Insurance categories

[jrpappy]

We would like to edit the insurance categories for existing patients so that we can better estimate insurance payments. For example, if we know that a certain Insurance group will historically pay 50% on a given code up to $200, we would like to add that to the group coverage so that our treatment plans have the closest estimate possible.

It's usually the same handful of codes that we are interested in, so I would like to set up individual spans for codes that we generally use (crowns, ant/post composites, perio, etc) and have my staff simply input the information for each group or patient based on historical data from EOBs.

It's fairly straightforward to set up these new spans. However, the changes made only show up for new insurance plans and do not show in the Benefit Information table of existing insurance plans. Is there a workaround for this?

I can have my staff add codes one by one under "other benefits" table but it is a time consuming task.

Thanks
John

[JoeMontano]

Hello John!

What version of OD do you currently have installed? (Help->Update->Using Version......)

[jrpappy]

15.4.48.0

[JoeMontano]

Awesome thank you for that!

To clarify my understanding, are you going into the Edit Insurance Window and selecting insurance company X (Lists -> Insurance Plans -> find/double click row for 'X') when you are editing an insurance plan?
Or are you going to the patients individual insurance plan, double clicking into it and modifying it from the Family module?

[jsalmon]

However, the changes made only show up for new insurance plans and do not show in the Benefit Information table of existing insurance plans. Is there a workaround for this?

The spans on individual insurance categories that you change will push out to all insurance plans that already have that category in their benefit list. New insurance categories that you introduce will not push out or "sync" with all your current plans. Also, there is not a tool currently in the program that would allow you to select insurance plans from a list to mass edit their benefit information. This would be a feature request (which it looks like you or someone else that shares this complaint just submitted this issue to our FR system recently).
http://www.opendental.com/manual/featurerequests.html

I can have my staff add codes one by one under "other benefits" table but it is a time consuming task.

Once you've set your insurance categories up as desired, you should be able to add these new categories to the existing insurance plans instead of adding each of the codes one by one. Or are you saying that some insurance plans have different spans thus you can't use the categories and instead have to work around this by doing it on a code level?

[jrpappy]

Once you've set your insurance categories up as desired, you should be able to add these new categories to the existing insurance plans instead of adding each of the codes one by one. Or are you saying that some insurance plans have different spans thus you can't use the categories and instead have to work around this by doing it on a code level?

OK. I see this now. In the "edit benefits" window I see now that all of the new spans that I created are present in the dropdown list. This will make the process much easier. I didn't know they would be available in existing insurance plans. And as long as the benefits for the entire group are the same, we can just set the radio button "change plan for all subscribers".

Thanks for your help!