Starting up with HMO/Supplemental Don’t understand set up.

[Juliebean98]

I’ve tried the set up instructions on the website and it doesn’t seem to be working. I also read through the Post “HMO claim affects the patient balance”

Example
Our UCR for D2710 is $1300 our minimum supplemental payment from the carrier is $250 for that code. If the plans copay is $50 the carrier will send us a cap check for $200. If the patients copay is anything over our supplemental fee the insurance will pay $0. If the patients plan has no coverage for that procedure the insurance will pay nothing because it will be defaulted to our UCRs.

What we would like to see:

Plan 1 - D2750 copay $50:
Billed fee-$1300 Insurance 1-$200 Discount-$1050 $Patient Portion $50

Plan 2 - D2750 fee schedule not a covered benefit:
Billed fee-$1300 Insurance 1-$0 Discount-$0 $Patient Portion $1300

Plan 3 - D2750 copay $533: Billed fee-$1300 Insurance 1-$0 Discount-$767 $Patient Portion $533

Any suggestions? I’m really struggling!