We currently do not have fee schedules set up within SoftDent, which means we have to manually modify treatment plans to reflect accurate patient payments.
Is there a way to add insurance write-off information to treatment plans? Currently there are three columns: patient, insurance, and total. We combine the insurance payment and write-off into the insurance column so that the patient and insurance columns add up to the total column. We'd like to have patient, insurance, and insurance write-off.
As you can see from the screen shot on the treatment plan if the correct estimation type is enabled on the insurance plan in this example percentage PPO and there is a bluebook with the codes and allowed amounts set up for an insurance plan, the estimation information prints out on the treatment plan. The actual writeoff can be set to when posted in the plan if you want to have it on charges when actual treatment is posted. Hope this helps.
The answer is no, there is not a section to edit the write-off.
in addition to what Bert already commented on.
if you create an allowance table with the plan set up as Bert mentioned
the link it to the insurance plan, your blue book will be created and show the correct numbers for the patients treatment plan estimate (keep in mind, it does not factor in the deductible)
would be nice if in the treatment plan screen, you could just type the deductible amount and let the computer do the math for you
Adding allowance tables is critical to your bluebooks , and in turn giving quotes to patients that they will learn to trust. These quotes are what drives your business. Your patients use them to determine if and how they want to proceed with treatment. Be sure you update them with every payment and pre-d, in the bluebook only. The only reason you would ever need to even touch an allowance table is if your negotiated rate changed.
My suggestion is not to update the Bluebook if you have an allowance table. The main purpose of the allowance table is to accurately build your blue book
Although I would update every time, if you are not participating with a carrier because they do not provide you with the allowance.
Wendy, I update /review the blue book for each plan as the blue book is specific to each patients GROUP number. Many, many insurance companies pay differently based upon any sub-group, sub-plan attached to that Ins Plan Group number. Changing this constantly within the Allowance Table, can really throw off your figures as items reflected in Allowance Table will automatically populate in the Blue books attached to that Allowance Table.
Once fees are entered in the ALLOWANCE table they should rarely have to be adjusted.
My Allowance Table is set up for plans in which I have a PPO agreement with AND for larger employers in which we are NOT contracted with. You may ask why I add in allowance tables for Plans in which I have no Agreement. Why? One: As patients come in with XYZ (non-contracted) plan, I simply add in the percentages into the Ins Plan field and then attach the Allowance Table which has been slowly updated over time to reflect the ALLOWED AMOUNT shown on EOB's and PRE D's (not what was paid).
Example: Mr. Jones (NEW PATIENT) is seen for a cleaning his bill is $100.00. XYZ ins plan states they pay at 100%. At this time, there is no bluebook or allowance table for this non-contracted plan. When Mr. Jones ins pays, we update the ALLOWANCE TABLE of $75.00 , attach the allowance table to his Dental plan and bill him for $25.00.
NeXT PATIENT ON XYZ PLAN;
Mr.Smith has XYZ Ins Plan and is in for a cleaning. When Mr. Smith checks out, I know that his insurance will cover 100% of their allowed amount 75.00 for a cleaning, and he will owe $25.00 because OUR fee is $100.00. I was able to inform him of a more accurate estimate as I have been populating the allowed amount for XYZ Insurance Company at receipt of Payments and Pre-D's.
Asking Mr. Smith for $25.00 today, keeps me from having to bill him later. This builds a better financial relationship with Mr. Smith.
We only do this for Larger Insurance Companies , that we are not contracted with. It is VERY helpful, especially when it is for larger treatment, ie implants etc.
AND More often than NOT, the ALLOWED amount is on the claim. If it is not, then I simply create a bluebook entry that reflects the payment of the non-ppo plan.
Sorry, but to answer your question on "how to add a write-off" to the tx plan. Simply create a Write-off code such as 58.01,and label it your insurance company name, for example: Delta. 58.01 Delta Adjustment- Then , on the treatment plan, you could add in a Delta Adjustment to each group number in treatment plan. Keep in mind, that doing this can become a staff issue. If you have a new staff member etc, they may post that adjustment and not realize for instance that the treatment had changed etc. Also, the second issue would be if your allowable changed from when the adjustment was created. A third problem would be that maybe the service you treatment planned was considered NON-covered and no adjustment is to be granted. Unless your office pre-authorizes every treatment plan, I would be very scrupulous who you allow to do this, as it could become an accounting nightmare. I only do this when there is no adjustment to Primary PPO but there is with the Secondary. As a rule, if the patient does not schedule treatment within that benefit year, all adjustments are deleted and reconfigured when they schedule if needed. Definitely set some ground rules. Softdent applies whatever write off is in primary plan., so Softdent will not write-off to lesser allowable, or standard COB.