Medical Insurance  

EZ2000 Plus Dental has good support for medical insurance, making it useful in Oral Surgery and in hospital settings.  Below are some of the features in EZ2000 Plus Dental that pertain to medical insurance. More and more dental procedures are considered to be medically necessary and therefore should be billed to the medical insurance company.

Turn on Medical Insurance features:  In the Main Menu, click Show Features, then select Medical Insurance. 

Insurance Plans:  In the Family module, every patient can have unlimited Insurance Plans.
- On the Edit Insurance Plan window, check the Medical Insurance box to identify the plan as medical instead of dental. 
- Select the claim form.  1500_02_2012 is the new 1500 Health Insurance Claim Form (version 02/12) that is included in version 14.2.  1500 is the old version of the form.  To reassign the new 1500_02_2012 claim form to current insurance plans, see Claim Forms, Reassigning Claim Forms.

Procedure Codes:  Medical codes can be entered in the Procedure Code List just like any dental code, or they can be imported from the various medical coding companies.  For cross coding, see Procedure Code Edit.

Medical Codes:  In the Procedure Edit window, Medical tab, there is a box for medical codes. If a default medical code is entered for the Procedure Code it will be filled in automatically. This is called crosscoding. When a new claim is created for a medical insurance plan, each Claim Procedure code sent to insurance is copied from the medical code of the corresponding procedure, if the medical code is not blank.

Diagnostic Codes:  In the Procedure Edit window, Medical tab, you can enter multiple ICD-9 codes for a procedure. For each visit, one procedure needs to have the Principal Diagnosis box checked. If this box is not checked the claim will not be paid.

Claims:  If a patient has medical insurance, and there are completed procedures with a medical code, clicking New Claim in the Account module will automatically create a dental claim and medical claim. The dental claim will show the dental code, and the medical claim will show the medical code.  See Claim Types.

Printing Claims:  The medical insurance plan will use the 1500 Claim Form (see Insurance Plans above).  You must print the 1500 claim form on preprinted forms because the red background has special requirements and they do not allow printing the background from a printer.

The UB04 claim form is included in version 12.0. 

E-Claims:  Medical e-claims are part of version 11.1.  See Medical E-claims.