Haris Ashley
Entering insurance payments in Dentrix is a critical task in any dental office to ensure the success of the business. Using the software efficiently results in cleaner accounting and more accurate reports. Dentrix offers several features to help with this process, such as the ability to split insurance claims, the Enter Batch Insurance Payment feature, and the Itemize by Procedure option. These tools help dental offices manage patient insurance details, track dollar amounts paid for procedures, and submit claims quickly.
| Characteristics | Values |
|---|---|
| Posting insurance payments | Efficient posting results in cleaner accounting and more accurate reports |
| Features | Ability to split an insurance claim, post patient payments, and enter batch insurance payments |
| Payment table | Allows you to enter specific dollar amounts paid for procedures, which Dentrix uses to estimate insurance coverage |
| Managing patient insurance details | Access a patient's insurance information by double-clicking the Insurance block in the Family File |
| Insurance benefits and coverage | A central location in Dentrix to view insurance information, including coverage levels, insurance plan type, and out-of-network benefits |
| Insurance claims | It is important to file claims timely and use Dentrix eClaims for quick submission |
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What You'll Learn
Using the Enter Batch Insurance Payment feature
Once you receive the payment from the insurance company, use the "Enter Batch Insurance Payment" feature to enter payments for claims. This feature is helpful when the insurance payment includes more than one claim. Dentrix will display an error message if your payments don't balance, helping you to avoid searching for a few cents at the end of the day when you run your deposit slip because you posted a payment incorrectly.
When posting a payment to an insurance claim, always select the "Itemize by Procedure" option to enter the amount the insurance pays for each procedure, rather than the "Total Payment Only" option. This ensures that the payment is posted to the correct provider of the procedure. This process is extremely important, especially if you have an associate doctor who is paid based on collections. Also, by choosing the "Itemize by Procedure" option, you have the ability to update the payment table in Dentrix.
To use the "Enter Batch Insurance Payment" feature, first activate Insurance Pay by opening Office Manager > Maintenance > Practice Setup > Dentrix Pay > Dentrix Pay Setup. Click the Features tab, then click Enable Insurance Pay. To use Insurance Pay, open the Batch Insurance Payment Entry dialog box (Ledger > File > Enter Batch Insurance Payment). Select the insurance carrier(s) for which this reimbursement pays outstanding claims. In the Amount field, enter the value of the electronic credit card or the total amount received from the insurance company. In the Payment Type list, select the type of payment received, such as Credit Card Payment or Check.
The payment table will track the dollar amount paid for a procedure code and will apply that information to all patients covered under the same plan. This feature is very helpful if your office is out of network with an insurance plan, or if an alternate benefit is paid.
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Splitting insurance claims
When it comes to insurance payments, Dentrix offers a variety of features that can help with posting patient and insurance payments more accurately and efficiently. One such feature is the ability to split insurance claims.
When to Split Insurance Claims
Splitting an insurance claim is beneficial when the insurance plan covers some procedures but requires more information before paying for other procedures. For example, if a patient has had a crown and a core build-up, the insurance may only pay for the core build-up initially until they receive the date that the crown was seated. In this case, you can split the insurance claim, post the payment for the core build-up, and keep the claim for the crown open and outstanding.
Benefits of Splitting Insurance Claims
Other Features in Dentrix
In addition to splitting insurance claims, Dentrix offers other features to help manage insurance payments. When you receive specific dollar amounts from the insurance company for certain procedures, you can enter this information into the payment table, and Dentrix will estimate insurance coverage for each procedure. You can also easily add, edit, or delete individual line items within the payment table as new information becomes available.
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Managing the payment table
To manage the payment table effectively, it is essential to record and document relevant information in the Dental Insurance Benefits and Coverage window. This information can be easily referenced from other areas in Dentrix when you need to review insurance coverage details. For instance, when planning procedures, you can access the insurance information by clicking on the Plan Detail icon (denoted by a blue icon with a dollar sign) under Treatment Plan Case Setup. This will open the main Dental Insurance Benefits and Coverage window, displaying the selected patient's insurance plan details.
Additionally, the Notes icon (musical note) provides access to any notes you have entered for the insurance plan. If there are no notes, this icon will not be visible. In cases where insurance exceptions have been made, the Notes icon is replaced by the Exceptions icon (a white "E" on a dark blue background). This feature is particularly useful for keeping track of exceptions, such as age minimums or maximums, frequency limitations, downgrades, and waiting periods.
When receiving specific dollar amounts from the insurance company for certain procedures, you can directly enter this information into the payment table. Dentrix will then use these values to estimate insurance coverage for each procedure. You have the flexibility to copy another plan's payment table as a starting point or select an existing fee schedule, allowing Dentrix to calculate the coverage percentage for each code. Furthermore, you can conveniently add, edit, or delete individual line items within the payment table as new information becomes available and is applicable to all subscribers to the insurance plan.
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Accessing a patient's insurance information
The new Insurance Benefits and Coverage window is a centralised location where you can view the insurance information you require. It is divided into major sections, accessible via tabs on the left side of the window. Within this window, you can enter and view detailed information about the insurance plan, including the date benefits commenced for the subscriber and patient, eligibility coverage levels, insurance plan type, whether out-of-network benefits apply, and the participating providers within your practice.
The Payment Table within the Dental Insurance Benefits and Coverage window allows you to enter specific dollar amounts paid for certain procedures, and Dentrix will use this information to estimate insurance coverage for each procedure. You can also copy another plan's payment table or select an existing fee schedule for Dentrix to calculate the coverage percentage for each code. The Benefits and Coverage window also provides sections to record Deductibles/Maximums, Coverage Table, and Exceptions for out-of-network plans.
To view a list of all patients assigned to an insurance plan, you can run the Insurance Carrier List. This list can be customised to include all subscribers or insured patients, along with provider IDs, mailing labels, and other relevant details. Additionally, the List Manager is a valuable tool for viewing patient information, allowing you to select a patient and access additional details through various Dentrix Modules.
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Using Dentrix eClaims
To start, access the patient's insurance information by double-clicking on the Insurance block in the Family File. Here, you can assign an insurance carrier and plan to the patient or their dependents. The new Insurance Benefits and Coverage window is a central location where you can view and enter detailed insurance plan information, such as the date benefits began, coverage levels, and plan type.
When you receive specific dollar amounts covered for certain procedures from the insurance company, enter this information into the payment table. Dentrix will then estimate insurance coverage for each procedure. The payment table is also where you can add, edit, or delete individual line items as needed. Additionally, with the ability to split insurance claims, you can retain any notes attached to the claim and track outstanding claims through your Insurance Aging Report.
When posting a payment to a claim, it is recommended to select the "Itemize by Procedure" option to ensure the payment is correctly attributed to the provider of the procedure. This also allows you to update the payment table in Dentrix. If the insurance payment includes multiple claims, using the batch insurance feature will notify you of any discrepancies in your payments.
By using Dentrix eClaims, you can streamline the process of filing and tracking insurance claims, resulting in more accurate and efficient payment postings for your dental office.
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Frequently asked questions
To enter an insurance payment in Dentrix, open the Batch Insurance Payment Entry dialog box (Ledger > File > Enter Batch Insurance Payment).
Use the Enter Batch Insurance Payment feature. Dentrix will give you an error message if your payments don't balance.
You can split a claim while retaining any notes attached to it. This will allow you to post the payment for the procedure that has been approved and keep the claim for the other procedure outstanding.
Double-click the Insurance block for a patient in the Family File. You can also assign an insurance carrier and plan to a patient or their dependents here.
The Payment Table is where you enter the dollar amounts paid for certain procedures. This information is used to estimate insurance coverage for each procedure and will be applied to all patients covered by the same plan.
