Single Insurance Payment

When insurance claim payments cannot be processed electronically, they can be manually entered into QSIDental Web. These insurance payments come from carriers in two ways:

In single checks representing a single claim for a single patient.
In a large batch check representing multiple claims for multiple patients.QSIDental Web has the capacity to process both.

Single claim payments are processed using the Insurance Payment tool. Open the insurance payment window by either:

Selecting Insurance Payment from the Transactions menu.

From the claim screen (accessed by clicking the claim in the Ledger), click the Insurance Payment button.

The patient information banner at the top of the window reflects the selected patient and the subscriber information for the primary insurance for the selected claim. Only the information relevant to the selected patient is displayed.

Outstanding Insurance Claims

The claims sent for the patient but not yet paid by the carrier. The patient name is displayed for clarity. Click the Browse (… ) button to quickly change patients while remaining in this module.


Outstanding Patient Claims	Description
DOS Date	Date of Service.
Sent Date	Date the claim was sent.
Claim	Primary vs. Secondary insurance.
Status	The status of the claim.
Subscriber	The name of the insurance subscriber. This is not necessarily the name of the patient.
Carrier	The name of the insurance plan carrier from whom payment is expected.
Type	Type of insurance –Dental or Medical.
Office	The office that originated the claim.
Bill	Billing Order
Provider	The provider that is associated with the claim. The Provider ID is established in the Provider Setup tool.
Charges	Total charges for the claim.
Est Ins (Estimated Insurance)	The estimated portion of the claim to be paid by the insurance carrier.
Ded Used (Deductible Used)	The amount charged toward the patient’s deductible.
Ins Paid (Insurance Paid)	The amount paid by the insurance to date for the claim.
Ins Adj (Insurance Adjustments)	The amount of adjustments made to the claim.
Rem Amt (Remaining Amount)	The amount remaining to be paid on the claim.
D DD M	Primary Dental Primary and Secondary Dental Medical

Selected Insurance Claim Details

The treatment specifics associated with the selected claim.


Selected Insurance Claim's Details	Description
Sel (Select)	Clicking this box selects the specific treatment for payment. The fee is automatically inserted as the amount paid when selected.
DOS Date	Date the treatment was performed.
Code	The ADA service or Practice Code for the treatment.
Th (Tooth)	The tooth associated with the treatment, if applicable.
Surf (Surface)	The surface associated with the treatment, if applicable.
Description	The description associated with the service code.
Provider	The provider that performed the treatment. The Provider ID is established in the Provider Setup tool.
Fee	Fee charged for the service.
Est Ins (Estimated Insurance)	The estimated portion of the treatment to be paid by the insurance carrier.
Ded Used (Deductible Used)	The amount charged toward the patient’s deductible.
Ins Paid (Insurance Paid)	The amount paid by the insurance to date for the treatment..
Ins. Adj (Insurance Adjustments)	The amount of adjustments made to the treatment.
Rem Amt (Remaining Amount)	The amount remaining to be paid for the treatment.
New Amt (New Amount)	The amount paid by the insurance carrier. When the treatment is selected, the fee is automatically added into this field. You can replace the figure with the amount actually paid by the carrier.
Disallow	The amount being disallowed by the carrier for the specific treatment. An adjustment can be applied for the single treatment as opposed to the full claim level (in the top section.). This can be done by typing the disllowed amount in the field and clicking the browse button to select the adjustment type.
Reason	Log the reason codes that indicates why a treatment was disallowed. It doesn’t appear directly in the ledger, but is captured for analysis via the QSIDental Web nightly download.

Click the Browse (… ) button to launch the Reason Code window and select for the specific reason the amount is being disallowed.
Select the Group Code from the dropdown.
Enter the specific reason code
Enter the Amount
Enter a “1” for quantity.

Note: The quantity field is part of the standard 835 communication and would be one in nearly all dental remittances.