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How to set up this insurance

Question asked by doctom4300 on Aug 16, 2017
Latest reply on Aug 24, 2017 by cgdfrontdesk

A patient has an insurance plan that is quite different from anything I've seen before.

 

For the procedures that the plan covers, for each claim it pays 100% of the first $150, and then 50% of the amount of the claim that is between $150-$2700. There is no deductible, and there is a yearly maximum of $1500.  We are out of network with this insurance. It is a PPO plan. Just to mix things up a bit, I'm not certain if they use UCR fees or not.

 

Is there a way to set this up in SoftDent so that the the amounts SoftDent says to collect from the patient are accurate?

 

So far this is just one patient, so we can just do the calculations manually, but I was curious if there's even a way to make SoftDent do these calculations.

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