Manual reset of insurance benefits?

[cabaa99]

Hi. PW offers the option to reset insurance benefits manually, which I assume are based on the insurance plan renewal date. Does this need to be run daily manually? Or the Office Expert that runs daily takes care of this?

[joedindo]

Why doesn't PW do this automatically?  Or why isn't there an option that would switch it from manual to auto?

[robertangus · Accepted solution]

Aldo,

   Resetting benefits involves two sets of actions. First you must reset the benefits to zero, and then you must recalculate the benefits that have been used (and the remaining deductibles) since the insurance policy's annual renewal date.

Follow these steps to do both:

1.) Click File > Maintenance > Reset Benefits.
2.) Confirm that the office has a valid/recent backup, and then click Yes.

   Once the Benefits Reset has been accomplished, it is necessary to recalculate the totals for all of the affected patients. To begin this process, close PracticeWorks on all computers.
1.) Click Start  > All Programs > CS PracticeWorks > Utilities > Benefits Recalculation.
2.) Click Yes.
3.) Click Close.

If you have insurance policy renewal dates other than the usual 01/01, this process may need to be run multiple times throughout the year to ensure all plans are reset as their renewal dates pass.

IMPORTANT: It is technically not necessary to exit from PracticeWorks before running the utility. However, if PracticeWorks is left open, all Clipboards should be closed to avoid possible Record Lock issues while the data is being updated.

[joedindo]

Please clarify the difference between the Reset Benefits step and the Benefits Recalculation step.  

In the past, a few versions ago, we had many problems with the patients' ledgers showing wrong totals after doing a benefits recalculation. As a result. my staff avoids doing the benefit recalculation step. I'm wondering what problem that would create not to do the benefit recalculation after a benefit reset.

Thanks. 

[sonyap]

Another problem (not necessarily related to resetting benefits) is that if a patient changes insurance plans in the middle of the year, the estimator doesn't change accordingly - it just adds up all the insurance payments on the ledger for that patient for that year, regardless of what plan it was under.