Matching and remarks¶
Matching is Ordo answering: which Open Dental claim is this EOB talking about, and which procedure line is which? Remarks are the notes that ride along when you post.
You do this on the Open Dental tab after Fetch Open Dental. See Inside an EOB for the screen layout.
How Ordo picks a claim (in human terms)¶
Ordo looks at the extracted patient and scores Open Dental patients and claims using things like:
- First and last name (small spelling differences are tolerated)
- Date of birth
- Subscriber ID
- Date of service
- Procedure codes (CDT)
- Amounts
A high-confidence match is pre-selected. A middling or “two charts look alike” result is marked for Needs review. A very low score is No match.
You are always allowed to pick a different candidate from the list. Ordo’s recommendation is a starting point, not a court order.
Identity vs money¶
Two different questions:
- Is this the right person and the right visit? (identity)
- Do the dollars add up? (reconciliation)
A hard mismatch means identity failed. Do not approve just because the dollars happen to match. Wrong patient + right dollar amount is still the wrong post.
Open the Audit tab. Each signal is one check:
| Signal | Example of a failure |
|---|---|
| Patient ID | EOB member ID does not match the chart. |
| Patient name | EOB has MARIA SANTOS. Open Dental has MARIA SANTOS-LEE. |
| Date of service | EOB June 12 vs chart July 3. |
| Payer / provider | Unexpected carrier or rendering provider. |
| Procedure codes | EOB has D1110; chart claim has D0120 only. |
| Amount reconciliation | Line totals do not line up. |
Failed signals are written in plain language so you can read them to a coworker without decoding scores.
Procedure lines¶
Once a claim candidate is selected, each EOB line is compared to Open Dental procedures.
| Column | Meaning |
|---|---|
| EOB | Plan covered amount from the remittance. This is what Ordo intends to post. |
| Open Dental | The InsPayAmt that will be written, and the Open Dental procedure number when a line is matched. |
| Difference | Leftover when the EOB line has no matching Open Dental procedure. |
| Status | Match or Differs (computed). |
| Remark | Your note on that line. |
Default remarks:
- Match — the CDT code mapped to an Open Dental claim procedure.
- Not matched — it did not.
You can edit the remark until a successful post. After post, remarks are read-only.
Example — extra EOB line¶
Cigna paid a D1110 cleaning and a D0274 bitewings. Open Dental’s claim only has the cleaning (bitewings were entered on a different claim).
- D1110 row: Match, $100.00
- D0274 row: Not matched, difference showing, no Open Dental procedure number
Mike does not approve this candidate if the bitewings belong on another claim. He switches candidate — or rejects and posts the bitewings on the correct claim later. Approving here would post the cleaning and leave the bitewings unexplained.
Example — same codes, different dollars¶
EOB D1110 plan covered $100. Open Dental estimated $80. That can still be a Match on code with a dollar difference. Read Audit amount reconciliation. If this is the right visit, posting $100 is often exactly what you want (the EOB is the source for what insurance paid). If it is the wrong visit, reject.
The two kinds of remarks¶
| Kind | Where you type it | Where it lands in Open Dental |
|---|---|---|
| Procedure remark | The Remark column on each line | Note on that claim procedure |
| Payment remark | Optional Add remark to Open Dental box at the bottom | Payment-level note (PayNote) |
They are independent. You can post line notes without a payment note, or both.
Example payment remark: Cigna remit 8/24 — check posted in Ordo by J. Park
On reject, if you checked the payment-remark box, that text can be stored as a procedure note so the reason for rejecting is not lost. Fill it in if you reject something non-obvious (“wrong year, patient has two Marias in family”).
Approve vs post vs reject¶
| Action | What it does | Writes to Open Dental? |
|---|---|---|
| Approve match | Locks the selected Open Dental claim. | No |
| Post payment | Writes InsPayAmt and notes. Disabled until approved. |
Yes (Actual, when connected) |
| Reject match | Discards the match. Unavailable after a successful post. | No |
If Open Dental changed after approve (someone edited the claim in the chair), Ordo asks you to review again instead of overwriting.
After a successful post you should see confirmation, including a claim payment number when the API returns one.
What your role can click¶
| Permission | Button |
|---|---|
| Approve match | Approve match |
| Reject match | Reject match |
| Post payment | Post payment |
| Edit extracted data | Corrections on EOB Review |
A Reviewer at Bright Smile can approve and reject but cannot post. Jennifer posts after Mike’s approval. That two-person pattern is optional; Owners can collapse it into one role.