Dentrix Ideas

Flag when an insurance claim has a partial payment.

Allow the user to flag an insurance claim as being partially paid when more payment is expected. Include on reports and keep claim current (not in History) and include for batch payment entry until it is complete paid. [3143 4492]
  • Guest
  • Jul 9 2019
  • Likely to Implement
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  • Jane Blair commented
    9 Jul, 2019 04:53am
    or have an option to close out claim so that you can keep it open and show amount out in insurance due. Now when we get one pmt on an ortho claim, it transfers the remaining amount to account due
  • Guest commented
    9 Jul, 2019 04:53am
    You can split the claim before the payment is entered and it is still in your tracking system. Make payment on the part thats paid.
  • Guest commented
    9 Jul, 2019 04:53am
    Agreed! For example, one patient get 50% coverage under her plan and 50% under her husband portion. They are the same plan, just under the different names, unlike a secondary ins plan. I can't note the two separate checks under the ins because it only allows one.
  • Sue commented
    9 Jul, 2019 04:53am
    SoftDent has this feature and it would be really helpful. Now we have to remove the patient's statement or send an inaccurate statement.
  • Guest commented
    9 Jul, 2019 04:53am
    Currently, you can use the "Split Claim" feature before making the payment. - Select the claim in Ledger - From the Insurance Menu, select "Split Primary Claim" Select one or more procedures from the upper "Claim #1" box, then press the down arrow to move the procedures into "Claim #2" - Click OK and the claim will be divided into two claims. - Make payment as normal on one claim, leaving the other open.
  • Guest commented
    9 Jul, 2019 04:53am
    I understand how to do that but sometimes they make 2 separate payments for the same procedure. It closes the claim & forwards the balance to the patient. GEHA is one that send 2 separate payments. Doing that will mess up the account & if you are not careful you will send a statement to the patient for a balance not theirs but the insurances balance.
  • Guest commented
    9 Jul, 2019 04:53am
    Eaglesoft also had the feature that you could keep a claim open. Payment could be posted on one service and the claim would remain open so that the remaining services waiting for payment would stay in the insurance balance versus transfering to the patient balance
  • Guest commented
    9 Jul, 2019 04:53am
    I agree, when I am entering a batch insurance payment and one of the payment entries are for an additional payment on a previously paid claim, there is not a way of entering that payment, at which, I need to enter payments individualy not as a batch.
  • Guest commented
    9 Jul, 2019 04:53am
    The "Split Payment" feature works well if you have more than one procedure attached to a claim, however, just today I had a claim on a patient with one procedure attached to the claim, the payment I received from the insurance company was not their full payment - they are sending an addtional check for this claim. If the check comes in as a bulk payment I will not be able to enter using the bulk insurance payment option.
  • gwen commented
    9 Jul, 2019 04:53am
    U can spilt the claim! Its under insurance
  • Piyush Kothary commented
    9 Jul, 2019 04:53am
    Aetna makes up to 20 payments for the same procedure for ortho claims. The best answer is to leave the claim open so patient portion and insurance portion don't get mixed up.
  • Gail Gomez commented
    9 Jul, 2019 04:53am
    Ortho claims are paid with multiple payments. Either designate that it is an ortho claim and leave it open until all payments have been made and allow user to close claim manually or allow option for all claims to remain open if needed until user closes.
  • Guest commented
    9 Jul, 2019 04:53am
    If you are trying to edit the original payment, I could see you having the difficulty you describe. Instead, you try it this way: In the Ledger, double-click to open the claim. Within the Claim Information dialog, choose the menu item "Enter Payment" and then "Enter Additional Payment" Double-click the provider to apply payment. (if the provider does not show in the list, choose the "Add" button to add them) Type the amount being paid on this additional payment. OK and OK/Post.
  • Brenna Larson commented
    9 Jul, 2019 04:53am
    I understand and do split claims but for example you have a procedure that they pay on and downgrade like a adult prophy downgraded to a child prophy. You have spoken with the insurance company and they are reprocessing this you have to enter the first payment and it clears that claim as paid there is no way to track the reprocessing
  • Kase commented
    9 Jul, 2019 04:53am
    We will be able to cancel our current Ortho claim software and go strictly with Dentrix.
  • Mikki Studley commented
    9 Jul, 2019 04:53am
    I guess my request was merged with this request...Please bring back the estimated portion after claims are paid...it easily identifies if we over/under estimated on the claim and that is where the balance is coming from. Zeroing it out takes away that advantage.
  • Unknown Unknown commented
    9 Jul, 2019 04:53am
    Allowing a claim that has been incorrectly paid by insurance, and has been resubmitted for correction/another payment, be flagged or stay open for continued monitoring.
  • Tammy commented
    9 Jul, 2019 04:53am
    This would be much easier than splitting the claim.
  • info@dentistryatwindermere.com commented
    9 Jul, 2019 04:53am
    Would like to be able to separate Pre-D claim. Sometimes ins co will approve only a portion of the claim and ask for addl info. ; leaving the claim showing as received, (but, not completely approved or denied)
  • mrdad@wavecable.com commented
    9 Jul, 2019 04:53am
    Splitting a claim is NOT a solution because sometimes insurance pays all procedures on the claim but at an incorrect percentage. This happens a lot with Delta Dental incentive plans. We need to record the payment because it is part of a bulk check, but we would like to leave the claim open because we are expecting an additional corrected payment from the insurance
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