Dental Attachments User Guide (Apex)

Dental providers can send claims that require attachments through Apex. Claims requiring an attachment are placed in a Pending status until the claim is released or an attachment is added and submitted. Once attachments are uploaded, the claims are updated and processed with the associated attachment information.  

Jump to Section: [Identify Claims that Need an Attachment] [Release a Claim, Pend a Claim, or Add an Attachment] [Submit Attachments] [After Attaching]

Identify Claims that Need an Attachment

Apex will attempt to automatically identify claims that require attachments based on payer rules. Claims that require an attachment will be put into a Pending Attachment status. Pending claims will not be processed until an attachment is added or the claim is released.

NOTE: Attachments can be added to any claim that is associated with a payer that supports electronic attachments and has not yet been sent to the payer by Apex.

There are multiple ways to identify a pending claim. 

• From the All tab batch list: Click the box displaying the count of Pending claims to view the pending claims associated with the batch.
  
  
  
• From the All tab: Click the Pending Attachments button to display all pending claims for the given date range. 
  
  
  
• From the Claim Status tab: Click Advanced Search and select Pending Attachments to search for all pending claims. 
  
  
  
• From the Failed by Apex tab: Use the Claim Status drop-down menu to search for all pending claims.
  
  
  
• From within a batch of claims on the All tab or Claim Status tab: The current status of pending claims is Pending Attachment.
  
  
  

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Release a Claim, Pend a Claim or Add an Attachment

Release a Claim

If you want to process a pending claim without adding an attachment, you have the option to release the claim from the All tab, the Claim Status tab, or the Claim Edit page.

• From the All tab or Claim Status tab: Locate the claim, click the Action button to open the drop-down menu, then select Release Claim. 
  
  
  
• From the Claim Edit Page: Click Release Claim in the Claim Information box in the upper right corner. 
  

Pend a Claim

You can manually set a claim to Pending Attachment status on the Claim listing page on the All tab. Select the claim(s) you want to pend, then click the Set Selected Claims to Pending button at the bottom of the page. This can be useful if Apex has not automatically identified a claim as requiring an attachment, and you are not yet ready to upload the attachment. 

NOTE: The claim must be associated with a payer that accepts electronic attachments.

Add an Attachment

You have the option to add attachments to claims from the All tab, the Claim Status tab, or the Claim Edit page.

NOTE: The claim must be associated with a payer that accepts electronic attachments.

• From the All tab or Claim Status tab: Locate the claim, click the Action button to open the drop-down menu, then select Add Attachment. 
  
  
  
• From the Claim Edit Page: Click Add Attachment in the Claim Information box in the upper right corner. 
  

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Submit Attachments

You can upload one or more attachment files in the following supported file types: BMP, JPG/JPEG, TIFF, PNG, PDF, TXT, DOC/DOCX, DICOM, and GIF. You can also take a screenshot of what you want to attach using your own screen capture tool (for example, Windows uses Snipping Tool or Snip and Sketch), as long the screenshot is saved in one of the supported file types. 

NOTE: There is a max file size is 20 MB per file and a total size of 200 MB for all files.

Select your Attachments

1. Note that the Claim ID that will be associated with the attachment is provided.
2. Click the Select Files button to open a window that will allow you to browse for your attachment file(s).
3. Verify that the File Name information is correct, i.e., the correct file has been selected.
4. If needed, you can Remove a file before proceeding and attach the correct file(s).
5. Select the Document Type for all files attached to the claim.
6. If the file type is a .dicom file, enter the Orientation Type and the Date Image was Acquired.
   

   NOTE: Orientation Type and Date Image was Acquired are required for .dicom file types only.

7. You have the option to enter additional Comments to be sent to the payer along with the attachment package.
8. Click the Prepare Attachments button when you are finished setting up your attachments, or click the Clear button the reset the page. 
   
   
   

Verify and Upload your Attachments

Once your attachments have been selected and prepared, they are ready for you to verify and upload.

1. Verify that you have selected the correct File Name and Type.
2. Enter the number of Pages for any file that is more than one page.
   

   NOTE: The number of pages can depend on file type. For example, PDF or DOCX files can be more than one page, while JPG and BMP files will always be one page.

3. If needed, you can Remove a file before proceeding.
4. Click the Upload Attachments button. 
5. You will be asked to continue with the submission. Click the OK button to send the attachments to the payer. 
   

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After Attaching

Once your attachments have been uploaded, your claims are automatically updated with the associated attachment information. The Claim Edit page displays the attachment ID and attachment file names. 

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