Required information on a claim

A claim or pre-treatment estimate automatically contains the required provider and patient information, which is selected when the claim is created.

In order to submit a claim or pre-treatment estimate for processing, additional information must be entered or selected for at least one claim line on the Treatment Details tab. Fields on the other tabs are optional.

The procedure code and the submitted amount are always required. Certain procedure codes may require tooth code(s), an oral cavity, and/or surface(s). A service date is required except for pre-treatment estimates.

To add additional lines to a claim, select the Add More Treatment Lines button. A new line will appear.

Add comments to the claim by filling in the Remarks section. All electronic attachments should be noted in this field.

To view a list of procedure codes, select the click here link under the Remarks section. The Dental Procedure Codes screen appears listing the code number and description of the procedure.

Additional claim details concerning the patient (account number, assignment of benefits, and more) can be added on the Claim Details tab of the claim form; see Submitting a claim with special patient information. If the patient has other coverage, see Submitting a claim with coordination of benefits for help with the COB Details tab. If one or more of the claim lines include orthodontic procedures, see Submitting an ortho claim for help with the Ortho Details tab.

Related Topics

Adding a claim or pre-treatment estimate

Working with a pending claim

Submitting a pre-treatment estimate in for pay

Last updated 3/4/2015