Treatment Plan Lifesaver!

[FarbodDental]

I am new to using SoftDent and have found it extremely frustrating treatment planning our contracted fees with our in-network insurance. The office was previously in-network with Delta and when the current doc bought the practice it changed to Cigna. Long story short some patients still receive Delta fees and treatment planning for them has been easy since they get a designated number put into their chart and magically (or so I thought) the Delta fees would show up without having to do any write offs. 

Here's an example

I could not for the life of me figure out where this number was coming from and why I couldn't do it for our Cigna patients. And of course everyone who was here when the software was set up have retired.  I loath presenting treatment plans with write offs and found it ridiculously difficult putting pre-auths in and the write offs being a mess.

Well I figured out the following:

First make sure the correct fee schedule is attached to the patients insurance: Allowance table 10 

Ctrl C to open the ADA codes 

I'm using D2740 as an example, double click to open it to edit and click Schedule/Fees

Here you can edit the fees. 0 is our offices fees, 10 is our Cigna fees and 11 is our Delta fees

So now when we go back to the patients information, you can put the designated number in the fee schedule and it'll use those fees when treatment planning.

Now if we treatment plan for D2740 it will do it with the contracted fees and no write off

It does take a while to input all the fees but it has made my treatment planning so much easier especially when it updating to reflect pre-auth amounts.

[mdunham]

The issue with this is that if you are filing to the Contracted company, the Contracted Company NOR the patient ever see your real fees.  Also, in the event of a Collection dispute and the case goes to court, the patient will only owe up to the amount signed on treatment plan.  One scenario would be:  Patient A had verified coverage, you applied a fee schedule, he signed Tx plan of contracted fees, however, when the claim returns his plan was terminated on date of service.  Now, the patient by law only has to pay for the fee presented on treatment plan, ie that lower dental plan fee.    A contracted rate is not the true value of the dentist's work.  Additionally, this offsets the average mean of dental fees in your geolocation and offsets contracting. See Fair Health Consumer. org.