Attaching insurance to patients

You can enter a patient's dental and medical insurance information into his or her patient record.

Note: All required patient information (name, gender, birth date, and address) must be entered before you can attach insurance to a patient.

To attach insurance to a patient

1. Do one of the following:

   • On a patient's Overview page, in the Insurance box, click (or tap) Add.

     

   • On a patient's Insurance Information page, click (or tap) Add Plan.

     

   The options for entering insurance information become available.

   

2. Specify the Subscriber.

   Do one of the following:

   • If the patient is the subscriber for the plan that you are going to enter, leave his or her name in the Subscriber box.

   • If the patient is not the subscriber for the plan that you are going to enter, clear the name from the Subscriber box, begin typing part of the subscriber's name, continue typing as needed to narrow the results list, and then select a subscriber's name. The names of the insurance carrier and plan (or employer) that are attached to the selected subscriber appear automatically. (Skip step 3.)

3. If the patient is the subscriber, use the Plan Search field to search for and select an insurance plan.

   Do one of the following:

   • Select a plan by carrier, plan, employer, or group number:

     1. Select Search by Carrier/Plan/Employer.

     2. In the Plan Search field, begin typing a carrier name, an employer or group plan name, or a group number.

     3. Continue typing as needed to narrow the results list, and then select a plan.

     

   • Select a plan by patient:

     1. Select Search by Patient.

     2. In the Plan Search field, begin typing a patient name.

     3. Continue typing as needed to narrow the results list, and then select the patient with the correct plan.

     

   • Add a new plan:

     1. If there are no results for the search criteria that you enter in the Plan Search field, click (or tap) Add New Carrier or Plan.

        

        The Add New Carrier or Plan dialog box appears.

     2. Do one of the following:

        • Select an insurance carrier from the list of carriers that have already been added to your practice database.

          

        • Add an insurance carrier to your organization's database:

          1. Click (or tap) Add Carrier.

             

             The options for adding a carrier become available.

             

          2. Begin typing a Carrier Name to search for that carrier from the database of supported nsurance carriers, continue typing as needed to narrow the results list, and then select a carrier. Alternatively, you can enter the name of a carrier that is not supported.

             Important: Henry Schein One maintains a database of supported payers. The database is updated regularly, and a list of carriers and each carrier's details is sent to Dentrix Ascend. Selecting a carrier from the list of supported payers ensures that your practice has up-to-date information for that carrier. Also, using a supported payer allows you to add attachments to claims (however, the payer might not accept electronic attachments; in which case, you can mail the attachments separately from the claims or print and mail the claim and attachments together).

          3. For a non-supported carrier, enter the carrier's phone number and extension (if applicable), fax number, and website address.

          4. Click (or tap) Save.

        The options for adding a plan become available.

        

     3. Enter the following details:

        • Plan's or employer's name and group number.

        • Insurance carrier's address.

        • Phone number, extension, fax number, email address, and name of the plan administrator (or contact person).

        • Benefit renewal month.

        • Source of payment.

        • Coverage type.

        • PPO contracted fees, and fee schedule of co-payments (for capitation plans only).

        • Any notes regarding the plan.

     4. Click (or tap) Save.

4. Set up the rest of the options as needed, such as the subscriber ID, relation to the subscriber, coverage type, and coverage period.

   Set up the following options:

   • Subscriber ID # - The ID used to identify the subscriber of the insurance plan on claims submitted to the corresponding carrier. The subscriber ID might not be the same as the subscriber's Social Security number.

   • Release of Information - The subscriber authorizes the release of information to the practice. With this check box selected, "Signature on File" appears in box 36 on insurance claims. With this check box clear, box 36 is blank.

   • Assignment of Benefits - The subscriber authorizes payments from the carrier to go directly to the provider. With this check box selected, "Signature on File" appears in box 37 on insurance claims, and the carrier will send payments to your practice. With this check box clear, box 37 is blank, and the carrier will send payments to the subscriber.

   • Relation to Subscriber - For a subscriber, since he or she is the current patient, Self is selected automatically and cannot be changed. For a non-subscriber, select Spouse, Child, or Other.

   • Coverage Type - The coverage order of the plan (such as Primary or Secondary). The number of items that are available on the list depends on the number of plans that have already been set up for this patient. If there are no plans, only Primary is an option; if there is one plan, Primary and Secondary are options; if there are two plans, Primary, Secondary, and Tertiary are options; and so on.

   • Coverage Period - The date range that coverage under the plan is valid for the subscriber and his or her dependents. In the Coverage Start and Coverage End boxes, enter the date when coverage started and, if known, when it will end. For a non-subscriber, you can specify an end date that is before or the same as that of the subscriber.

   • Eligibility - The patient's eligibility for coverage under the plan has been checked. If known, select the patient's eligibility status from the list: Unable to Verify, Eligible, or Ineligible. Then, enter today's date (or the date that eligibility was actually checked) in the Verification Date box.

     Note: Changing the eligibility status here affects the patient's eligibility status for his or her appointments on the Insurance Eligibility page and vice versa.

   • Note - Any notes regarding the insurance plan.

5. Click (or tap) Coverage Tables to edit the coverage table for the insurance plan.

6. Click (or tap) Benefits to edit the deductibles and benefits for the insurance plan. Access to the deductibles and benefits is available only if a subscriber and a plan have been selected. When you attempt to access the deductibles and benefits, if you have not already saved the plan, a message appears and states that you must save the plan before you can access the deductibles and benefits. Click (or tap) Yes to save the plan and continue.

7. Click (or tap) Save.