We cannot seem to get the estimates for our posterior composites correct due to down coding by the insurance companies. So say we charge $100 for the procedure and the fee schedule is $90 so we write off $10 but then the insurance pays on $80 because of down coding. Our patients are always confused as to why they are receiving an additional bill if they paid our estimate when they were here.
What we do to avoid that is to change the percentage in the blue book. So instead of 80% we will change to percentage that gets it to the closest reimbursement. So it will take a little math to find the correct percentage.