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jawdoc
Canine III

Estimates and entering insurance allowables

Hello everyone! 

How are you using the WinOMS to figure patient estimates? Are you entering insurance plans and allowable fee schedules into your systems?  Do you use this feature to estimate what insurance will allow and pay?  If so is it accurate? 

I have been experimenting with the system and it does not seem to take into account the maximum even though there is a field in the insurance plan to add the maximum.  It's odd that it doesn't calculate insurance due in the Treatment Plan.  What good is an insurance estimate if it is not calculated until charges are actually applied to the account?  Maybe I'm not using it accurately. 

Any feed back would be appreciated Smiley Happy Thank you!!

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stephanieoms
Canine III

Re: Estimates and entering insurance allowables

Our insurance team does the calculations themselves and plugs the numbers into the treatment plan. We've been told, and in our experience, it is not reliable to trust the system to calculate the treatment coverage. I don't know why WinOMS offers that feature, unfortunately misleading. 

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jawdoc
Canine III

Re: Estimates and entering insurance allowables

Thank you!  That's how we are figuring treatment plan estimates as well.  This would be a nice feature if the system did work accurately.  Maybe it will be in a future system update.

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