Description
This quick guide provides an overview summary of the Do Not Send To Insurance feature for procedure codes.
About
Users can now mark chosen procedure codes as codes that are not to be sent or billed to insurance. This is especially helpful in instances where offices track procedure codes internally or collect on a cash-pay basis.
Steps
Click the More menu, then in the drop-down list, click Administration.
2. In Administration, within the Procedures drop-down, click Procedures.
3. The Procedure Admin module will open. Users can search for codes by categories, procedure status, or by clicking the Search button to search for a specific code.
4. After the Search button is clicked, a search bar will display. Enter the applicable code (e.g., 1351 for Sealant) in the Search field.
5. The code information will appear on the page with a column for Send To Insurance. Codes are automatically set to Yes for sending to insurance. To change this status, click Yes.
6. A Yes/No dialog box will appear. Click No to not send this code to insurance. This will be the ongoing insurance action for the code unless changed.
Note: This will only affect newly treatment planned codes moving forward and will not affect any existing treatment plans that used this code prior to changing the send status.
7. The code will now have No as the setting under Send To Insurance.
8. Codes that have been marked as Do Not Send To Insurance will appear with a $0.00 total for the code in a patient's appointment dialog box.
9. Procedure codes can also be changed to Do Not Send To Insurance in the Appointment dialog box, treatment plan, or invoice. To change the procedure code, begin by clicking the applicable procedure amount under the Insurance column.
10. The Edit insurance allocation dialog box will open. To prevent the procedure code from being sent to insurance for billing, ensure that the Do not send to insurance checkbox includes a checkmark.
11. With the Do not send to insurance option selected, a notation will appear stating "The procedure code has been modified from the default settings". This informs users that the procedure code's default settings are set to Yes for the clinic and will still be sent to insurance for other patients. To continue, click the Save button.
12. The procedure code will now show that the patient is responsible for payment for that procedure and it will not be sent to insurance for billing.
13. Any procedures that were marked as Do Not Send To Insurance will not show on a printed claim.
14. In Curve Hero Reports, a filter has been added to be able to exclude procedure codes marked as Do Not Send To Insurance from the Procedures with No Claim report.
15. To enable the filter for the Procedures with No Claim report, click Add a Filter under the Filters section of the Reports Sidekick.
16. Click Column.
17. A dialog box will open. Click Send To Insurance.
18. Ensure that is true is selected for Send To Insurance. The is true setting must be enabled to exclude procedure codes from the report that were marked as Do Not Send To Insurance.
19. Click Apply Filters to apply the new Send To Insurance filter to the Procedures with No Claim report.
20. The Procedures with No Claim report will no longer show a procedure code that had been marked as Do Not Send To Insurance.
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