Set Up Insurance Submission Defaults

Use the Insurance Setup editor to specify whether insurance benefits are paid to the patient, as well as select your default insurance submission method, and default recurring insurance code. You can also specify a third-party billing name and address for insurance claims, and enter your Claim Connect credentials for electronic submissions in this editor.

Choose Your Settings

1. Open Insurance Setup Editor - Home ribbon bar > Tools section > Editors > Insurance > Insurance Setup. (You can also use the Search field to look for the editor you want to work with.)

   

2. Choose Your Settings - Enter your Claim Connect credentials, benefit designation, and default insurance submission settings in this editor.

   

   Claim Connect Settings - (Electronic claims only.) If you file some or all of your insurance claims electronically, enter your Claim Connect account username and password in these fields. (Claim Connect is the integrated electronic insurance processing clearinghouse. You must have a Claim Connect account in order to submit insurance claims electronically. If you need more help,please contact Ortho2 for assistance.)

   Assignment of Benefits - Enable this option if you want all insurance benefits paid directly to your patients, rather than sent to your office. (When the patient receives insurance benefit money directly, the patient is responsible for paying you all financial obligations, and you do not include the insurance company as a member of the financial contract. You do, however, assign the insurance plan to the responsible party, and create an Insurance Detail record for that plan so that you can submit insurance forms on behalf of the patient.)

   You can override this setting by selecting an alternate assignment of benefits for individual patients for whom you submit electronic claims. See "Patient Insurance Details" for details. Or, override this setting by selecting an alternate assignment of benefits for specific insurance companies. See "Insurance Company Editor" for details.

   Insurance Submission - Choose whether you always send paper forms, whether you always submit claims electronically, or whether you want to be prompted for the submission format whenever you generate insurance forms.

   Default Recurring Insurance Code - (Optional.) Select a code from your Insurance Codes list to use specifically for scheduled continuation of treatment insurance forms. This will be the default recurring code for new insurance detail records, and can be changed for individual records as needed. (See "Insurance Code Editor" for details about your list of available insurance codes.)

   3rd Party Billing - (Optional.) If the billing name and address used for some or all insurance claims should an something other than your general practice address (as entered in your Practice editor), or the address of the office assigned to the patient folder, enter that name and address in these fields.

3. Save Changes - 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.

   

More Information

Editor History - When you open more than one editor without leaving the Editors window, a history of those editors appears at the top of your screen. You can click a name in the history to return to any previously opened editor, easily going back and forth between editors. This is useful, for example, when you are working with editors that are related to one another, such as the Treatment Chart Style editor and the Treatment Chart List editor.