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kpratt
Premolar I

In house Dental Membership Savings Plan

Does anyone have any tips or suggestions on setting up an in house dental membership savings plan in PracticeWorks?
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carolyn621
Premolar II

Just remember - do not send the claims or print to paper because they will be in claims. At check out uncheck the boxes or right click the procedures before checking out. It can be a learning curve to remember several of these steps.
carolyn621
Premolar II

We set it up an insurance company w/ "Savings Plan" as the group - the company name is the Practice. Example, D1110 is covered at 100%; enter info as one would if a commercial insurance plan. We made specific adjustment codes for Doctor & Hygiene, i.e., spadr (savings plan adjustment doctor); spahyg (savings plan adjustment hygiene). this can track the adjustments.
I can think a few ways to set it up although it is what makes sense for your office and how you want to track the adjustments.

Hi Carolyn. Thanks for the input. That's how we currently have it set up and is working Ok so far.

I'm still looking forward for a reply from CS about the automatic discount codes, which perhaps we can also leverage to other cases.

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@cabaa99 

Hello, sorry for not having replied as of yet, I thought I did.

We don't actually have a good write up already created for the automatic codes.  I'll set aside some time tomorrow to create one and get that information to you on here. 

Johnathan Downer | Technical Support Analyst
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robertangus
Moderator
Moderator

I would need more specifics on the plan before I could recommend the best approach, but if it's a straight percentage off on certain procedures this can be accomplished using an automatic adjustment code and turning it on so it applies to specific procedures and for specific patients. 

I will give you a call to discuss this in more detail.

This is also something I need help with as well. Will the auto adjustments show the discount on a treatment plan?

In our office Diagnostic & Preventative services are covered/discounted 100%. Implants/Ortho are discounted 15%, and all other services are discounted 20%.

Any and all help is GREATLY appreciated. 

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Automatic Adjustment codes will not show up in treatment plans, they will only apply themselves during a checkout or when adding entry directly to ledger. They are not part of the insurance estimating within PracticeWorks.

If you want them to show in a treatment plan, you would need to use the other method of setting up your membership plan as it's own employer plan and insurance company. Once you have created them, you will need to set up insurance estimating within them to match your plan.

Implementing your membership plan this way will create insurance claims as it would for any other insurance company setup. If you choose this route, you will need to manually clear these claims every time.

It's my understanding that you want to avoid, even the slightest reference, the appearance of an In House Dental Plan as insurance ... at all cost.  Treating these types of plans as insurance increases the risk that those plans fall under "insurance" category, and thereby fall under dental insurance rules and regulations.

Therefore, setting up these type of plans in Softdent as an insurance company would be something that I would discourage.  There are ways in which to setup "discount plan" in Softdent, and .... it's a lot of work to manage on the front end and back end.

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Yes, that's been a concern. However, the software construct called "insurance plan" in Practice Works works reasonably well to address the need of a membership plan without the extreme overhead of other methods. So we opted for being very clear in the our literature that is not an insurance plan, and we have a T&C doc that the pt signs also indicating that.

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@cabaa99 

 

I've attached a PDF with the steps on setting up the automatic codes with the assumption of being used for a 'discount plan' of sorts. 

Let me know if you have any questions. 

 

Johnathan Downer | Technical Support Analyst

Great. Thanks for the instructions

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Where can I find more info about setting up automatic discount codes?

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