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Premolar III

Blue book - Patient payment method

Is there any way to set up code specific estimating for an entire blue book so that the "patient payment method" is set as #2 (Patient pays any part of the UCR Fee not covered by insurance.  Office writes off any fees in excess of UCR) for every service?

 

 

15 Replies
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CS Dental Employee
CS Dental Employee

Re: Blue book - Patient payment method

Kind of . . . 

The only time you would want to do this is with a brand new plan (no code specific estimating information has been entered yet). In the Code Specific estimating window, there is a button that says, "Initial Plan Setup." That will allow you to choose a Patient Payment Method, as well as other settings for that plan.

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Premolar III

Re: Blue book - Patient payment method

@debi_peterson maybe I am doing something wrong.  I have attached a screenshot of a test run for adding a plan where the office will write off anything in excess of UCR, but patient pays any balance (option #2).  I am unable to make this the setting across the board without also setting a percentage.  How can I set one percentage for the entire plan?

Initial plan setup NOT WORKING.JPG

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Moderator
Moderator

Re: Blue book - Patient payment method

The initial plan setup utility does require one of the Insurance payment methods to be selected, and if the percentage or fixed amount is selected it requires an entry other then 0.  This will set that amount on all codes, so you would end up having to go through and change the percentage or fixed amount to the needed amount for each code on the list. 

There is not a way to make it so you do not enter that information. The closest would be to select the third option for "Only covered by capitation plan, or insurance does not cover."  This will at least keep it from putting in the same percentage or fixed amount on each code, then you just go through and set the needed amount on the codes that the office actually uses. 

Johnathan Downer | Technical Support Analyst
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Premolar I

Re: Blue book - Patient payment method

Thanks for bringing up this topic. Our office has been using PW for 20+ years and insurance estimating was never setup. There are over 100 insurance plans in the system. I came on board about 2 years ago and cleaning this up is taking forever. I get extremely frustrated with their not being an option to buy pants the percentage. it is time intensive two then go back into each individual code and set the correct percentage. If anyone comes up with a workaround please post it here.
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Premolar I

Re: Blue book - Patient payment method

Sorry I should have proof read before posting. I was using talk to text and it should have said bypass not by pants
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CS Dental Employee
CS Dental Employee

Re: Blue book - Patient payment method

You are correct, you have to pick something (which is why I said, "Kind of" Smiley Happy). If it were being set up from the beginning, I tell people to pick whatever the Basic percentage is, because that will be the highest number of codes. After putting them all at 80% (for example) you change the preventative and major codes to the appropriate percentage.

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Premolar I

Re: Blue book - Patient payment method

Any chance there will be an update to the insurance estimating process?  It would be great if we could enter code ranges and percentages much like in the benefit table.

 

20200213_192412.jpg

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Premolar III

Re: Blue book - Patient payment method

I appreciate the response, and no offense to you, but that's absurd and 110% impractical.

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CS Dental Employee
CS Dental Employee

Re: Blue book - Patient payment method

I agree with this completely! It would make the initial entry much easier. 

@tyson_edwards is this something we can look at doing?

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