Create a Custom Claim

Follow the steps below to create a custom claim form for your practice.

  1. Go to Tops Ortho > Practice Setup > Letters/Forms.
  2. Click on the Forms tab.
  3. In the Insurance Claims menu, highlight the claim form you want to use as a basis for your custom claim. Typically this will be the ADA 2019 Claim form or the CAO Form. It is okay to duplicate a locked form; doing so will not change the locked form.
  4. Click Duplicate.

  1. Name your custom claim and click Edit Layout.

  1. The claim form will display; you will notice it contains a lot of yellow placeholders. These placeholders pull information automatically from the patient chart.
  2. To remove a placeholder, click on it in the template and press Delete on your keyboard.
  3. To draw a text box where the placeholder was, click the tool that looks like a script A. Draw your text box where you would like it to appear on the claim.

  1. Change your tool to the arrow cursor and double-click inside the text box you drew.
  2. Enter your text.
  3. To change the font and size of your text, right-click over your text and select Font > Show Fonts.
  4. Use the Fonts box that displays to edit your text size. Typically, it will need to be 9.00 pt to fit on the claim form.
In this example we are entering the doctor's name as static text in box 53

  1. When you have completed your edits, go to File > Save.
  2. Close your custom claim template.
  3. Go to Action > New Insurance Claim. You will now see your custom claim form as an option in the Form dropdown menu.

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