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Information will be populated on the claim when an insurance requires a Prior Authorization number. It is pulled from the the Prior Authorization number entered and insurance pop-up menu selected on the Prior the Prior Auth tab of the Incident. There must be at least 1 remaining visit left for this to pull onto the claim.

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The prior authorization number must also be selected in the insurance claim creation window from the Prior Auth pop-up menu.

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ADA Box 3 - Company/Plan Name, Address, City, State, Zip Code

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This box will be blank if there is no secondary insurance.   Information is populated by the Subscriber ID field on the associated insurance on the patient's Insurance tab in the Patient screen.

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This field lists the guarantor's name and address listed in the Primary or Secondary screen (Note: Name includes only First, Middle and Last name fields).

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ADA Box 13 - Subscriber Birth Date

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Information is pulled from the Subscriber ID field for the associated insurance on the patient's Insurance tab in the Patient screen.

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ADA Box 16 - Plan/Group Number

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Information is pulled from the Employer information selected in the Employer pop-up menu for the guarantor associated to the primary insurance.

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ADA Box 18 - Relationship to Subscriber

This field pulls from the patient's Relationship to Primary and Secondary pop-up menu in the Patient screen.

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ADA Box 19 - Reserved For Future Use

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Selecting Unknown in the Sex pop-up menu will leave this field unchecked.

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ADA Box 23 - Patient ID

This information comes from the Patient ID that is automatically assigned to each patient in MacPractice. You can see this information in the sidebar’s “Patient ID” column with a patient selected, or in the MacPractice window header.

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You can enter up to five of the surface codes without any spaces.

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ADA Box 29 - Procedure Code

This box pulls from the Code field in the charge window.

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ADA Box 29a - Diagnosis Pointer

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