Treatment Estimate for Onlays Incorrect

[snofalls]

Is there a reason why when treatment planning an Onlay the percentage changes from 50% to 80%? On family account under insurance (benefit Info) the percentage is broken down and under crowns is will be set at 50%, but when printing TX plan for patient it will TX estimate @ 80% as if it is a restorative procedure. We have double checked everything and have onlays under crown and bridges for procedure codes. Is this happening because Dr. is putting down MODL for example for onlay? Any help would be greatly appreciated!

Linda
Snoqualmie Falls Dental

[Jorgebon]

Go to the main menu and look under Setup / Insurance Categories. You should find that onlays fall under restorative. That's why it gets calculated at the restorative percent. If you have an insurance plan that covers onlays at less than other basic restorative procedures, you have to decide on one of the many ways of defining that plan's insurance coverage in Open Dental. Probably one of my favorite ways of doing it is by defining the specific onlay codes as covered at 80%. You do this by going into the edit plan window and double clicking the benefit information box. Then click the ADD button, select Category = None, enter the proc code and enter the percent. Do that for each of the onlay codes.
There's also another way, but maybe not recommended. That would be to define a new category span in the setup/insurance categories menu and call it something like "onlays" or "Other Restorative".
Jorge Bonilla, DMD

[jordansparks]

Or instead of adding a new category, just alter the spans for the existing categories.