I am having trouble with the Estimation Type for an insurance plan that i am trying to add. I referenced a document and it clearly covers a step by step process but i am having trouble with the first step......Selecting an Estimation Type.
- Flat Fee
- Flat Fee PPO
Plan info: Blue Cross/Blue Shield DHMO. Dr. is an In-Network Provider (No Capitation). The fee allowance on MOST procedures is 80% of the UCR which means we accept a 20% write-off on MOST procedures. I have the max allowable charge for each procedure not included in that 80% . I also have the plans benefit details and the patient co-pay schedule for each covered procedure.
So i have all the info but i can't plug it in correctly and I believe my first mistake is not selecting the right estimation type for the bluebook tabs that i need to see, i.e Fee.Copay.Plan Fee. ins. Pymt and a write-off........Please Help.