Practice settings: insurance

This section of Practice Settings is primarily used for configuring billing and treating dentists and/or dental entities.

Insurance payers require a billing dentist or dental entity, and a treating dentist to process patient claims successfully.

  • A billing dentist is the provider whom dental coverage and claims are paid to. 
  • A treating dentist is the provider who performs the service.
  • A dental entity is the legal entity name of a dental practice.

Once billing and treating dentists or dental entities have been created they must be associated with a clinic group under Practice Settings > Primary Information > Clinic Management before claims can be generated. To learn more, see Practice settings: clinic management.

Batches

Configure the type of claim queues your practice uses. Buttons for each queue appear in Practice > Insurance > Batches under the Batch Claims heading.

  1. Go to Practice > Practice Settings > Insurance > Batches
  2. Toggle No/Yes for the submission methods and types of claim processed in your system



  3. Select Save

Billing and Treating Dentist 

A summary of existing billing and treating dentists is displayed in Practice Settings > Insurance > Billing and Treating Dentist, but individual dentists must be set up under Provider Management first.


To setup a provider as a billing or treating dentist:

  1. Go to Practice > Practice Settings > Providers & Resources > Provider Management 
  2. Find the name of the provider you want to set up as a billing or treating dentist
  3. Select  under their Actions column
  4. Enter the required information:


    Billing Dentist Requirements
    Billing AddressThe provider or dental entity's address.
    Dentist License NumberThe provider or dental entity's license number provided by a regulatory body or state to practice dentistry.
    Group NPIThe provider or dental entity's group national provider identifier (NPI).
    TINThe provider or dental entity's tax identification number (TIN).
    Work Phone NumberThe provider or dental entity's phone number.
    Treating Dentist Requirements
    Dentist License NumberThe provider or dental entity's license number provided by a regulatory body or state to practice dentistry.
    Mailing AddressThe provider or dental entity's address.
    NPIThe provider or dental entity's national provider identifier (NPI).
    Provider Specialty CodeThe provider or dental entity's specialty code to practice in a specialized area.
    Work Phone NumberThe provider or dental entity's phone number.




  5. Select Account from the left panel


     
  6. Toggle Billing Dentist and/or Treating Dentist



    • A warning message appears if any of the required fields are missing.

  7. After a billing or treating dentist has been configured, they must be associated with a clinic group under Practice Settings > Primary Information > Clinic Management


After a provider is configured as a Billing and/or Treating Dentist. They appear in the summary table in Practice Settings > Insurance > Billing and Treating Dentist.

  1. To update their account details, select  in the Edit column



    • The start and end dates are filled out automatically when the Yes/No toggles in Provider Management > Account were updated.

Dental Entities 

You can configure dental entities for your practice billing workflows. After a dental entity is configured, it must be associated with a clinic group under Practice Settings > Primary Information > Clinic Management

  1. Go to Practice > Practice Settings > Insurance > Dental Entities 
  2. Select Add Dental Entity


     
  3. Enter the required information

    Dental Entity Requirements
    Dental Entity NameThe dental entity's name.
    Start DateThe start date of activity.
    End DateThe final date of activity.
    Group NPIThe dental entity's group national provider identifier (NPI).
    License NumberThe dental entity's license number provided by a regulatory body or state to practice dentistry.
    TINThe dental entity's tax identification number (TIN).
    Work Phone NumberThe dental entity's phone number.
    Billing AddressThe dental entity's billing address.


     
  4. Select OK
  5. After a dental entity has been configured they must be associated with a clinic group under Practice Settings > Primary Information > Clinic Management

Explanation of Benefits (EOB)

Choose if you want these columns to appear in Practice > Payments > Batch Payments when allocating insurance payments and processing EOBS.

  1. Go to Practice > Practice Settings > Insurance > EOB
  2. Update the toggles for each of the available columns



  3. Select Save