Even though I find mdunham's post from June 7, 2017 regarding correctly estimating downgrades very creative. I still feel that the software should give us the capability to be able to give our patients this information without having to go to such elaborate measures. We have had this software for many many years and have been asking for this to be fixed within the software to no avail. There have been no updates to the insurance portion of the software for as long as I can remember even though so many things have changed in the processing of dental claims. Please listen to your customers, we are the ones working with or trying to work with this software everyday.
We are not the only software that has to use these creative measures. It is really due to the ADA and CDT, they do not have codes by tooth locale. I consult for some offices in which use Dentrix and Eaglesoft as their PMS. In those offices, we still had to create Locator codes. Eaglesoft states they have a "downgrade handler tool" but it only works for codes that are not downgraded by tooth locale. Softdent is not alone in this insurance dilemma. I can tell you that this systems handles this situation with more predictability if data is entered correctly than Dentrix or Eaglesoft. If you need help, certainly reach out to me. I would love to help.
You are correct though, something needs to be done. How, I am not sure. Perhaps when ADA and CDT decide to recognize that we need these codes. I recently filled out the lengthy forms and required information for the CDT to possibly add pre-molar codes to our Posterior Composite Codes, as well as Anterior and Premolar codes for All porcelain Crowns, Inlays and Onlays, Porcelain fused to Metal Crowns, etc etc. They have not projected those changes to the CDT18, I will request again for CDT19 , but the window to submit is closing soon.
Apparently it would mean an overhaul of codes, which of course can be lengthy. Because the insurance companies 15 year lease on the CDT, we dental offices have more control over codes that can be developed and utilized.
In the Utopian world, dental plans would just pay for what we submitted and leave it at that. Maybe if the ADA and CDT have to deal with a large overhaul they will have a chit chat with the dental plans.???
However, has we all know dental plans love loopholes, but it keeps them in business. In turn in aggravates us, but to make life simpler and more predictable we try to adapt.
I wish there was a simpler way, this is the only way that I have figured to keep my books in check.
Yea, I know it can be done. That was just the "un-official" answer. Hopefully we see changes either within the plans themselves or the CDT. Of course, Murpheys Law may apply! As soon as we change the code they change the way they process. ♀️
Get Outlook for iOS