Learn how to create and send insurance claims by viewing an interactive guide or step-by-step instructions.

How to create a single claim

Choose an option to jump to the applicable steps:

• Creating a primary claim
• Creating a secondary claim
• Creating a medical claim
• Creating a claim for another insurance plan (e.g., tertiary)

Creating a primary claim:

1. Select the patient and go to the Account Module
2. In the Patient Account grid, select the procedures for the claim.
3. If the patient has only primary insurance, in the toolbar, click the New Claim button.
   • If the patient has additional insurance plans (e.g., secondary), click the dropdown next to the New Claim button, and select Primary.
4. Procedures on the claim are listed in the grid. In the Edit Claim window, enter applicable information for the claim.
5. Send the claim:
   • To send the claim now, click the Print button or the Send button.
   • To send the claim later, click Save.
   • To send the claim as part of a batch, click Save and see Sending Multiple Claims.

Creating a secondary claim:

1. Select the patient and go to the Account Module
2. In the Patient Account grid, select the procedures for the claim.
3. In the toolbar, click the dropdown menu next to the New Claim button.
4. In the menu, click Secondary.
5. Procedures on the claim are listed in the grid. In the Edit Claim window, enter applicable information for the claim.
6. Send the claim:
   • To send the claim now, click the Print button or the Send button.
   • To send the claim later, click Save.
   • To send the claim as part of a batch, click Save and see Sending Multiple Claims.

Creating a medical claim: To see medical features in Open Dental, enable Medical Insurance in Show Features.

1. Select the patient and go to the Account Module.
2. In the Patient Account grid, select the procedures for the claim.
3. In the toolbar, click the dropdown menu next to the New Claim button.
4. In the menu, click Medical.
5. Procedures on the claim are listed in the grid. In the Edit Claim window, enter applicable information for the claim.
6. Send the claim:
   • To send the claim now, click the Print button or the Send button.
   • To send the claim later, click Save.
   • To send the claim as part of a batch, click Save and see Sending Multiple Claims.

Creating a claim for another insurance plan (e.g., tertiary):

1. Select the patient and go to the Account Module.
2. In the Patient Account grid, select the procedures for the claim.
3. In the toolbar, click the dropdown menu next to the New Claim button.
4. In the menu, click Other.
5. In the Create New Claim window, select the insurance plan.
6. Select the Relationship to Subscriber.
7. Procedures on the claim are listed in the grid. In the Edit Claim window, enter applicable information for the claim.
8. Send the claim:
   • To send the claim now, click the Print button or the Send button.
   • To send the claim later, click Save.
   • To send the claim as part of a batch, click Save and see Sending Multiple Claims.

How to create claims for a single patient with multiple insurance plans

1. Select the patient and go to the Account Module.
2. In the Patient Account grid, select the procedures for the claim.
3. In the toolbar, click the New Claim button.
4. Send the claim:
   • To send the primary claim now, in the Edit Claim window, click the Print button or the Send button.
   • To send the primary claim later, in the Edit Claim window, click Save.
   • To send the primary claim as part of a batch, in the Edit Claim window, click Save and see Sending Multiple Claims.

Depending on the patient's insurance plans, primary, secondary, and tertiary claims are created. Claims for medical insurance must be created separately. See Sending Medical Claims.

How to create claims for multiple patients

1. Go to the Manage Module.
2. In the Daily section, click the Send Claims button.
3. In the Send Claims window, click the Procs Not Billed button.
4. In the Procedures Not Billed to Insurance window, set desired filters and click the Refresh button.
5. Select procedures or click the Select All button to highlight all procedures in the list.
6. Click the Create Claims button.
7. Click OK on the warning message.
8. Click OK on the confirmation message.

Claims for primary, secondary, and tertiary insurance plans are created for all of the selected procedures. If there are any errors for a procedure, a claim is not created. To send the claims as part of a batch, see Sending Multiple Claims.

How to send multiple claims at once

1. Go to the Manage Module.
2. In the Daily section, click the Send Claims button.
3. In the Send Claims window, select the claims to send.
4. Click the Print button or the Send E-Claims button.
   • The selected claims are sent electronically or printed. When printing, if no claims were selected, only claims marked as Paper are printed. Sent or printed claims are displayed in the History area.

Additional Resources

See our video: Creating a Claim Webinar

• Account Module
• Claim Types
• Edit Claim
• Edit Claim - General Tab
• Edit Claim - Attachments Tab
• Edit Claim - Misc Tab
• Medical Insurance
• Cross Code
• Send Claims
• Procedures Not Billed to Insurance Report