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Assignment of Insurance Adjustments per PATIENT

Assignment of Insurance Adjustments per PATIENT

Softdent currently assigns any adjustment to the Primary dental plan.   It would be very useful if we could assign the plan in which to calculate the adjustment.   The tab for the assignment would most likely need to be within the patient screen.    A correction of this type would allow offices to have the correct adjustment in the event the primary is a PPO that you are contracted with yet still considered out of network, dependents, dependent children, or simply in cases where there is not an adjustment on Primary due to non-covered services etc.    This correction would be an ENORMOUS selling point for Softdent as it would be the only software with that capability.    

20 Comments
Canine III
Quite understandably.
Canine III

Your avatar sucks

Canine III
IK IK
Canine III
How about now?
Canine III
You suck
Premolar I

thank you!

Premolar III

Hi Melissa,

Below is some feedback from Wendy Potts.  Are we on the same page with how you'd like this to work?  

Thanks,

Jeff

juriz

Softdent currently assigns any adjustment to the Primary dental plan.   SoftDent assigns the "PPO Write-off to a claim #, when the secondary Ins payment in entered, a write-off can be posted to it as well

It would be very useful if we could assign the plan in which to calculate the adjustment.  THIS WOULD BE A HUGE BENEFIT, I am asked daily for the ability to override the insurance payment and write-off for both primary and secondary, currently they need to add up the write-off and insurance payment and enter this amount under the "insurance payment"
This is where it needs to happen (Transactions/Add & Treatment Plan/ADD)


The tab for the assignment would most likely need to be within the patient screen.    A correction of this type would allow offices to have the correct adjustment in the event the primary is a PPO that you are contracted with yet still considered out of network, dependents, dependent children, or simply in cases where there is not an adjustment on Primary due to non-covered services etc. This correction would be an ENORMOUS selling point for Softdent as it would be the only software with that capability.   agreed

Wendy Potts | CertifiedTrainer

First Molar I

The ability to add an adjustment in the patient window is great.   However, what I was getting too, was how Softdent CONFIGURES the adjustment, and where it pulls that information.  The only way I can see is if this is placed somewhere within the patient tab, as assigning the configuration per PLAN, would be ineffective and serious waste of energies.    

First Molar I

Sorry, I needed to think about what I just wrote.    

To summarize:   We need to able to choose which plan , per PATIENT, in which to apply the adjustment too.    I am not a developer, but maybe this info could be inside the Insurance tab within the Patient Screen.  The user would select the primary and Secondary for the patient and THEN select Which plan to assign the Adjustment too.   We would be telling Softdent which plan to apply the adjustment to for that patient.  

Warning:  Choosing this PER PLAN entirely would be ineffective as it would be the adjustment for EVERY patient within that plan.  Obviously, the adjustment (lower allowable) can be different per patient; due to different allowable schedules per Companies and the relationship of the patient to the insured, non-covered services and the like.    My phone number is 757-679-6536 if you need to reach me.  

In reviewing Wendy's notes again, I would say that having an adjustment in the window would be great. (Wendy, forgive me if this is what you implying , but for the sake of us all being on same page, I will over emphasis what I mean .)     However, programming Softdent to adjust PER PLAN would not be beneficial at all. 

The rules of COB are this:     The patient always has the benefit of the LOWER allowable between two plans.  The Dr. can collect up to the higher allowable or his/fee. (this generally happens when one plan does not COB, is indemnity, changes benefit for a procedure etc) .  Additionally, the patient Cannot make money from their plans.    It sounds confusing but I can show the math that supports that if needed.  

***  At any rate, we need the freedom to choose which plan that Softdent ESTIMATES the adjustment, so that our treatment plans are the best they can be.  

We do not post adjustments on DOS, as we are a high PPO practice, I perform adjustments after insurance has paid.  

As it is now, I have to go in and provide additional or correct adjustments on treatment plans after pre-d's come in, so they appear correctly to the patient.

Correcting the way Softdent retrieves the information to adjust would correct an enormous issue for offices, and of course be an enormous selling point for Softdent.   Seriously, you need to give me a job.       

First Molar I

To make things simpler, the system could have an Auto Configuration to adjust as it does now, but the user would have the ability to re-assign when needed.