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Claim Form Edit
Claim forms can be customized or added as needed.
In the Claim Forms window, double-click a custom claim form.
Changes to claim forms only affect printed claims and do not affect electronic claims. We recommend contacting Open Dental support to make changes, as changes may affect claim submission and payment.
Possible reasons to modify a claim form:
The left side of the window shows the items on the claim form. The right side of the window has an edit panel.
Description: Name of the claim form.
Width / Height: Dimensions of the claim form when printed. Edit width and height when claim form is not printed on standard 8.5 in. x 11 in. paper.
Is Hidden: Hide a claim form so it no longer shows as an option in various drop downs.
Print Images: Set whether or not background images print.
Offset X / Offset Y: Change the alignment of the form when printing on a preprinted form. Values can be positive or negative and shifts all elements on the page by the given number of pixels in hundredths of an inch.
The Items grid displays fields currently added to the claim form. When an item is highlighted, the corresponding field on the claim form displays in red.
Add: Open the Claim Form Item window to add additional items to the claim form. Alternatively, double-click a field to change it.
X / Y Pos: The X and Y coordinates of the selected field. Can be edited.
Width / Height: The width and height of the selected field. Can be edited.
Click Add to create a new Claim Form Item or double-click an existing Claim Form Item on the claim form to edit.
Image File Name: When a background image is selected or being added, enter the file name here. The file must exist in the A to Z Folder. When an image is entered here, no fields should be selected on the right.
Format String: When adding a field that includes a date, enter the date format here.
Field Name: If not using an Image File Name, select the field to be used on the claim form.
Click Save to keep changes.
If adding a new claim form from scratch (i.e., not importing XML), do the following in order.
Hints: