How to post insurance payments in Dentrix

How to post an insurance payment in Dentrix

1. 1

   Find the claim and check the procedures

   Open the claim by patient and date of service, and confirm each line on the EOB matches a procedure on the claim.

   Payers sometimes pay a different code from the one billed, or pay one procedure and deny another. Note any difference before you post, so the money lands on the procedure that was done.

2. 2

   Enter the payment per procedure

   Apply the paid amount to each procedure line, not as one figure for the claim.

   Per-line posting is what makes the patient statement, the write-off report and the provider’s collections correct. A claim total breaks all three.

3. 3

   Post the write-off the payer allowed

   Write off the difference between your fee and the allowed amount on each line, with your office’s contractual write-off type.

   If Dentrix calculated a PPO write-off estimate when the claim was created, compare it with the remittance and post what the payer actually allowed. Keep each payer’s current fee schedule in Dentrix so the estimate and the remittance agree more often.

   When the allowed amount is below your contracted fee and no code explains it, leave the gap open and dispute it. See how to find dental insurance underpayments.

4. 4

   Check the patient’s share

   What remains on each procedure should equal the deductible, coinsurance and copay on the EOB.

   If the remaining balance is different, a payment or write-off above is wrong. Fix it now: the patient statement goes out from this number.

5. 5

   Finish the claim and route what is left

   Mark the claim received, send the secondary claim with the primary EOB if there is one, and move denied or short-paid lines to a work list.

   Each item on the work list needs the reason code, an owner and the date the appeal window closes. Check each payer contract for the window.

6. 6

   Add it to the deposit and match the bank

   Record the check number or EFT trace number, add the payment to the deposit, and confirm the deposit equals what reached the bank.

   For a virtual card, post the full amount the payer paid, book the processing fee as a cost in your accounts, and match the card processor’s payout net of the fee.

When a line is short with no explanation, the underpayments guide shows how to tell a contractual write-off from money the payer still owes, and the PPO fee schedule entry explains allowed amounts.

Posting one check for many claims

Large payers often send one check, or one EFT, that pays claims for a dozen patients. The bank sees one deposit; the ledger needs a dozen postings. Post each claim from the EOB on its own, per procedure, with the same check or trace number on each. Then add up the claims and confirm they equal the check before it goes on the deposit.

When one claim inside the check is short or denied, flag that claim and post the rest. Holding the whole check back because of one line is how a week of payments goes unposted.

Dentrix and electronic remittances (ERAs)

An ERA, the 835 file, carries the EOB’s information in a standard electronic form. With a clearinghouse that delivers ERAs, and enrollment with each payer, the payment detail can be applied in Dentrix from the file instead of typed.

That removes the typing, not the review. Someone still checks write-offs, partial payments and denied lines, and someone still matches each EFT to the bank by its trace number. Payers you are not enrolled with keep sending paper, portal PDFs and virtual cards. See EFT and ERA enrollment.

A daily posting checklist

Run this at the end of each posting day. If every line is true, the ledger and the bank agree and nothing is waiting in a pile.

1. Every remittance received today is logged with the date it arrived, paper, ERA, portal and card.
2. Every remittance received today is posted per procedure, or on the work list with a reason.
3. Write-offs match the allowed amounts on the remittances, not the estimates.
4. Denials and short pays have an owner and an appeal date.
5. Each insurance deposit in Dentrix matches a deposit on the bank statement.
6. Card fees and differences are written down with a name and an amount, never plugged.

How ScoutIQ handles it

ScoutIQ works on top of Dentrix, Dentrix Ascend and 59 practice management systems in all. It collects remittances from staff uploads, a ScoutIQ PO Box for paper EOBs and checks, your clearinghouse and payer portals, reads every line, and posts paid amounts, write-offs and patient responsibility to the right Dentrix claim.

95% of insurance payments match their EOB with no human review (see the data page). Short pays and denials go to a queue with the payer’s reason and the days left to appeal, and your team files the appeal. Every EFT, check and virtual card is matched to the bank deposit and booked to QuickBooks or Xero: see reconciliation. ScoutIQ does not submit claims. Most practices are live in 48 hours.