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After a Conversion: How to Handle Outstanding Claims 

Most Final Conversions do not convert outstanding claims.  Thus, before you can receive a claim payment, you must create each claim. 

Note: Conversions from EZ Dental and Dentrix convert outstanding primary claims, but not secondary claims.

To track outstanding claims, print an outstanding claim report from your old software (as of your final conversion date). As you receive and enter payments in Open Dental, mark the claim off the list. This will ensure you have an accurate list of pending claims.

  1. If needed, verify the patient's insurance benefit information. See After a Conversion: Verify Insurance. This will ensure insurance estimates are accurate and reduce data entry when entering claim payments.
  2. Create the claim.
    1. In the Account module, select the procedures and click New Claim. 
    2. Click OK on the Edit Claim window.  This will create the claim.
  3. Receive the claim and attach it to a payment.
    1. Double click the claim to reopen it.
    2. Receive the Claim.  If insurance was entered correct, the estimates should match the payment amount.
    3. Finalize the Payment (attach the claim to the payment).

When family balances equal 0, clean up income transfers.  See Conversions: Income Transfers.

If you are unable to create claims: 
For some conversions, it is difficult to convert transactions properly.  Thus, claims won't convert and you may not be able to create a claim.  In these circumstances, you have two options:

  1. Simply add the payment to the patient's account, making a special note for your records. Note that the payment will not be associated with a claim, and your reports will display accordingly.
  2. (Not Recommended) Enter claim payments into your old software. Only consider this option if the transactions did not convert. You will also need to enter payments in Open Dental so that patient account balances remain accurate.

See also: Post-Conversion Checklist.

 

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