Open Dental Forum

Our office is considering going out of network with Metlife. We are out right now as we recently contracted with an umbrella company and are waiting for them to recognize us as in network under the umbrella company. As a result, we have noticed that the out of network reimbursements for Metlife are quite high. However, we do not want to alienate the Metlife patients we have and in the interim have been discounting the services as patient discount credits to the Metlife allowed fees. IF we do go out of network with Metlife, we discussed continuing to apply those discounts so as not to lose our established Metlife patients. Long-term, processing claims is going to be time consuming as the discount amounts need to be entered manually. I am trying to think of a way to configure the insurance plan that uses another fee schedule to automatically calculate the discount amount for each procedure that would be equal to the Metlife write off amount. Can this be accomplished or am I doomed to forever calculate and enter the discounts manually?

Do you need the discounts to show as adjustments on the account?
If so, manual entry is currently the only option, but you may be interested in voting for feature request #7227 which would allow patients to have both an insurance plan and a discount plan.
If the discounts don't have to show as adjustments, would it work for you to continue to have the plan setup as a PPO plan? You could use option 1 or 2 from this page, https://www.opendental.com/manual/planppo.html. Option 1 would track the discounts as write offs. Option 2 would provide discounts but they wouldn't be tracked as write offs or adjustments.

Thank you! I think the simplest solution for me right now is just applying a discount to each procedure in the treatment plan equal to the amount of the usual adjustment and removing the write-off. I'm going to vote for that feature as well.