Sensei Cloud Medical Billing – Carestream Dental

Related Training
Medical Billing Recorded Class

Sensei Cloud enables you to bill medical insurance policies as needed. You can add a patient's medical policy as primary or secondary coverage, and submit claims with the relevant codes and information. If medical billing is not enabled for your practice, this feature can be purchased; contact your Carestream Dental representative for details.

Medical Billing Setup Requirements

Proper setup is important to avoid medical claim rejections. Before you begin submitting medical claims, ensure that the required information is correctly entered into your system:

1 - Location Business Information

(Administration > Location > Practice Location or Service Location)

Verify that the information entered in the Business section of your practice and service location records is complete. For more information, see:

2 - Professional Information for Each Doctor

(Administration > Team > Team Members)

Verify that the required fields in the Professional Information section for each team member whose Role = Doctor are correctly populated, particularly the Dentist License Number field. For more information, see How to Create or Edit a Team Member.

3 - Medical (CPT), Diagnosis, and CDT Codes

(Administration > Procedures & Fees > Procedure List & Fee Schedule)
Because Current Procedural Terminology (CPT®) codes are required for billing medical insurance, procedures must be linked with CPT codes in your software.

You can also add ICD-10 medical diagnosis codes for each procedure performed, and these codes are included in the claim details. To enable the use of diagnosis codes, select Administration > Practice Settings > Diagnosis Codes. Under Actions, click Enable Diagnosis Codes.

Specific dental procedure (CDT) codes can also be included on medical claims, as long as alternate billing is enabled for the procedure code as well as the medical insurance plan that is being billed.
Note: The procedure codes must be set up (including a CPT code) at the time of posting.

For more information, see the following procedures:

Adding Medical Insurance Plans

(Patient tab > Patient Record > click Edit Patient Record > Insurance Information > click Add Insurance Policy)

In order to bill medical insurance, the insurance Plan Type must be set as Medical. For more information on creating medical insurance policies and attaching them to patient records, see:

Note: When adding an insurance payer, enter the Payer ID number indicated in the Change Healthcare Payer ID list.

Posting Charges and Generating Claims

(Patient tab > Financials > Ledger > click New Charge)
When posting a charge to a patient's ledger, select the desired medical insurance plan from the Insurance to Bill drop-down list, and then click Post Charges & Bill Ins.
The patient's primary insurance plan (as defined in the patient record) is selected by default unless you manually change the selection. The primary plan determines coverage, but you can bill insurance in any order.
Note: You can only bill posted charges to a medical plan or policy when the procedures are linked to CPT codes. Dental procedure (CDT) codes can also be included on medical claims when alternate billing is enabled for the procedure code as well as the medical insurance plan.
For more information, see:

Submitting and Managing Medical Claims

(Location tab > Claims > Claims Management)
Medical claims can be submitted first or second (e.g., following the submission and adjudication of a dental claim), regardless of whether the medical insurance policy is set as the patient's primary or secondary insurance.
Note: Secondary medical claims are not submitted electronically; they must be printed.

For more information, see:

Posting Insurance Payments and Billing Next Insurance

(Patient tab > Financials > Ledger > click New Payment)
Next, you can make an insurance payment against claims, which reduces the patient's insurance due amount. Select one of the insurance payment types from the Payment Type drop-down list, select the appropriate insurance claim from the Claim Number drop-down list, and then click Post Payment.
After posting a payment, you are prompted to Bill Next Insurance (with options to Post Write Off or Handle Later). Click Bill Next Insurance to create a subsequent claim.