Important Notes About Insurance Estimating

• A person listed as the owner of insurance for another must be the owner of his own insurance.
• The system automatically adjusts the coverage & deductible paid to date for the patient with each transaction entry.
• The coverage and deductible paid to date are automatically re-adjusted if:
  1. You manually change the insurance estimate or procedure charge.
  2. You delete the procedure.
  3. The insurance payment is different than the estimate.
• The first time you enter transactions for a patient after his Renew Date, the system updates the renew date to represent the upcoming year and resets the deductible and coverage paid to date. DO NOT update the Renew Date manually.
• When a person has secondary coverage, the system assumes the secondary insurer will calculate what they would "normally" pay on a given procedure, and will pay this amount or the amount remaining after the primary payment (whichever is less).
• If Assignment is set to No on the owner's employer record:
  1. The system will not include the estimate for that carrier in the estimated insurance payment for the procedure (this portion will be included in the patient portion of the balance).
  2. The system will still adjust the patient's deductible & coverage paid to date for reference.
• As transactions are entered, the system calculates and displays the insurance portion of the balance. If the normal percentage of a procedure is not covered, a message displays on the screen explaining why. Example messages: Applied to deductible, Insufficient Interval (when entering a Prophylaxis), etc..
• Patient billing and walk-out statements reflect that the patient owes his portion of the balance immediately. When the Grace Period for Pending Insurance (See System Settings) has transpired, the patient is responsible for the full amount of the charge regardless of the insurance estimate.