With Blue cross after a patient has reached their max you do not have to take the write off. Is there a way for softdent to calculate that so that is doesn't show the write off after maxing out?
If you have supporting documentation from BCBS on this please share. Thanks
The write-off after the maximum has been met would be determined by your states insurance rules. What state are you in?
Also, was this procedure for a non-covered service etc? I would love to help you with this.
Bedsides State Rules, this is also contract defined. One PPO contract may Differ from another in regards to adjustment beyond Maximum.
Sorry, no one answered your question. For Plans we do not adjust beyond Max, we mark the service "uninsurable" in the tax plan for quoting and posting.
After patient ENT has paid etc, we mark procedure insurance in the transaction screen and file claim. In my experience, if the plan pay even $1.00 towards the service an adjustment is owed to pt.
More times that not ; you are contractually bound to file All procedures regardless of compensation.
There is not away to have the system ask the amount above Max from Pt.
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