Various Insurances in Dental4Windows

Various Insurances in Dental4Windows

Quote
Listed below is how to Setup patient file for CDBS, New Zealand (NZ) Dental Benefits Scheme, Department of Veterans Affairs (DVA) and insurance claims, set a patients fee level, add multiple insurance plans against one patient and remove insurance plan from patient file.

Setup Patient File for CDBS

Info
After CDBS and Medicare Easyclaim is activated, to process CDBS claims via Dental4Windows, the patient must have the following setup. 

  1. Go to Patient Records > Patients tab > Insurance/Various sub-tab
  2. Location Fee Level: Child Benefit Scheme
  3. Insurance Level: Child benefit scheme
  4. Member ID: Enter the patient's card number (no spaces)
  5. Series: Enter the patient's series number (no spaces)

Setup Patient File for New Zealand (NZ) Dental Benefits Scheme

Patients under NZ Dental Benefits should be setup per the below instructions to ensure amounts owing and paid are responsible by OHSA/SDSA.

  1. Select the Region/School from the School List

  2. Send Invoices to = Insurance
  3. Select OHSA or SDSA

  4. Go to Insurance/Various sub tab
  5. Location Fee Level = select OHSA or SDSA

  6. Enter the NHI ID of the patient

Setup Patient File for Department of Veterans Affairs (DVA)

DVA patients should have the following set in the file to ensure invoices are to be paid by DVA and online claims are possible (depending on the claiming system used by the practice).

  1. Go to Patient Records > Patient tab
  2. Address sub-tab
  3. Send Invoices to: Insurance, Veterans Affairs

  4. Insurance/Various sub-tab
  5. Location Fee Level: Veterans Affairs
  6. Insurance Level: Veterans Affairs
  7. Enter the Member ID and Series

Setup Patient File for Insurance Claim

There are different ways on how the Patient's Insurance Information to process a claim can be entered in Dental4Windows.

Single Insurance

  1. Go to Patient Records > Patient tab > Insurance/Various sub-tab
  2. Select relevant Insurance Company and Insurance Plan 
  3. Enter Member ID and Series
  4. Date from if applicable 

Multiple Insurance 

We recommend that all users have Add Multiple Insurance Plans Against One Patient (see below section) setup. 

  1. Go to Patient Records > Patient tab > Insurance/Various sub-tab
  2. Insurance Level: Click List   

    1. Click Add
    2. Select relevant Insurance Fund
    3. Enter Member ID
    4. Enter Series

    5. Click Exit

Info
If the dialog setting is turned on (see Select Insurance Plan using section), users can search the Insurance Plan by description. This setting is recommended for all UAE Dental4Windows users.


InfoIf Link a Fee Level to an Insurance Fund is setup the following message will appear if the Fee Levels don't match with the Insurance Fund. 

Set Patient's Fee Level

The following must be set in the patients' file for the correct fees to be selected when processing Treatment Plan/Treatment. 

  1. Go to Patient Records > Patients tab > Insurance/Various sub-tab
  2. Location Fee Level: Select the required Fee Level from the drop list

Add Multiple Insurance Plans Against One Patient

The Multiple Insurance Environment allows the patients to be setup with more than one Insurance plan for claiming purposes.

InfoEnsure the Multiple Insurance Environment is activated. 
  1. Go to Patient Records > Patient tab
  2. Insurance / Various sub-tab > Click List
    1. Click Add
    2. Select the Insurance Plan from Code column
    3. Enter the Member ID found on patient card
    4. Enter the Series found on the patient card
    5. Enter a Date Start and Date End if applicable for this insurance plan
    6. Repeat steps to add more insurance plans

Remove Insurance Plan from Patient File

Single Insurance Environment

  1. Go to Patient Records > Patient tab
  2. Insurance/Various sub-tab 
  3. Change the Insurance Plan to <None>

Multiple Insurance Environment

  1. Go to Patient Records > Patient tab
  2. Insurance/Various sub-tab > Click List
    1. Highlight the row no longer required
    2. Click Remove
      1. Select to either Delete or Discontinue