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sonyap
First Molar I

When is the deductible marked as "met"?

When posting an insurance payment in which the deductible was applied, we make a notation on the patient's ledger.  However, how does PW know when to mark the deductible as "met", thereby preventing it from being factored into future estimates?

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saint_tammy
CS Dental Employee
CS Dental Employee

Re: When is the deductible marked as "met"?

PracticeWorks does know when the deductible is met. When the estimating table or code specific estimating is marked as "deductible applies" the system will subtract the deductible from the first procedure. this information is visible at check out by looking at the [prim details]. It's also stored on that person's clipboard insurance information [View]. it will tally remaining individual and family deductibles. This is helpful if the person goes elsewhere for a procedure and you have knowledge that they have already met their deductible, you can update this information to show remaining amount, etc.
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sonyap
First Molar I

Re: When is the deductible marked as "met"?

Ok - so PW doesn't really know.  It is simply reading off of the blue book information that we have entered.  The insurance company may or may not actually apply the deductible to that given claim.

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saint_tammy
CS Dental Employee
CS Dental Employee

Re: When is the deductible marked as "met"?

CS PracticeWorks estimates off the estimating information input into the system by the user. CS PracticeWorks does not have ties to Insurance Companies to know if patients are seen else where, so it's only capable of "tracking" from ledger entries and payment data, etc.
eServices such as eVerification (eligibility) would allow CS PracticeWorks to link to an insurance page and give a user the ability to see real time information such as remaining deductibles/Maximums and coverage details. this information is controlled by the individual insurance companies. It doesn't pull that data back into CS PracticeWorks, but at least the user can verify remaining amounts, etc.
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