Claim Correction FEE Schedule

[drmaximus]

How do I fix the problem scenario:

1. New patient calls and schedules appointment for cleaning and exam, front desk makes the appt and puts in planned procedures Prophy and exam with standard fee schedule
2. Patient arrives day of appt, provides insurance information, and correct fee schedule is selected
3. Hygienist forgets to hit the "update fees" button in the tx plan before setting procedures complete
4. Hygienist writes her note and "sets complete" the procedure
5. Front desk makes the claim and bills out, collects the copay (sometimes incorrect because the estimate is based on the wrong fee schedule)

Is there an easy way to correct this without: Erasing the procedures and reentering them so the program will calculate the correct estimates?

Thanks

[Arna]

By using the PPO Percentage Plan Type for your insurance plans, most of this work is eliminated. Open Dental retains the UCR fees in the account, but writes off the difference between your UCR fees and the contracted insurance fees. It also makes it easier to handle payments that come in that don't match the fee schedule in the system. If the patient's insurance was wrong or they aren't covered, there is no changing fee schedules and updating fees.

For your scenario, you want to ensure data integrity. If you delete and re-treat those procedures, you are losing a note that the hygienist wrote. You have two options (depending on how the note was written).
1. Manually change the fees (there is a claim attached to these procedures, so you will have to select 'Edit Anyways' at the bottom of the Edit Procedure screen).
2. Change the status of the procedures back to TP and use the TP module to 'Update Fees'. (not recommended, as you have to remove claims, Group Notes etc.).