Calculating Insurance and Patient Fees

[josephfaiz]

I was wondering if anyone has as many issues as we have had with getting open dental to calculate the patient portion and the insurance portion correctly on the patients preestimate. We have even called open dental several times and no one can solve this issue for us....
Thank you,
Dr. Joe Faiz

[alexei]

Post some examples. Otherwise it's pretty impossible to say what the issue is.

[jordansparks]

Insurance is the most complicated part of the program. I just looked at your call notes. It looks like an especially complicated insurance plan. The notes say that the insurance does not have a fee schedule based off percentages. It has allowed fees that the insurance is going to pay and it also has a copay fee schedule. See
http://www.opendental.com/manual/insplantypes.html
Use PPO Percentage. Also, use a co-pay fee schedule. Set percentages to 100%. If you only have the insurance co-pay fee schedule available rather than the patient co-pay amounts, then you will have to subtract to obtain each fee in the co-pay fee schedule.

That's the very short answer to your question.

[drtech]

works great for all standard and PPO plans...

yes those pesky allowed plans we still can't get to work right. As Jordan suggested, maybe I need to set them up and the sched and the 100% payment..