eDental Management Section
In today’s release we have published the first major update to the eDental claims management system. The goal is to make even clearer where the practice needs to action something and also show additional information all in one location.
These updates pertain to both General and Orthodontic Dental claims.
Should you have any questions with regard to the error codes provided within the eDental System please see the guide provided by PSD here or call our support team on 0191 500 6789.
The first thing you are likely to notice is that some tabs may show in red with a number next to them, this shows that the section has entries which require attention or some action. You will also note that hovering over one of the status elements will provide a full tool tip explaining the status of the claim. For instance the screenshot above shows RAI means Request for additional information, which would normally relate to files the board requires you to upload.
Claims by Day
Claims by day shows all the GP17’s that have been sent via eDental that day, we outline both the amount of the claim (DPD) and the Patient Revenue charge where applicable (Patient), if there is an error you will see this highlighted on the screen as well as the error count. If the claim has already been sent it will show the difference in value.
Adapter
Sometimes the ePractitioner adapter may be offline, this could be because PSD are undergoing maintenance or your internet connection has been offline. In these situations your eDental claims will queue in the software, to view these claims you simply click on the waiting tab. Please ensure you call support on 0191 500 6789 if your claims have been sat in here for more than 2 days. Under normal operation we would expect this tab to be empty.
Expired
Once a claim has been sat in the Adapter queue for too long it will stop trying to send as the message has expired. These will automatically show in the Expired tab. If you are now connected to eDental again, simply highlight the claim and click Re-send, this will force the claim back through the adapter. If the claim is one you do not wish to send or it is to old to be valid, simply highlight the claim and click clear.
Errors
eDental has a very detailed claims matrix which looks at hundreds of variables and checks their validity before passing to the Midas payment processing system. Chairside you will be provided with any errors which is a great way to correct them in real-time, if you are not able to deal with the error there and then, they will appear in the Errors section and you can manage them directly from here. Highlighting the claim will show the error at the bottom of the screen with all detail, double clicking on the form will open the treatment plan. You can access guidance on the error codes here if you still can’t solve the problem, then feel free to call support on 0191 500 6789
List of common errors and what to do
Complete not Sent
Complete not sent is a simple way of finding all general dental claims where the whole treatment plan has been completed but the claim has not yet been sent. Usually this is an oversight by the dental team and the claim will need to be submitted by the dentist. We recommend that the PM and dental team work to ensure this list is empty at least once a week, if this is not possible they should at least understand why each claim listed here has not been transmitted.
Outstanding Claims
Outstanding Claims are all general dental claims that have work to be completed but the patient does not currently have an appointment booked within the next couple of months. The system will show claims where the patient has a 6 month recall appointment booked but nothing in the short term as well as patients without any appointments. This is another section that should be checked weekly at a minimum.
Approvals - Ready
Approvals ready is simply all the claims that require prior approval and have not yet been sent to the board for approval
Approvals - Update
Approvals update lists all prior approval claims that have received an update from PSD, these are listed including their status, the colour coding shows the import of the item, hovering over the status will present a full textual description of the status. Simply double click the form to open it then follow the normal process to submit.
Approvals - Information Required
When PSD require more information pertaining to a prior approval claim or in some circumstances a standard claim (lab slip etc.) the claim will show in the Information Required section. Please note that these should be actioned in a timely fashion to avoid the claim being closed by PSD.
Approvals - Needs Appointment
Once a prior approval claim has been granted approval by PSD the system will list these in Needs Appointment should the patient not have an appointment booked already. This ensures you can simply check PA claims where there are no future appointments booked since the point of approval being granted.
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