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BrushUrTeeth
Canine II

Separating Outstanding Claims by Insurance Type

Is there a way to run the Outstanding Claims by Insurance Type that separates the HMO from the PPO aging claims?  

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lindamoseley
CS Dental Employee
CS Dental Employee

SoftDent does not have a report that will do this. However I have a solution that will give you what you need. It will require a bit of input to get it going, but once done, then you can get the information needed. 

Go to your list of Insurance companies.  Edit insurance companies NAMES according to the plan type. In the name specify the type. For example, HMO Delta, HMO Cigna, HMO BCBS, PPO Delta, PPO Cigna, PPO BCBS. And for out of network insurance plans you could use "OON" in the name. 

For this to work, you must have the HMO or PPO at the beginning of the insurance company name. Now check the insurance PLANS to link all the plans that use these companies. Be sure that your companies are not being used for different types of plans. In other words, only plans that are PPO type use the companies with PPO in the name. You will likely have companies with the same address, but have different names here. (PPO vs HMO) 

**TIP: While on the Insurance COMPANY window or list, Click the "Show Ins Plan" button located on the options bar to see all the plans linked to the selected company.

Once this is all set up when you run the Outstanding claims report BY COMPANY, you can select the ones you want. Yay!

I know this requires some time and effort to set up, but in the end you have the benefit of running the report you want and it is easy to see plan types on the patient transactions window too. Win win. See screenshots below.

lindamoseley_0-1672932085991.pnglindamoseley_1-1672932198543.png

lindamoseley_2-1672932385339.pnglindamoseley_3-1672932637689.png

 

 

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drcavola
First Molar I

@BrushUrTeeth If you have the Insurance Company specified as such (ones that are HMO, and others that are PPO), then when you run your list of Outstanding claims by insurance company, specify those/that insurance company only and then run the list.  If you don't have those specified by insurance company (example:  Cigna HMO, or Cigna PPO), then you likely cannot separate.

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