Open Dental Forum

I'm submitting claims to Delta Dental as an OON provider. 90% of the time, the payment goes to the enrollee. My goal is to make my patients experience as seamless as possible without selling my soul to Delta. So, for these instances where AOB is the enrollee...I typically write off fees greater than the allowed amount, collect the estimated deductible and copayment at time of service, and then charge the patients Credit Card for the remainder (insurance reimbursement) after they've received their check. The process works well and patients appreciate it.

In my workflow, I collect the deductible and copayments and submit the claim, ... great, so far so good. Then, when I see the payment has been made to the patient, I'll Enter Payment By Procedure Code. I'll then enter Allowed, Ins Pay ($0), and WriteOff (UCR - Allowed). Still doing great... I can collect the Blue Book Fees for better estimates moving forward and accurately track my patient's account balance. MY ISSUE is that because Ins Pay is $0, Open Dental does not accurately track Ins Used. If I capture the payment to the patient in Ins Pay, then my account balance is screwed up.

Is there a better way to accomplish my goal in Open Dental? If not, may I request a feature? Perhaps if 'Assignment Of Benefits' is unchecked in the Family/Insurance module, the Ins Paid on the claim can be applied to Ins Used and ignored on the patients account balance? Throw a preference in the Family Module Preferences / Insurance section called 'Ignore Ins Pay when Assignment of Benefits is Unchecked' to ensure you don't screw anyone else up.

Thanks!

https://www.opendental.com/manual/insplan.html

In the Family Module, double-click an existing insurance plan. In the upper right corner, click on "Add" - Adjustment to Insurance Benefits.
Every time you know how much Delta paid the patient, "Add" and post the amount that was paid here.
The amount of "Benefits used" by the patient during the year can be added here, and it is always available on Delta website.
You need to do the same , for all of your out of network plans, if a patient saw another dentist, and used some of his benefits.

Now Open Dental can do the estimates correctly.

Thanks. I'm aware of the feature but it's a work around that creates a lot of room for error and is incredibly inefficient.

"You need to enter the payment in OD"
If you did not receive the money, that's the place to enter it, takes few seconds.
It is easy, does not need to be complicated, no need for adding different setup options, and no need for new accounting , etc.... But of course , each office works differently.