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Canine II


Delta Dental has a plan that is TOA (table of allowance) this is new to me. The patient is responsible for the difference from the fee schedule to our office fees. How do I set this up in Softdent. No matter what category or sub category pair I choose does not post the balance to the patient. 

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First Molar I

  Off the Top Flat fee Plans with subtype Indemnity will allow your fee, subtract the Flat fee, minus deductible and charge difference to the patient.     If SD, is not doing that, perhaps delete any bluebook and allowance table and reenter after plan setup calculations are entered.  As sometimes SD will not recompute BB values correctly when new Calculation types are selected on the plan info tab.    Q:)  Are you contracted with Delta Dental?  If so are you a Premier or PPO provider? -----  It sounds as if you are not contracted in which you could build an allowance table of Delta OON (out of network). then add that Allowance table to a Flat fee/ percentage OON plan.        Delta does not generally allow PAR providers to charge to thier fee unless the Code is non-covered and the dentist resides in a State where non-covered legislations allow the provider to bill to their fee for non-covered services.    In this instance, you would simply enter the code into the existing Bluebook and select the "upgrade procedure" box, enter 0 in the percentage box.  Then the patient will owe to your fee for that code only.     

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CS Dental Employee
CS Dental Employee

Possibly try this...

Flat Fee:
The insurance plan pays a flat fee, or pre-defined amount for certain types of procedures. There is no maximum allowed amount, nor can Allowance Tables be attached.
Method - Flat Fee
Total Fee: $63.00 = T
Ins. Pays: $50.00 = I
Pat Pays: $13.00 = P
P = T - I
Would this work? 
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