims.