Medicare / CDBS Claiming in Dental4Windows

Medicare / CDBS Claiming in Dental4Windows

Quote
Dental4Windows has the functionality to process Child Dental Benefit Schedule (CDBS) claims electronically
  1. The activation action creates the necessary items, charting operations, fee level and health fund insurance details automatically.. 
    1. However, the activation options above are only available where/when the schedule has not been previously run
  2. Items, charting operations, fee level and health fund insurance details must be maintained and managed by the practice once initial setup is complete.
  3. Child Dental Benefit Scheme (CDBS) claiming
    1. There are 4 possible options for Medicare Child Dental Benefit Scheme (CDBS) claiming: Bulk Bill, Fully Paid, Partly Paid & Unpaid

Setup CDBS

Activate Child Dental Benefit Scheme CDBS

Dental4Windows has the functionality to process CDBS claims electronically; however, the surgery must be registered with Medicare to utilise this scheme. None of the CDBS requirements or procedures are enforced or created by Centaur Software. For information on the Child Dental Benefits Schedule, please contact Medicare Australia.

Instructions change depending on the build of Dental4Windows. Check via the Help menu > About.

Build 3403 or Higher Activation

This action creates the necessary items, charting operations, fee level and health fund insurance details automatically when the feature is activated.

  1. Go to Location Setup > Items
  2. Record menu > Setup Child Dental Benefits Schedule
  3. Read the information provided in the Setup Child Dental Benefits Schedule window
  4. Click Yes to proceed or No to cancel
  5. Another window will appear once the activation is complete
  6. Click OK
  7. Close Dental4Windows and reopen for the CDBS features to appear

Build 3376 or Lower Activation

If you are on a current Support and Maintenance contract, please contact support@centaursoftware.com.au to activate the scheme.

Using Child Dental Benefit Scheme Features

Claim via Bulk Bill

The following instructions relate to claiming Child Dental Benefit Scheme (CDBS) via Bulk Bill, linked to a terminal. Note that the Rebate column in Treatment tab shows the maximum Medicare Benefit for each item and unless manually updated each time a change occurs, they may be incorrect. To check a patient’s benefit cap balance, refer to Medicare. 

InfoIt is recommended each CDBS patients' file is Setup Patient File for CDBS

  1. Go to Patient Records > Treatment tab
  2. With the CDBS items entered, go to Itemised Invoices menu > New Invoice Only / F2       
    1. Main Responsible Party: Insurance
    2. Send to: Child Dental Benefit Scheme
    3. Click Medicare

      1. Claim Type: Bulk Bill
      2. Referral Override: Not Applicable
      3. Click Submit

    4. Within the Create Itemised Invoice window, click Save

Claim via Part Paid

The following instructions relate to claiming Child Dental Benefit Scheme (CDBS) via Part Paid method, linked to a terminal. Note that the Rebate column in Treatment tab shows the maximum Medicare Benefit for each item and unless manually updated each time a change occurs, they may be incorrect. To check a patient’s benefit cap balance, refer to Medicare. 

InfoIt is recommended each CDBS patients' file is Setup Patient File for CDBS
  1. Go to Patient Records > Treatment tab
  2. With the CDBS items entered, process a partial payment from the patient via usual methods
  3. Once the treatment has been partially paid, go to Invoices tab
  4. Select the relevant invoice to claim
  5. Invoices menu > Medicare Claim

    1. Claim Type: Part Paid
    2. Referral Override: Not Applicable
    3. Click Submit

Claim via Fully Paid

The following instructions relate to claiming Child Dental Benefit Scheme (CDBS) via Fully Paid method, linked to a terminal. Note that the Rebate column in Treatment tab shows the maximum Medicare Benefit for each item and unless manually updated each time a change occurs, they may be incorrect. To check a patient’s benefit cap balance, refer to Medicare. 

InfoIt is recommended each CDBS patients' file is Setup Patient File for CDBS
  1. Go to Patient Records > Treatment tab
  2. With the CDBS items entered, process a payment from the patient via usual methods
  3. Once the treatment has been paid, go to Invoices tab
  4. Select the relevant invoice to claim
  5. Invoices menu > Medicare Claim

    1. Claim Type: Fully Paid
    2. Referral Override: Not Applicable
    3. Click Submit

Claim via Unpaid

The following instructions relate to claiming Child Dental Benefit Scheme (CDBS) via Unpaid method, linked to a terminal. Note that the Rebate column in Treatment tab shows the maximum Medicare Benefit for each item and unless manually updated each time a change occurs, they may be incorrect. To check a patient’s benefit cap balance, refer to Medicare. 

InfoIt is recommended each CDBS patients' file is Setup Patient File for CDBS
  1. Go to Patient Records > Treatment tab
  2. With the CDBS items entered, go to Itemised Invoices menu > New Invoice Only / F2       
    1. Main Responsible Party: Insurance
    2. Send to: Child Dental Benefit Scheme
    3. Click Medicare

      1. Claim Type: Unpaid
      2. Referral Override: Not Applicable
      3. Click Submit

      4. Within the Create Itemised Invoice window, click Save

Payments

Enter Payment

When a Child Dental Benefit Scheme (CDBS) payment is received, it should be entered against the relevant patient(s). If the payment covers multiple patients, it will be entered as one following the below instructions. 

  1. Go to Patient Records > Receipts tab
  2. Receipts menu > New Receipt / Click icon 
    1. Payment from: Insurance, Child Dental Benefit Scheme
    2. Amount: Enter the total amount received
    3. Payment Type: Enter the method the payment was received via
    4. Autoallocate Payments: Remove the tick
    5. Amount Paid: Enter the amount paid per patient
    6. Click Create

Why is the patients Medicare claim being declined?

If an error appears when trying to process a Medicare claim saying "Error sending Medicare Easyclaim. Check Hicaps Connection", this is often caused by there being a gap in the Member ID field of the patient insurance. Remove any gaps found. Please also ensure the Member ID and Series are correct. If it’s still declined, it may be an issue with the patients Medicare account so please call Medicare support to find out why it’s being declined.
  1. Go to Patient Records > Patients / Treatment Plan / Treatment tab
  2. See Insurance Level section
    1. Check Member ID has no gaps, remove if so
      Incorrect: Spaces

      Correct: No Spaces

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