How do I submit an insurance claim in Canada?
You can submit an insurance claim once you have created your treatment plan and generated an invoice for the patient.
To submit an insurance claim in Canada:
In Dentally, go to the 'Account' tab in the patient record.
Find the invoice you wish to make a claim on, and select the three dot menu on the far right.
In the menu that appears, select 'New claim'.
In the window that pops up, complete the required fields. Note that the 'Billing Provider' field is compulsory.
If you have completed a predetermination, you can include the pre-authorisation number in the 'Predetermination #' field.
Select your 'Type Code' against each item as required from the dropdown list.
Scroll down and complete any of the additional information as required.
If the treatment was a replacement, then you will be asked to complete the date for the prior replacement. This needs to be entered as year/month/day or chosen from the pop-up calendar.
Once all fields are completed, click 'Generate claim'. You can also select to print the claim.
This will then transmit the claim to CDAnet. If there are any errors, you will be advised immediately. Claims can be viewed in the 'Claims' tab of the patient record, and managed from the claim management tool.
You will be presented with a screen showing the transmission status and a link to view the response from the insurance carrier. This will likely be either an explanation of benefits or an acknowledgement.
📝 Please note: As soon as a response has been received from the primary insurance, the secondary insurance will be sent as appropriate, if needed.
How do I use the 'Claims' tab in Canada?
This section can be found in the patient record.
It shows all claim transactions that are listed for the patient, and their status.
In this section, you can also add attachments for the claim or download responses from insurance carriers.
This is different from the claim management tool, which can be used to oversee claims for all patients.
