At times when you send an insurance claim that contains multiple procedures, the carrier may pay for some but request additional documentation for other procedure(s). You do not need to wait to post the payment for the paid procedures until the carrier pays for the others. Instead, split the claim and post the payment (or, post an additional payment later). This lesson will demonstrate how to split the claim.
Watch the following video to learn how to split a primary insurance claim. (Duration 0:25)
Additional Tips
- You cannot split a claim if any of the following conditions are true:
- The claim is a pre-treatment authorization.
- The claim is a primary claim with a secondary claim already created.
- The claim is a “secondary” claim.
- A payment has already been posted for the claim.
- The claim is in history.
- If you mistakenly move the wrong procedure to Claim #2, you can move it back to Claim #1 by selecting it and clicking the up arrow. However, you cannot “rejoin” claims once they have been split apart.
- Spitting a claim grants you the benefit of tracking “outstanding” procedures, as they become procedures of unpaid claims.
- To learn more about splitting a primary claim, read Splitting Claims in Dentrix Help.
Check Your Knowledge
If you have access to Dentrix, check your knowledge with this exercise.
- Switch to the Dentrix demo database.
(Skip this step if you are using the Dentrix Learning Edition software.) - Select Randall Young’s Ledger; post two or more completed procedures; and, create a primary insurance claim for him.
- Split the claim into separate claims.