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Insurance Details

The Insurance detail page of the patient folder contains information about the patient's insurance coverage for each treatment phase and contract.

Get Started

Assign Insurance Plans - You assign insurance plans to the patient on the Responsible Party page of the patient folder. See "Responsible Party Page" for details.

How to Get Here

Patient FolderClick to Open - Insurance page. (See "Open Patient Folders" for details about opening a patient folder.)

Use This Feature

Choose Record to Work WithClick to Open - Your list of existing records appears at the left. Click the record to work with. The details for that record appear at the right. Since each insurance detail record is associated with a single treatment phase and contract, it is very common for a patient to have multiple records.

Create a New RecordClick to Open - Generally, you do not need to create insurance detail records manually. Whenever you include a responsible party's insurance plan as a member of a financial contract, a new insurance detail record is created automatically. You must, however, open the insurance detail record to complete the form submission fields as needed. However, if you assign all insurance benefits directly to the patient, you will not include insurance companies as contract members, and you will need to create Insurance Detail records manually. This will provide a way for you to submit insurance forms on behalf of the patient.

Delete Empty Insurance DetailsClick to Open - If you create an insurance detail record in error, you can remove it by clicking Del at the top of the records list. For an insurance detail to be available for removal, no charges or receipts can ever have been posted to the associated contract, and no electronic submissions can ever have been submitted against the detail. When you delete the insurance detail, the associated contract (if any) is deleted also. Note that the Del option is available only when you have selected an insurance detail that is available for removal.

Plan Details

Click to OpenAfter choosing the record to work with, you can review and edit the company, subscriber, and benefits details on the left-hand side of the insurance detail record.

Form Submission Details

Click to OpenClick the Form Submission bar to view and change the financial data, additional services provided, and notes regarding this insurance coverage.

Form Field Details

Click to OpenClick the Form Fields bar to view and change the additional fields required to submit a claim for orthodontic services.

Additional Coverage Information

Click to OpenClick the Additional Coverage bar to identify the patient's other insurance coverage, if any. This field is available only when multiple Insurance Detail records are assigned to the same contract as the Insurance Detail record you are working on.

Electronic Submission Details

Click to OpenClick the Electronic Submission bar to enter details about filing electronic claims for this insurance plan. If you print and mail paper forms, you can ignore this tab.

Findings Information

Click to Open Click the Findings bar to enter details to be included in the Narrative Description fields of your Pre-treatment Estimate and Statement of Actual Services insurance forms, as well as electronic submissions. Generally, these fields are used to provide a treatment narrative, but you may enter any additional information required by the insurance company as needed.

More Information

Save ChangesClick to Open Click Save in your Quick Access toolbar or File ribbon bar (or press Ctrl+S on your keyboard) to save any changes you have made.

Insurance Data Links - Insurance plan details are linked in your Employer editor, Insurance Company editor, and the Responsible Party page of your patient folders. When you make a change in one place, the change affects the others automatically. However, Insurance Detail records in your patient folders are not linked: Changes to Insurance Detail records do not affect the other records, and vice-versa.

Submit Insurance Claims - Run Insurance forms to generate and submit your patients' insurance claims either on plain paper with an approved laser printer, or electronically. Choose from a variety of formats and form types.

Work with Patient FoldersClick to Open Edge includes several tools for working within your patient folders, regardless of which page is currently selected.

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