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Treatment Plan not adjusting insurance estimate to benefits

Posted: Tue Mar 24, 2026 7:18 am
by Tumlin0100
Patient has insurance entered in -not new.
We enter in treatment plan but it is not accounting for the benefits at all.
Example:
Patient's OOP max is $1500 (which shows up on the Right side under individual's insurance).
On his new treatment plan, it states expected insurance payment: $3037..

It is also not accounting for claims already paid within the calendar year, under the same policy.
Any idea on how to get this resolved?
We recently updated to the newest version and it seems to have caused this.

Re: Treatment Plan not adjusting insurance estimate to benefits

Posted: Thu May 28, 2026 8:12 am
by BRANDACARE
This happened to us too after an update: super frustrating!
Two things that fixed it for us: first, manually refresh the Benefits Used inside the insurance plan. Second, double-check whether the OOP max is set at plan level vs patient level. updates sometimes reset that without warning.
Which version did you jump from?