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5 comments

  • Avatar
    Michael Walter

    For the providers to post the fees correctly, they need to have the correct fee schedule attached. I had you go into the User Accounts and find the section for Fee Schedule. This will determine the amounts that post for work done by that provider.
    I want to also suggest, when adding providers, to make sure you select which insurance carriers he is contracted with. This will allow the system to estimate write-off amounts for the insurance. If a provider is not marked as contracted, it will treat those covered patients as out of network (no contracted fee, no insurance write-off)

  • Avatar
    Peg Greeley

    If you select which carriers the provider is contracted with in provider set up, will the in network fees for that carrier be used in the treatment plan for accurately calculating the patient estimated out of pocket expense?

  • Avatar
    Michael Walter

    Hi Peg.

    When you have the carriers contracted with the provider, it will still post the provider fees to the ledger and the treatment plan. However, it will then calculate an insurance write-off automatically. This will be the difference between the insurance fee-schedule (allowed amount) and the provider fee schedule.

    So yes, the patient estimates will be fairly accurate and we will improve this accuracy when we release the coverage exceptions for downgrades of service.

  • Avatar
    Greg Quandt
    Hi Peg,

    Also make sure to attach the PPO fee schedule to the insurance plan. Then the contracted providers will use that fee schedule.
  • Avatar
    Michael Walter

    The amount that posts to the ledger will still be the provider fees. The ledger and treatment planner will compare the insurance fee schedules to the provider fee schedule to estimate write-offs. It will also use the insurance fee schedules for the coverage estimate.

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