- Unlike, Benefit Check requests and Pre Authorization requests where you only chose one procedure code in the drop-down menu and maybe asked about codes in the Additional Comments box, Claim Submissions allow you to submit Multiple Line Items for one specific Date of Service by clicking the “Add Additional ADA Code” link on the lower-right of the blue bar.
- Just like you may have had to for Pre Authorizations, you may be Required to submit a file/document when you see the red “Required” word next to one of the sections labeled “X-Ray” or “Periodontal Chart/Other”. You will Not be able to Save/Process a Claim Request until all red “Required” notifications have disappeared/satisfied.
- All your Claim Submission requests are saved on the grey menu/tab “Submitted Claim”. When you click that menu/tab, New requests will be noted with the Status as “In Process” and is on the CODE claims team’s To-do list to review your submission and send it out to the Insurance company. When the Status is “Processed” the CODE claims team had everything we needed to create a Medical claim and it has been sent out.
- If a Claim Submission has a “Rejected” status, that means a CODE claims team member reviewed your Claim Request but there is something that needs to be addressed or corrected before the Medical Claim can be sent out to Insurance company. You will always get an email notification about a Rejection, you do not have to check the Submitted Claim tab/menu every hour/day.
- The next training section “Claims Follow Up” will discuss the Medical Claims processing and how to find out about a Claim Status.
Claims Submission
