Electronic Filing Operating Procedures

Transaction Entry

Make sure that in the Options Purchased box, Electric Claims must be "Y".

• The SITE CODE must read ECF if you are filing with RECS or WebClaims.
• The SPECIALTY CODE must read 301 for a general practitioner.
• If you have multiple licenses on your system, make sure to enter the SITE CODE and SPECIALTY in the PRACTITIONER INFORMATION.

Click on the Settings tab, then click System Settings.

Make sure that File Insurance Electronically is set to "Yes". Click Apply when finished (this will return you to the main screen).

The facility number, modem, and printer settings are all adjusted in your software.

To add a single claim to the Claims Awaiting Submission File:

Click on Transactions, then Family Ledger.

Type the first few letters of the desired patient's last name. Double-click the name of the patient for whom you would like to file insurance.

This brings up the Family Ledger for the patient:

Make sure PD: has a value. This indicates the patient has a Primary Dental insurance carrier. Enter a procedure code to the right of the patient's name. If you want to file insurance on a procedure already in the ledger, right-click on it and choose "Mark Unfiled to Primary". This will put the letter "U" to the right of the dollar amount. The "U" must be there for the insurance to be filed electronically. Click the button that says File Insurance or CTRL+I. This will bring up the Insurance Form Information (Print Batch) screen.

Fill in the necessary information and click Proceed. The next screen will prompt to File Electronically (Y/N). When you choose yes at this screen, the claim is sent to the Claims Awaiting Submission File.

To send the Claims Awaiting Submission File:

It is a good idea to preview the file before sending it. This can be done by clicking Insurance, then Electronic Filing, then Claims Awaiting Submission Report. If this report is correct, proceed to Send Claims. If this report is incorrect, choose Exclude Claims From Submission. Click Insurance, then Electronic Filing, then Send Claims!!!

Clicking Send Claims will bring up either your RECS software or will open the WebClaims website.

• For RECS click on the telephone.

• For Webclaims, click on Login.

When the claims have been transmitted, the software will return you to your Data Team DDS program. A screen stating "Clear Claims Awaiting Submission File?" will appear. Choose YES if the claims were sent successfully. Choose NO and contact Data Team if they were not.

The next time you send electronic claims to RECS, you will receive a previous transaction report.

End of Day Procedures

As the last item of business for the day, follow these steps:

1. Go to Electronic Filing at the Insurance Menu and display the Claims Awaiting Submission Report.
2. If claims appear on the report that should not be filed, use Exclude Claims From Submission to remove those claims.
3. If claims are missing, prepare those claims again.
4. If all the claims are reflected appropriately, print a copy of the Claims Awaiting Submission Report. Keep this report until it can be compared to the confirmation report received from the clearing house.
5. Select Send Claims.
6. If there were any rejected claims, correct the indicated problem and re-prepare the claim for submission. The Claims Awaiting Submission Report may be helpful when re-preparing the claim for submission.