How to Add an Insurance Carrier
Summary:
Both employer and insurance company plans can be entered.
Steps:
1. Click the Insurance menu on the toolbar and choose Add/Edit Carriers or click File > Update > Insurance > Add/Edit Carriers.
The Insurance Carrier File Update window will appear.
2. Click the Add Carriers button.
The Create New Insurance Carrier ID dialog box will appear.
3. Enter an ID (max 10 characters) for the new insurance carrier. For example, you might enter MANU for Manulife.
4. Click OK. The Carrier is added to the list of Insurance Carriers.
5. Type the full name of the insurance company in the Name field. The name you enter will be printed on EDI responses.
6. If your practice deals with a particular department at the insurance company, type the name in the Department field.
7. Type the address of the company in the Street Address, City, Province and Postal fields. These fields are optional.
8. In the Mail to Attention of field, type the name of the person to whom you should address any correspondence.
9. Type the name of the person you should ask for when making a phone call to the insurance company in the Phone Contact field.
10. Type the Phone number you should use to contact the insurance company. Do not enter the dashes or brackets as they already displayed on the screen for you.
11. Type the Extension number at which you can reach the contact person when you telephone the insurance company.
12. The EDI Carrier ID field is one of four areas in ABELDent where EDI information must be entered in order to submit insurance claims electronically.
a. Type the EDI Carrier ID number assigned to you by the Canadian Dental Association in the field provided.
Each plan used by a patient whose claims are submitted through EDI must be assigned an Insurance Carrier. The Carrier must have a EDI network ID recorded in order to process insurance claims electronically.
Do not create more than one insurance carrier entry with the same EDI Carrier ID number. This will only cause great confusion when sending claims, and will result in problems when sending for ROTs (Request Outstanding Transactions).
b. In the EDI Network list box, click the down-arrow and select the network ID that the insurance company will using for EDI Claims.
The following networks are available for selection:
ABC - Alberta Blue Cross
ACE - NDC Health
CD - Dentaide
CDCS - CDCS Health
ICA - iTRANS
MBC - Manitoba Blue Cross
PBC - Pacific Blue Cross
SHN - BCE Emergis
13. Type the CDAnet Version number supported by this carrier. If the CDAnet version number is "04", click the CDAnet4 Setup button.
14. Click the Birthdate Required? check box if the patient or subscriber’s date of birth is mandatory for claims being submitted to this company.
ABELDent will warn you before submitting the claim if a birth date is missing. The insurance plan subscriber is the person applying for the insurance plan.
The insurance coverage may be for the subscriber and/or for a dependent. The plan subscriber does not necessarily have to be a patient of the practice; however, all insurance subscribers must be entered in the ABELDent system.
14. Click the Certificate No. Req’d check box if the patient’s or subscriber’s certificate numbers are mandatory for claims to this company. ABELDent will warn you before submitting the claim if the certificate number is missing.
15. Click the Policy No. Req’d check box if the policy number is mandatory on claims for this company. ABELDent will warn you before submitting the claim if the policy number is missing.
16. In the Other Req’d text box type any other mandatory information.
17. In the Eligibility Contact field, type name of the person you should ask for when making a phone call to the insurance company regarding a patient’s eligibility.
18. Type the Eligibility Phone number you should use to contact the insurance company about a patient’s eligibility. Do not enter the dashes or brackets as ABELDent already displays them for you.
19. Type the extension number in the Ext field at which you can reach the eligibility contact person when you telephone the insurance company.
20. Type the Fax No. for the Eligibility contact at the insurance company.
21. Click the Bulk Cheque net amount may differ from Gross option to allow a bulk cheque to be reconciled. This only applies in those cases where the component payments of a cheque do not equal the total cheque amount because of insurance company "holdbacks" or other payment reductions.
This option should not replace the procedures used to handle insurance retractions with bulk cheques.
22. Check Direct Deposit if the carrier you are adding remits bulk cheques directly into a practice's bank account. If this is checked, the Direct Deposit option on the Bulk Cheques screen will also be checked automatically.
23. Click Apply Now.
24. Continue to add other Carriers and when you finished click OK to exit.
Product (s): ABELDent
Category: Insurance
Classification: Public
Date Created: 2 Sep 2016
Created by: Brian Neale