Mastering the Claims in Open Dental

Managing insurance claims can feel like a full-time job in a dental office, but Open Dental's custom tracking feature in the Outstanding Claims Report makes it easier to stay on top of claims and improve your revenue cycle efficiency. Let’s dive into how to make the most of this feature and keep your claims workflow streamlined.

What Is the Custom Tracking Feature?

Open Dental’s custom tracking feature allows you to assign claims to specific tracking categories. This helps you organize and prioritize claims based on their status or the actions needed. Whether you're monitoring unpaid claims, resubmissions, or follow-ups, custom tracking ensures nothing slips through the cracks.

Why Use Custom Tracking?

Insurance claims often require a back-and-forth process that can become overwhelming. Custom tracking allows you to:

• Categorize claims by their current status (e.g., "Needs Follow-Up," "Resubmitted," "Pending Payment").

• Quickly identify bottlenecks in your claims workflow.

• Delegate tasks effectively and ensure timely follow-ups.

• Maintain a clean and organized Outstanding Claims Report.

How to Set Up Custom Tracking Categories

Here’s how to create your custom tracking categories in Open Dental:

1. Navigate to Definitions:

   • Go to Setup > Definitions.

   • Scroll down to the "Claim Custom Tracking" section.

2. Add Your Categories:

   • Click “Add” to create a new category. Examples include:

     • "Needs Follow-Up"

     • "Waiting on Insurance"

     • "Pending Secondary"

     • "Sent to Collections"

3. Assign Colors (Optional):

   • Assign colors to each category to visually differentiate them on the Outstanding Claims Report.

4. Save Your Changes:

   • Once your categories are created, they’ll be available for use when working with claims.

Using the Custom Tracking Feature in the Outstanding Claims Report

Once your tracking categories are set up, here's how to incorporate them into your claims workflow:
Run the Outstanding Claims Report:

• Go to Reports > Standard > Outstanding Claims.

• Set your filters, such as date range, carrier, or clinic, and run the report.

1. Update Claim Tracking:

   • Review the list of outstanding claims.

   • For each claim, assign it to a custom tracking category by clicking on the claim and updating the "Custom Tracking" field in the claim details.

2. Prioritize Follow-Ups:

   • Use the custom tracking categories to focus on claims requiring immediate attention. For example:

     • Address "Needs Follow-Up" claims first.

     • Check on "Resubmitted" claims to ensure the insurance carrier has received them.

3. Filter by Category:

   • Use the "Filter by Custom Tracking" option in the Outstanding Claims Report to view claims in specific categories, making it easier to focus on high-priority items.

Best Practices for Using Custom Tracking

To get the most out of the custom tracking feature, follow these tips:

• Standardize Category Use: Make sure your team understands how to assign claims to categories consistently. This avoids confusion and ensures accurate reporting.

• Review Regularly: Set a schedule to review the Outstanding Claims Report weekly or bi-weekly, focusing on claims in critical categories like "Needs Follow-Up."

• Integrate into AR Workflow: Combine custom tracking with your accounts receivable management process to ensure claims and patient balances are reconciled promptly.

Document Actions: Use the commlog to document each step taken on a claim, such as calls to the insurance carrier or resubmissions, so everyone has a clear picture of the claim’s history.

Final Thoughts

Open Dental’s custom tracking feature is a game-changer for managing insurance claims. By organizing claims into actionable categories and consistently reviewing the Outstanding Claims Report, your team can stay ahead of insurance delays and boost your practice's cash flow.

Start setting up your custom tracking categories today and experience the difference in how efficiently you manage outstanding claims.

What tracking categories do you use in your office? Share your favorites in the comments below! 👇