Generate a Pre-Estimate Claim

Your patient wants you to send a pre-estimate to their insurance. How can you do this when they have not yet begun treatment? We've got you!

1. Open the patient chart.
2. Make sure that the patient's treatment plan has been set up in the Dx/Tx Plan section in their Clinical chart. For claims purposes, you must fill in Dental Classification, Treatment Phase, and Treatment Length. A Treatment Plan name is not required but is helpful:

3. Next, go to the Admin side of the patient chart and click on the Contracts/Ledgers tab.
4. Double-click on No Contracts under the treatment plan you created (this is why the Treatment Plan name is handy, in case you prepared more than one treatment option.)
5. The contract worksheet will open. Enter the contract information, including the expected insurance amount, just as you would if the patient were starting treatment.
6. Record the contract only; do not charge the Initial Fee.

7. Go to Action > New Insurance Claim and select the Pre-Estimate Claim claim type from the dropdown.
8. Select the contract that you just recorded and click Use Selected Contract.
9. Select a claim form (typically ADA 2019 Claim) and enter Remarks, if needed (the second field).
10. Click Add New Claims to Tops.
11. Tops will generate the Pre-Estimate Claim for e-filing or mailing.