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Managing Procedure Billing Order for Dental Insurance Claims

Jasmine Lee
Updated

Overview

The Billing Order assigned to a procedure determines whether it is eligible to be billed to dental insurance and which insurance plan it can be submitted to.

In the Ledger, review the Bill column to identify a procedure's billing status:

 

Bill Column ValueMeaning
DBillable to one dental insurance plan
DDBillable to primary and secondary dental insurance plans

 

Before You Begin

Verify that the patient's insurance plan has been attached to the patient record if the procedure is intended to be billed to insurance.

Make a Procedure Billable to Dental Insurance

For Procedures Posted before Insurance Attached

  1. Open the patient's Ledger (or Transaction Entry) screen.
  2. Locate the procedure requiring correction.
  3. Click the Date of Service for the procedure.
  4. Click Advanced.
  5. Change the Billing Order from None to Dental.
  6. Accept the recalculation prompt.
  7. Click Save.

Note: The procedure fee remains unchanged. Only the billing order is updated.

Verify the Update

After saving, confirm the procedure displays:

  • D (single insurance plan), or
  • DD (primary and secondary insurance plans)

in the Bill column.

Mark a Procedure as Do Not Bill

If a procedure should not be submitted to dental insurance, update the Billing Order to None.

Steps

  1. Open the patient's Ledger or Transaction Entry screen.
  2. Click the Date of Service for the procedure.
  3. Click Advanced.
  4. Change the Billing Order from Dental to None.
  5. Accept the recalculation prompt.
  6. Click Save.

Result

The procedure will display None in the Bill column and will no longer be available for:

  • Dental claim creation
  • Pre-authorizations
  • Insurance billing

Note: Changing the Billing Order to None does not remove the procedure from the patient's ledger; it only prevents the procedure from being billed to insurance.

Create the Insurance Claim

After all applicable procedures have been updated:

  1. Navigate to the patient's Ledger.
  2. Verify the desired procedures are marked with D or DD in the Bill column.
  3. Select the procedures to include on the claim.
  4. Click Create Claim.
  5. Complete the claim creation process.

The Create Claim button is available only for procedures that are eligible for dental insurance billing.

Additional Resources

If multiple procedures require updating, repeat the steps above for each procedure. Properly configuring the Billing Order ensures that procedures are either submitted to insurance when appropriate or excluded from claim generation when insurance billing is not required.

 

 

 

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