E-CLAIMS question

[501Aflak]

For Orthotrac... is there a difference in how E-Claims are sent based on if you have ADA 2006 or ADA 2012 forms selected in Insurance Claim Options?  I have had several insurance companies ask for ADA 2012 forms and we still have ADA 2006 marked on our claim options.

Thanks!!

[gibbsortho]

It is because the system is not updated to the new form I dont know why they dont try to change it because insurance companies are missing information like the remaining months of treatment or I think it is the total months of treatment it is one of those and so they end up calling our office asking that question and it delays claim processing

[tshaw]

Hello @501Aflak!

The eClaims are submitted in a HIPAA-compliant data format.  The ADA form revisions only apply to physically printed claims. 

[kslav2002]

We are on OrthoTrac Version 15.1.5.92 and have ADA 2019 forms selected and get insurance companies calling about missing information as well.  When I print a claim on an ADA 2019 claim form, Box 42 says Months of Treatment on the actual form but it prints the Remaining Treatment Months.  I am sure this is how things are also getting transferred to the companies in the HIPPA-compliant data format. Is this something that has been updated in newer versions of OT???

[501Aflak]

@tshaw, I ask because I get questions from insurance companies about info that is not sent over via e-claims, even though I  complete it on my "screen". What is received does not have all of the same things, so I thought maybe it was due to the version I was completing being different than the version being received by insurance. Also, I need to use 2012 for a few printed claims, but I cannot get them lined up correctly when printing, even after running the utility for that.  I have just saved a 2012 claim form on my computer and I manually input all info if I need one printed. Thank you for the information!