Inquiries on insurance

[glamorgan]

Hi everyone

I have 2 questions on the insurance

1. If the insurance company rejects a claim, what should I do within OD? how OD deals with rejected claims? how patient's account is affected? Any report detailing this?

2. Which report will help me find the insurance deductible for each patient's insurance claim?

Thanks

[jordansparks]

Enter it as zero payment.
2. I don't quite understand.

[Manny Ramirez]

I have a quick question about this subject. If the insurance does not cover a particular procedure. Can the office charge the regular office fee instead? Is the doctor still obligated to contracted fee ? I wander how this is being handled by other dentists

[Jorgebon]

That depends on the contract with the insurance company. If it doesn't specifically say that you have to charge the contracted fees for non covered procedures, then you can charge your normal fees.
Jorge Bonilla, DMD

[Jorgebon]

Regarding the two original questions:
Insurance may pay $0.00 or they may pay less than they are supposed to pay according to the contract. In either case you just enter the amount paid in the Ins Pay column when entering the payment into Open Dental. The balance owed can either be written off or charged to the patient. If after some reconsideration the Insurance company pays what they owe, then you should create a Split Caim and enter the amount.
Jorge Bonilla, DMD

[Dwayne]

Another option would be to enter a supplemental payment on the original claim.

[Jorgebon]

That's right, use the split claim when they don't pay one or more procedures together with some they do pay in a single claim.
Jorge Bonilla, DMD