In another thread, there was mention of updating insurance estimation - it is my understanding with all the new plan designs out there there may be need for some different calculation methods going forward.
@suzanne, and others, what do you know about insurance estimates/the changes you are seeing, and what you need the software to do to make you the most successful?
Since 2018, I've seen a lot of new plan designs that are impossible to track in Softdent currently. Here are some of the issues:
Awesome information - thank you for writing this up!
I will sit down and review tomorrow then forward on as user stories to our development team.
Another thing I've encountered with some Delta plans is a fixed co-pay by appointment....If a patient comes in for a preventive/diagnostic appointment, they pay $65 regardless of whether they just have an exam or have exam, x-rays, and cleaning. It would be nice to have that estimate correctly, if possible. I think insurance companies dream up ways to give us nightmares.
I agree that this needs everyone's eyeballs. Insurance is changing all of the time, and our estimating needs to be flexible enough to handle those changes.
@callton Yes! We have a section of plans that have a $5 or $10 copay for every visit no matter what procedure is done. Then they pay their % of the fee schedule, after subtracting the copay to the first procedure on that DOS.
1.) As of today, 42 states have adopted "Non-covered or Fee Capping legislation" A very easy way for SD to correct some insurance estimation is to AUTO CHECK the Box w/in BB screen to upgrade to practice fee. , ie NO ADJUSTMENT.
2.) Allow adjustments on Secondary Plans, Especially if there is no adjustment to be considered on patients' primary plan, ie, non-covered, Primary plan is non-contracted. etc.
There is MUCH more that can be done to improve Ins estimation, these two tasks would in the very least provide much relief to users.