Open Dental Forum

New Mexico is one of the few states that taxes healthcare with a sales tax. To make it more bizzare, money that is paid by a insurance company under a ppo contract is not taxed. Money received from patients that are covered by a ppo is taxed. I.e. For a crown done on a Delta PPO patient, I have to pay tax on the $400 copay but not on the $400 insurance payment.

I have personally paid thousands of dollars in penalties for *overpaying* my taxes because we misunderstood which payments were taxable and which were not (and for being honest about it).

So, I need to accurately catalog every insurance payment as taxable or non-taxable. Luckily, I am a programmer by hobby.

I need to set a flag on each benefit plan. The "filing code" field seems like a winner. What affect will it have if we use it as a flag? I would set it as either PPO or null.
Or, can you throw a check box called "NonTaxable" on the insurance plan information page?

I'm not a paying customer as of yet but I need to have this nailed down before we go live because the tax penalties are staggering.

With Dentrix, I created a duplicate of the standard claim format and named it PPOCLAIM and used that as my marker on the insurance information page. It looks like that may be an option for OD as well.

What would you suggest?

Jim Margarit

The filing code is used in the electronic claims. If you use the wrong filing code, the claim might not get past the clearinghouse.
Jorge Bonilla, DMD

One way to add a tax is to do it manually when the front office person prepares the walk-out statement for the patient. You can add an adjustment to each cash payment made by the patient. You can go into Setup/Definitions to add a positive adjustment name such as "Sales Tax". You can then write a query that will produce a report on these payments. The only disadvantage to this is that the front office person has to do it manually and this means a higher probability of human errors.
Jorge Bonilla, DMD