Help setting up Copay amounts

[rmb23]

I am a preferred provider for an insurance company that gives me exact fees to charge the patient for each procedure. I have previously been setting these up using insurance type "Medicaid - Flat copay" However, I hate doing this because the patient never see the write-off I am giving them by being a preferred provider.

The online manual says I can set this type of insurance up with insurance type "PPO" and then assign an "Advanced usage co-pay" Fee schedule. I don't see the "Advanced usage co-pay" anywhere. All I see is an "other fee schedule section" did the interface change? Where is advanced usage co-pay?"

If I set the insurance type as "PPO" set the fee schedule and set the other fee schedule copay with the correct fee schedule OD is not doing the math right like it does using the “Medicaid- flat copay” way.

I am using 6.1.8

[jordansparks]

http://www.open-dent.com/manual/insplantypes.html

In the PPO section, look for the bold text that says "Advanced usage co-pay". It is just talking about the other fee schedule section in the Open Dental window. I just reworked that section to hopefully make it clearer.

So I have a question about your specific situation. If you know the exact fees to charge the patient, then that must mean that they gave you two fee schedules, right? One for the fee to charge for each procedure, and the second for what portion of that fee is the patient's responsibility. Just want to make sure we are talking about the same thing.

[rmb23]

Correct, I have 2 fee schedules from them. The allowed amount and the patients copay amount. I set the allowed amount as the fee schedual and the copay amount as the copay fee schedual and set the insurnace type to PPO. When I do this the computer is still using the % instead of using amount in the "Copay fee schedual" to figure the patient copay amount.

[jordansparks]

The co-pay fee schedule is definitely supposed to override the percentage. It should be ignoring the percentage on procedures where there is a co-pay amount in the co-pay fee schedule. So if it's truly behaving as you suggest, then it's a bug. I'm going to put it down as a bug until I can verify. If I can't duplicate, then we will need to get a copy of your database to try to duplicate.

[jordansparks]

Sorry about the confusion. I just did some testing and tried to better document the expected behavior of the program. As it turns out, in your case you should set your percentages to 100%. Then, the amount remaining after the co-pay will be calculated as entirely paid by insurance.

[rmb23]

Thanks so much for your time! Works good now with the 100% put in.