Operating Procedures
Defining Insurance Plans For Employers
As you add new employers, if you do not know the specific coverage settings for their plan and would just as soon use the settings as defined on the Standard Coverage plan, you can specify Standard Coverage as opposed to creating another plan with the same settings.
If you learn the specific coverage settings for an employer after the fact, you can create an insurance plan with those settings and change the plan number on the employer record from the one that represents Standard Coverage to one that represents the new plan. The new settings will immediately take effect for every patient who has that employer. See Edit Insurance Plans for more information on creating an insurance plan.
Defining Patient Insurance Information
The information on the patient record related to insurance payment estimating is everything from the Enroll Date to the Family Deductible (See Patient Insurance Information). Once the initial settings have been set for these fields, the system automatically keeps them up-to-date. They require NO maintenance by you.
In making the initial settings for these fields, the system makes its best estimates as follows:
| Enroll Date | Defaults to at least six months prior to the current date. This insures standard wait periods have been satisfied for all types of procedures. |
| Renew Date | Defaults to the day and month of the upcoming year as specified on the patient's insurance plan. |
| Deductibles | Default to $0.00 paid towards deductible so far this year. |
| Coverages | Default to no coverage received so far this year. |
If you have a better estimate for any of these initial field settings, you can overwrite the system's estimates as you see fit.
Entering Transactions
When entering a prosthetic replacement or a procedure that falls under the Prior Extraction Rule, click on the Prosthetic F8 button in the lower right corner of the screen. A window will prompt for the original placement date and whether the Prior Extraction Rule applies. If this is the original placement, leave the original placement date blank.
