Adding a claim or pre-treatment estimate

Before adding a claim, verify that the desired license, and service office combination is selected on the Selected Office Details screen. You can verify this information by clicking the Selected Office Details button. This will display the dentist and office information. If you have multiple offices, select the correct option in the drop-down field. The service offices are listed by the License number of the dentist, and the Zip code of the office's location.

Access the patient information as described in Locating a member.
The Subscriber Information screen appears, click the button for the correct patient.
The Claim Entry - Treatment Details screen appears. The screen displays the Treatment Details tab. Enter the claim information; see Required information on a claim for help in filling out the treatment details.
If necessary, enter additional information on the other tabs:
- Claim Details — to change the default settings on overall claim details; see Submitting a claim with special patient information
- COB Details — to add coordination of benefits information; see Submitting a claim with coordination of benefits
- Ortho Details — to add orthodontic information; see Submitting an ortho claim
When all appropriate claim information has been entered, return to the Treatment Details tab to continue. You can:
- Submit the claim for processing by selecting the Submit Claim button. The Claim Payment Statement screen (or Pre-treatment estimate screen, if the dates of service are blank) appears, displaying a summary of the entered claim information.
- Pend the claim for later editing by selecting the Submit Later button. For a pended claim, the Claim Summary screen appears. See Working with a pending claim for more information.
- Cancel the claim by clicking on the Cancel Claim button.