We collect the estimated patient portion at the time of service. When we do the monthly billing, we do not want the statement to print if the insurance is still pending.
Which ICM should we be using?
If an account's ICM is set to "1" and insurance is still outstanding for ANY claim on the account then no statement will be sent.
SoftDent help says
If ICM1 is assigned to an account with insurance, the Insurance Calculation wizard is displayed. The wizard reminds you that to bill the patient portion immediately, the account must be set to ICM2.
Since we are collecting an estimated amount from the patient at the time of the procedure, don't we need to set the ICM to 2?
Compared to the other ICM meaning, looks like you should be ICM 2
If the practice bills an account the full fee at the time of service and does not accept benefits, select ICM0. The amount due ages immediately from the service date. You can still print insurance forms for your patients as a courtesy, and SOFTDENT Software still calculates the estimated insurance payment for the patient's information.
If the practice bills an account only after first billing their insurance company and receiving payment, select ICM1. All patient charges are held current until the insurer has paid. When using ICM1, the account's amount due is always $0 for any charges submitted on an insurance claim. SOFTDENT Software bills the account for charges not covered once you've posted the final insurance payment and marked the claim complete. This amount becomes the amount due and ages from the final insurance payment date.
If the practice bills an account their estimated portion (the fee less any estimated insurance payment) at the time of service, select ICM2. The estimated insurance portion is held current, and does not age until you post the final insurance payment and mark the claim complete. The estimated patient portion ages from the service date.
But if we use ICM 2, statements print even if there are outstanding claims.
ICM 2 is the setting you want to use. There is a system setting that selects ICM 2 automatically for all new accounts created in System> Change System settings> Insurance.
Each individual account can be manually changed to any of the ICM settings. Open the account and look on the right hand side of the account window about 2/3 down. Make sure it is set to ICM 2.
As to why SD wants to print a statement, it could be because another family member has a balance due, or that patient did not pay their full co pay amount, or the patient had an older balance that is still outstanding; not related to last treatment performed with outstanding insurance.
I hope you can find this document useful in the future:
SoftDent: Understanding Insurance Calculation Method (ICM)
Chris, That article explained what I already knew.
What I can't figure out is how to suppress a statement if there is any insurance pending on the account while also collecting an estimated amount from the patient at the time of service. The former seems to indicate ICM1, while the latter ICM2.
Think of the ICM as the "clock start time" setting for Softdent. Softdent needs a timer by which to calculate the length of time a balance is due, and consequently overdue, if not paid.
Although related because of the clock setting, billing is billing and should be done regardless of ICM settings. There are ways to preview a billing statement, and not print or send electronically if there is an insurance balance due.
BTW, it is my understanding that "monthly" billing is not recommended. You should bill weekly - using what used to be called "cycle" billing with Softdent. I'm sure many of the trainers could elaborate more on that.
We use a code "Z" to mark any accounts that we don't want to receive a statement. That may be someone who paid 1/2 of their portion at the prep of a crown and will pay 1/2 at the seat date OR it may be someone who owes $6, and I don't want to waste paper and postage for continued statements...they may have already received 2 statements and we will collect at their next visit. That way, when I run statements I exclude "Z" and a statement won't generate for this account. You only need to mark the account since statements generate from such. We mostly use ICM 2 as we want to collect their portion all the time, but we will allow 2 payments for crowns, since Dr. Saari's crown preps are still a 2 stage process. We use ICM0 for those insurance companies who send benefits to the patient. I don't believe we have ever used the ICM1.
Actually, that specific account User Code is "N" - not included in current billing statements. Code "Z" is not charged a finance or billing charge.
Yes, I am aware of that, thanks for the reminder, but we used N for another circumstance as a known reason for it and we know "Z" code is for this. So we don't change it....been doing it for too long!! I am all for change but not on this - hah!!
Wouldn't it be nice if we could "customize" our own User codes, both account and patient? In that sense, we could assign any letter to specific functions, as you all do!!
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