Open Dental Forum

I participate with some state mediciad plans. In my state most patient are under a PPO plan but there are a few of these PPO plans with limited benefits and then you can bill the state welfare department directly for the non-covered procedures sometimes and get payment. For example a panorex is not covered by the primary PPO plan that gets billed first but the state if you submit a claim will pay for the panorex after the denial from the primary PPO.

So my question is in OD...

I set up both the primary and secondary plans in OD and in many cases the primary plan covers everything and there is nothing to submit to the secondary state welfare department. I don't actually want to waste the time and expense of sending the secondary claim to clear it out of OD. If I try to delete the secondary claim in OD it continues to say "not sent." If I do nothing with the secondary claims I have pages and pages of unsent claims on my unsent claims report. I don't want my account inaccurate by marking it as sent and no payment if I didn't really submit anything especially being a medicaid plan.

Is there an easy workaround? I can only mark it as "Do not bill to insurance" in OD at the procedure level and not the actual insurance plan level right?

Why can't I delete the secondary insurance claim and have it not say "not sent"?

If there is no need to send the secondary claim, why not manually change the CLAIM STATUS to "Received". Now you can enter "0.00" for payment and note in the remarks area that there was no reason to send this claim as the primary was paid in full?

It seems the program doesn't know if a claim was deleted or forgot to be sent, therefore it defaults to "unsent"

Jim

There are a few things you can do. First of all, you can do as JimZ mentions and just mark the secondary claim as received with $0.00 payment. Instead, you can instead delete the secondary claim, double click on the procedure, double click on the secondary insurance estimate and delete it. Additionally, you can delete the secondary claim, double click on the procedure, double click on the secondary insurance estimate and check the "Do Note Bill to This Insurance" checkbox. All of these should stop the procedure from saying "Unsent".

Deleting the claimprocs is a lot of work.
Just mark the claim as received (you don't need to enter Payment by Procedure).

Arna...

I will try Travis recommendation. I don't want to mark it as received if I never sent anything. I am talking about Medicaid claims. I clearly want to know if I billed the medicaid system for a procedure or not. There is no such thing as a billing error with Medicaid... any error or oversight is called fraud.

True.
Travis' solution works if the claim is not sent.