The Billing Order of a procedure code defines the order in which the treatment will be billed to insurance. When a procedure code is added, the system will assign a billing order based on the effective date of the patient's insurance plans and the date of service of the code. If the patient's insurance plan is not yet active, or if it expires before the appointment date, the insurance plan will not be taken into account for the procedure code's billing order.
The following are the billing order values and their descriptions.
N: Do Not Bill to Insurance. This means that no insurance is associated with the code.
M: Bill to the Primary Medical Insurance first. Applicable if Medical insurance is available for the patient.
D: Bill to the Primary Dental Insurance.
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Tip: In billing order, D = Dental insurance and M = Medical insurance. The billing order can be DM, MD, DDM, DMD, or MDD. For example:
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Topics Covered
- Set Up Default Billing Order
- Change Billing Order of a Code
- Change Billing Order of a Completed Code
Set Up Default Billing Order
Watch this video for a concise summary.
To set up a default billing order for a code, perform the steps below.
Navigate to the System Menu > select Practice Settings > Codes > Procedure Codes.
Click on the intended code from the Procedure Codes grid.
Click Edit.
- Select the Default Billing Order.
- Click Save.
Change Billing Order of a Code
Explore this video for an in-depth walkthrough.
To change the billing order of a code, perform the steps below.
- Select the patient using the Global Search Bar.
- Hover over Clinical > select Treatment Planner.
Tip: This can also be accessed from the Appointment slide-out and the Chart when the show fee estimate checkbox is enabled. |
- Click on the Billing Order under the B.O. column of the intended code.
- Select the intended Billing Order from the options displayed.
- Users can select multiple codes and update the billing order of one code to apply the same billing order to all selected codes.
- Changing the billing order may result in a change of fees for the associated procedure codes.
- Choose Yes if you want to retain the existing fees and click Update.
The insurance amount will be reflected in the Insurance 1 and Insurance 2 columns for primary and secondary dental insurance.
If there is only one insurance, the amount will be reflected under Ins. Est column.
Note: Ensure the billing order is not set to N when creating a claim. |
Change Billing Order of a Completed Code
Watch this video for a step-by-step explanation.
If a patient brings up new insurance information after a procedure has been completed and/or sent for claims, you can change the billing order of such completed codes. Let's get started!
On the Treatment Planner, ensure the Hide Completed Items box is unchecked. Then,
- Select the intended code(s).
- Click on the Billing Order under the B.O. column of the intended code.
- Select the intended Billing Order from the options displayed.
- The selected Billing Order will be updated for the code(s) without altering the fee.
- In case a claim was submitted for the code(s), a Warning will appear alerting of any existing claims linked to them.
- Void/Delete claim(s) that must be voided.
- Click Update to proceed without voiding/deleting claim(s) that can be retained.
On clicking Void, a modal will appear. Here,
- Enter the Carrier Claim Control No. and any additional Remarks, if needed.
- Click Yes to proceed.
Practices can use this simple guide to learn all about the Billing Order in CareStack.