Open Dental is CDAnet certified and ready for use in all Canadian offices. The cost is C$129/month for the first year, then C$99/month after that. We charge less for the Canadian version due to some minor Enhancements that are still needed.
You must be using the latest release of Open Dental version 11.0 or later in order to send electronic claims in Canada. To see the Canadian features, you will need to set your computer
to English Canadian or French Canadian from your Windows control panel
before opening Open Dental.
Database and Claimform
Install our Trial Version. As long as your computer is set to Canada in the Windows Region and Language Settings before you install, the Canadian database and claimform will be automatically installed.
If you need to send ADA paper claims for an American patient, change the claimform for that ins plan to the ADA claim form. You will need to purchase blank forms from somewhere. We are not allowed by law to include them in our software for users outside the Unites States.
CDAnet compliant electronic claims can be sent from Open Dental using either ITRANS or Claimstream. If you send claims to Alberta Blue Cross, then you should setup Claimstream. If you send claims to carriers other than Alberta Blue Cross, then you need to setup ITRANS. If you send claims to Alberta Blue Cross and other carriers, then should setup ITRANS and Claimstream both.
Set the default Clearinghouse to CDAnet.
Make sure that the Export Path matches the setting in the iCA setup described earlier.
Carriers and Networks
In the Insurance
Carriers list, there is a checkbox at the top for CDAnet Only which lets
you view only Canadian carriers. The list will by default contain all carriers maintained by Open Dental. However, you can add or update carrier information if needed. If you have added a new carrier for some reason, make sure to set the Is CDAnet Carrier checkbox and to set the Carrier Identification Number.
The data in the lower half of the window is not editable by users but is instead maintained by Open Dental based on the Carrier Id Number entered. To add a new carrier or to update an existing carrier, verify that the Carrier Id Number is correct, and then run the Database Maintenance tool, which will set the data in the lower half of the window to the correct values.
The following carriers are supported by itrans:
If you attempt to submit to a carrier who is not on the list, you will get an error message. The error message you would receive when sending would be "Primary carrier network not set." However, you might also get this message if you have not set up your carriers properly. The usual procedure for setting up carriers is to fill in the carrier identification number of the carriers you wish to send to, then run Database Maintenance to fill in the network, version and encryption method for the carriers in question. Database Maintenance will only fill these three values for carriers that are on the list of supported carriers, so if you put a carrier identification number within the carrier edit window for a carrier that is not supported, running Database Maintenance will not update the three values. These three values are required to send electronic claims.
As new carriers are added to the list of carriers supported by itrans, you will need to Update your Open Dental Version in order to send claims to them. The beta version will always automatically contain the most current list. If there is a very new carrier, and you do not wish to use the beta version, then you will at least need to update to the most current stable version of Open Dental. In that case, you will need to add the Carrier, fill in the Carrier Id Number, and run Database Maintenance.
The Insurance Plan Edit window looks slightly different in Canada than it does for other countries so a screen shot is provided below which is specific to how the window will look for Canadian offices. For more information about how to create an insurance plan, see the Insurance Plans page, but be aware that the page contains screen shots showing how the Insurance Plan Edit window looks for other countries. The key differences are simply due to different terminology, but all of the insurance plan fields are in the same place for all countries.
Scroll to the bottom of the Insurance Plan Information section on the left and there will be a Canadian section.
Dentaide Card Sequence is where you enter the mandatory two digit value for Dentaide. Plan Flag is where you can indicate one of three kinds of Provincial Medical Plans. A=Newfoundland MCP Plan. V=Veteran's Affairs Plan. N=NIHB. It is usually left blank. Diagnostic and Institution codes are only required if Plan Flag is set to 'A'.
In the Procedure Edit window, to the middle left, there are some checkboxes called Type Codes. By default, "none" is selected. If you need a type code to go out on a claim, you would change it from the procedure edit window for that procedure.
Fee Schedule Tools
The following copyright notice applies to Ontario users:
The ODA Suggested Fee Guide which is included in the Open Dental Software Inc. software and the copyright therin, is owned by the Ontario Dental Association and may be used soley in conjunction with the Open Dental software under licence from the Ontario Dental Association. The "ODA Suggested Fee Guide", "ODA Suggested Fee Guide for General Practitioners", "ODA Design" and "ODA" are trademarks of the Ontario Dental Association.
See Canada Fee Schedules
Lab fees are treated just like ordinary procedures except
for a few key differences. For the codes which are lab fees (99xxx),
go to the Procedure Code Edit window,
and check the box that says "Is Lab Fee". To enter lab
fees for a patient, first create the procedure, then edit the lab fee amounts inside of the Procedure Edit window, Canada tab. Up to two lab fees are allowed, because only one or two lab fees can be sent in eclaims. After typing the lab fees into the Procedure Edit window and clicking OK, one lab procedure with code 99111 will be automatically created for each of the entered fees. The 99111 codes will show in the Chart module and the Account module just like normal procedures do, but cannot be attached to claims. Attached lab fees will show directly below the procedure they are attached to and begin with "^^" to visually indicate they are attached. When sending eclaims, any lab fees attached to a procedure will be sent on the same line as the procedure. Lab fees can be removed by editing the procedure and clearing out the appropriate lab fee amount. Lab fees can also be detached from procedures by right-clicking in the Chart module progress notes and choosing the "Detach Lab Fee" option. Lab fees can be manually entered into the Chart and attached to another procedure by highlighting both procedures and selecting "Attach Lab Fee".
The lower half of the Edit Claim window contains a section specific to Canada. In the main grid, Lab fees will show on the same rows as the procedures they are attached to instead of as separate rows.
When a non-preauth claim is sent and adjudicated electronically, ITRANS generates a transaction reference number for the claim so that it can be uniquely identified. Transaction reference numbers are composed of letters and numbers and will automatically show in "Trans Ref Num" box on the left side of the Canadian tab within the Claim Edit window once the claim has been successfully adjudicated. Claim reversals require a valid transaction reference number so that ITRANS knows without a doubt which claim is being reversed. ITRANS does not allow claims to be reversed on any date other than the date they were originally adjudicated. If a claim needs to be reversed on a date later than the date it was originally adjudicated, then the claim must be manually reversed. Once the claim has been manually reversed, it should then be manually deleted from Open Dental so that the patient account is accurate. To reverse a claim that has been adjudicated, click the Reverse button just to the right of the Trans Ref Num box. The Reverse button will be disabled if there is no transaction reference number or if the adjucation date of the claim is in the past. Not all Canadian insurance carriers support claim reversal. If you attempt a claim reversal for a carrier that does not support reversal transactions, after clicking the Reverse button, Open Dental will display a message informing you that reversal transactions are not supported by the carrier. In some situations, a carrier may choose to reject a claim reversal even when the transaction reference number and reversal date are valid, and when this happens, the only way to reverse the claim will be to reverse it manually.
ITRANS requires automatically printing patient copies of certain forms in very particular circumstances. Dentist copies are never automatically printed. A single patient copy of a response from ITRANS will be automatically printed immediately after a claim is sent if the response is not a rejection notice, after a claim reversal request, after a request for outstanding items (each item will be printed separately), after a payment reconciliation request. Some offices find the extra printing less useful than others and for these offices it is recommended that a PDF printer such a PrimoPDF be installed and used as a default printer on each of the computers where claims are typically processed. When a PDF printer is used as a default printer, any print jobs that are automatically printed will appear in a PDF file on the screen so that the user can cancel the print job by closing the PDF or choose to print if desired.
See the Tooth Nomenclature box at the lower right of Module Setup. Change it to FDA notation if not already set. In Canada, valid tooth surfaces are MOIDBLV(vestibular). In USA, valid tooth surfaces are MOIDBLF(facial) as explained on the Enter Treatment page. For USA, we also use V to represent a class 5 location along the gingival margin of the B or F. For Canada class 5 is represented by "5" instead of "V" to avoid confusion with vestibular.
Within the Account module, pressing the New Claim button will never create a secondary claim. Secondary claims can be manually created from within the Account module by clicking the New Claim button dropdown and choosing the Secondary option. When the patient has primary and secondary insurance with the same carrier, both the primary and secondary claims are processed when the primary claim is sent. In this situation, there will not be a secondary claim listed inside of the patient account, but both the primary and secondary responses can be viewed by printing the claim history of the primary claim. If the primary and secondary carriers are different, a secondary claim will be automatically created with status Waiting To Send at the point in time when the primary claim is sent electronically. There are two electronic message formats for Canadian claims, version 02 and version 04. Some carriers are still using the version 02 message format and for those carriers secondary electronic claims are not possible. A secondary claim will be sent electronically and automatically if the carrier accepts secondary claims, and if the primary claim was sent to a version 04 carrier, and an EOB has been received for the primary claim. In any other case, secondary claims must be sent by physical mail. It is best practice to first create the primary claim and send it or print it before worrying about the secondary claim because sometimes the secondary claim will be created and possibly sent electronically and automatically.
Receipts can be printed from the Account module using the dropdown on the Statement button. The main purpose of printing receipts for Canadian patients is for income tax purposes. Receipts will print the same as for other countries, but will exclude the following items: statements, claims, claim payments, procedure descriptions, procedure codes, and procedure tooth numbers. An additional note will be added at the bottom which reads "KEEP THIS RECEIPT FOR INCOME TAX PURPOSES."
The message format for electronic claims is designed to allow electronic attachments for carries that support version 04 of the standard. As of the writing of this paragraph, no carriers are currently supporting electronic attachments. Open Dental will not be able to send electronic attachments through ITRANS until more carriers can accept them. The format is technically known as transaction type 09 and the response is known as transaction type 19. For now, the best method for submitting attachments electronically is to use NEA Fast Attach.
If you are using the Clinic feature in Canada, make sure to use a different provider for each dentist/clinic combination. Each dentist is assigned an office number which is entered in the Provider Edit window. So if a dentist is at two offices, the only way to enter two office numbers is to use two separate providers.
See Setup Providers.
Raw Data for Invalid or Unknown Response
A form with the above title will print when a response from ITRANS is unknown or invalid and will usually occur when running the request for outstanding transactions (ROT). An ROT causes this issue in Open Dental when the practice used to send claims to ITRANS through their previous practice management software and then switches to Open Dental. In this situation, ITRANS will send responses to Open Dental which belong to the old system and Open Dental will not have all of the data it needs in order to display the response properly. For example, the practice sends a claim in the old software and later switches to Open Dental and runs an ROT and the response to the ROT is an EOB regarding the claim that was sent in the previous practice management software. The form that prints is a basic and shows the contents of the message from ITRANS so the patient can be manually located and updated.
This section applies only to existing customers or developers
Importing of claimform:
If you are already using Open Dental and wish to add the Canadian claimform, you can use this file: CanadianClaimForm.xml. After downloading it, go to the Claimform Setup window and import it. You will also need to place the background gif into your AtoZ folder as described in the section below.
Some existing customers may need to download the new claimform background here: Canada.zip . It also includes a version 6.8.39 database if you need one for some reason.
Installation of database:
1. Rightclick on the download link and select Save Target As... Save the file to a new folder on your C drive or on your desktop, and unzip it (right click, Extract All...). It will contain a database folder as well as the claim form image.
2. Stop the MySQL service as follows: Right click MyComputer | Manage | Services and Applications | Services, then look for MySQL in the list. Highlight it, and stop the service.
3. Rename the old database at C:\mysql\data\opendental\. You could rename the opendental folder by appending something meaningful to the end. Like this: opendentaloldusa or opendental_2009_11_30. So now, you should not have a folder called opendental in C:\mysql\data\.
4. Copy the downloaded database folder called 'canada' into C:\mysql\data\, and rename it to opendental. So, now, if you open C:\mysql\data\opendental\, you should see about 500 files, starting with account.frm, account.MYD, etc.
5. Copy the claim form gif into C:\OpenDentalData\. So now, if you open C:\OpenDentalData\, you should see all 26 A-Z folders, the gif you just added, and a few other files and folders.
6. Restart the MySQL service.
7. Run Open Dental.
Changes to the Database
This is a list of changes that we will make to the posted database. Until we make the changes, new users will make these changes themselves.
- Insurance Categories have better defaults.
- At least one provider should be entered and should have a fee schedule assigned.
- Practice setup set to use that provider.
that IsProsth is set for all crowns, bridges, ortho appliances, and dentures.
- Shorten procedure descriptions and abbreviations.