Pract-Eze Dental has full support for medical insurance, making it useful in Oral Surgery and in hospital settings.
Insurance Plans
In the Family module, every
patient can have unlimited insurance plans attached to them. There is a box in
the Insurance Plan
edit window on the left about half way down that says "Medical Insurance".
Checking this box identifies the insurance plan as medical rather than dental.
Just below that, also change the claim form to HCFA 1500.
Procedure Codes
Medical codes can be entered
just like any other dental code in the Procedure Code
setup. Cross coding works by entering the medical code in the corresponding
dental code window as described in the procedure code setup page.
Diagnostic Codes
In the Procedure Edit
window, there is a place at the top to enter the medical code and the ICD-9
code. If you have assigned a medical code in the procedure code setup, then it
will have been filled in automatically for you, although you can still change
it. The diagnosis code will need to be entered manually for each procedure. One
procedure for each visit will need to have the box checked for Principal
Diagnosis.
Creating Claims
If a patient has medical
insurance, and there are any completed procedures with a medical code entered,
then clicking the New Claim button at the top of the Account module, will
automatically create a dental claim as well as a medical claim. The dental claim
will show the dental code, and the medical claim will show the medical code.
Printing Claims
As described above, the medical
insurance plan will have been assigned to use the HCFA 1500 claim form. There
are actually two of these forms to choose from, and you will probably use the
preprinted option because it will print only the data, and not the red form
background as well. If you need to alter the way it prints for some reason, then
you can do so in the Claim Form Edit
window.
E-Claims
Any claim that is attached to a
medical insurance plan will go out as a medical e-claim, which has a
slightly different format than a dental claim. This feature must first be turned
on in Setup | Miscellaneous.
Additional validation is performed on medical claims, including requirements for
National Provider ID, diagnostic codes, and a principal diagnostic code. You
will have to make sure you find a clearinghouse that can accept both medical and
dental e-claims. We have not done testing with any clearinghouses yet for
medical claims.