In Account Module Preferences, click the Insurance tab
Show provider income transfer window after entering insurance payment:
- Checked: Automatically open the Payment window after entering Claim Payments so you can fine tune provider balances by transferring income.
- Unchecked: The Payments window will not automatically open.
Set medical claims to institutional when using medical insurance:
- Checked: The default ClaimType will be set to institutional when a medical claim is created.
- Unchecked: The default claim type will be set to medical when a medical claim is created.
Claim Form treating provider shows Signature On File rather than name:
- Checked: If the provider also has Signature on File checked on the Provider, Signature on File will print in the TreatingDentistSignature field on the ADA 2012 and 2018 Claim Forms.
- Unchecked: If the provider also has Signature on File checked on the Edit Provider window, the provider's name will print in the TreatingDentistSignature field on the ADA claim form.
PPO write-off description (blank for "Write-off"): Determines the wording for insurance write-offs used in the Description column of Account module and on statements. The default will be Write-off if left blank.
Claim Attachment Export Path: Enter the path to the folder where images attached to a claim will be exported. See Claim.
On medical e-claims, send treating provider as ordering provider by default: Set the default ordering provider sent in medical e-claims. Also see E-Claims Complexities.
- Checked: The procedure's treating provider will be the default ordering provider.
- Unchecked: There will be no default ordering provider.
On e-claims, send treating provider info for each separate procedure: Only applies to e-claims. Paper claims have no place to include information for more than one treating provider. This option should be checked unless you have a very good reason for needing to not send information about treating providers.
Require ACN# in remarks on claims with ADDP group name: This was added for one specific customer, and can be ignored by everyone else.
Allow procedure adjustments from claim window:
- Checked: Right click procedures on the Edit Claim window to add a procedure adjustment.
- Unchecked: The right click Add Adjustment option will not be available.
Payment exceeds procedure balance: Determines whether or not users are allowed, warned, or blocked from allocating an insurance payment that is greater than the procedure's remaining balance (procedure fee - payments - write-offs + adjustments).
- Allow: Users can allocate an insurance payment that is greater than the procedure's remaining balance and will not be warned.
- Warn: Users can allocate an insurance payment that is greater than the procedure's remaining balance but will receive a warning.
- Block: Users will not be allowed to finalize insurance payments for insurance amounts that are greater than the procedure's remaining balance. They will receive a prompt detailing the balance but will not be allowed to proceed with the payment.
Allow Future Payments: Determines whether or not users are allowed to enter insurance payments with a future Payment Date.
- Checked: Create an insurance payment with a future payment date. Reports will not reflect this payment until the payment date.
- Uncheck: Prevent users from entering a payment with a future payment date. Users will be prompted with a warning message and they will not be able to finalize the payment until the date is changed.
- If either this preference or the preference for Allow future dated transactions (Misc tab) are enabled, future dated insurance payments are allowed.
- If either this preference or the preference for Allow future dated transactions (Misc tab) are disabled, future dated insurance payments are not allowed.
Claim Identification Prefix: Change the default format of the claim ID. This number is assigned to a claim using the prefix selected, then adding an auto-generated claim number. Useful for internal tracking of claims. Click Replacements to select a prefix.
Creating claims with $0 procedures: Determines whether users are allowed, warned, or blocked from creating claims with $0 procedures.
Note: Clicking New Claim with no procedures selected will skip unsent $0 procedures, regardless of this preference value.
- Allow: Users can create claims with $0 procedures.
- Warn: Users are prompted with a warning message when attempting to create a claim with $0 procedures. Click OK to create the claim or cancel to exit without creating a claim.
- Block: Users cannot create a claim with $0 procedures.
Exclude 'None' as an option on Custom Tracking Status: Determines whether None is an available status option in the Edit Claim - Status History Tab.
- Checked: Removes None from the status options. The tracking status will default to the first custom option in the list. Edit status options in Definitions: Claim Custom Tracking.
- Unchecked: None is the default status option.
Disallow write-offs greater than the adjusted procedure fee: Determines whether or not write-offs can be greater than the procedure fee (fee - adjustments).
- Checked (default): Prevent write-offs from exceeding the adjusted procedure fee.
- Unchecked: Allow write-offs that exceed charged fee after considering adjustments. May result in unintended credit on patient account.
Prompt for secondary claims: Determines how secondary insurance claims are handled.
- Checked: When primary claim is received, a popup will appear to determine how to handle outstanding secondary claim. Options will be to change claim status to Waiting to Send, send the secondary claim now, or the do nothing.
- Unchecked: When primary claim is received, a popup will remind the user a secondary claim is outstanding, but no options are presented.
Recalculate estimates for received claim procedures: Determines if estimates can be changed for a procedure that has been received.
- Checked: Allows users to recalculate estimates on received claim procedures.
- Unchecked: Does not allow users to recalculate estimates on received claim procedures.
Canadian PPO insurance plans create lab estimates: Determines if lab fee estimates should be created for PPO insurance plans.
- Checked: Lab fee estimates will be created for PPO insurance plans, visibile on claims.
- Unchecked: Lab fee estimates will not be created. Users will need to manually enter lab fees when receiving claims.
Note: This feature is only available for Canadian databases. See Canada Lab Fees
for more details.