A universal robust Blue Book

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grinfixer
Posts: 10
Joined: Wed Sep 23, 2020 3:16 am

A universal robust Blue Book

Post by grinfixer » Sun Mar 21, 2021 9:43 am

Is there any way that OD can consolidate the UCRs for the major players for us FFS practices. The largest part of our problem is basing a patient portion on a UCR of which we are unaware. It's great to know in seconds via a variety of third parties as well as OD that restorative on a particular plan pays 80%. It's the 80% of what that is problematic. As we all gather data and enter it into OD, can OD build a "Super Blue Book"? I've posted this on various message boards and FB groups and there simply is nothing like this available.

In a recent FB post, Modento, after their recent acquisition by Dental Intel, is also entering the eligibility/verification arena and when asked about UCR responded, "Kelsey Masterson Admin: Out of network benefits will be included in our default overview. However I may need to look into UCR/fee schedule details further to see if this is a possibility at all."

This functionality would be a game changer. It's the single biggest reason we still have to have a real person on the phone all day long.

sammyp42
Posts: 23
Joined: Wed Jun 04, 2014 12:55 pm
Location: Redwood City, CA

Re: A universal robust Blue Book

Post by sammyp42 » Sun Mar 21, 2021 10:00 am

I think Sikka (sikka.ai) does this to a certain degree. It's not instant, but they got their fingers all over the place and gather quite a bit of UCR data. Used them a while ago, but not very active with them ATM. Looks like their service offerings have evolved a bit over the years.

grinfixer
Posts: 10
Joined: Wed Sep 23, 2020 3:16 am

Re: A universal robust Blue Book

Post by grinfixer » Mon Mar 22, 2021 7:01 am

Well, I've looked at the SIKKA site and although they have a bunch of integrated products, none seem to perform what I'm looking for. I've reached out to them via email. We'll see...

joes
Posts: 239
Joined: Tue Aug 13, 2019 12:41 pm

Re: A universal robust Blue Book

Post by joes » Tue Mar 23, 2021 10:03 am

Open Dental does have a Blue Book feature, but it doesn't currently use data aggregated from multiple users. Please consider submitting a feature request for this.
Joe Sullivan
Open Dental Software
http://www.opendental.com

msmfd
Posts: 21
Joined: Mon Feb 22, 2021 7:32 am

Re: A universal robust Blue Book

Post by msmfd » Wed Mar 24, 2021 8:34 am

This is a great idea! We have some insurance companies that we do not participate with and it's so tedious to wait for EOB's to come back to piece together some form of fee schedule, and there's no way to accurately predict co-insurance for incoming new patients w/unknown insurance plans. Id gladly contribute any info I have for the common good! :wink: I'd create a request myself but need my OD updated first.

grinfixer
Posts: 10
Joined: Wed Sep 23, 2020 3:16 am

Re: A universal robust Blue Book

Post by grinfixer » Sun Apr 04, 2021 4:30 am

Well, here's what came back from Sikkasoft:

"We can give you the UCRs for the 17 plans you mention, across 10 zip codes, going back 3 years, for a $94,000 one-time cost to you. If you want more zip codes, it would be an incremental fee of $2,500 per additional group of 10 zip codes. If you would like the data on an ongoing basis, that would be a separate discussion."

Not hard to imagine that $94,000 is just beyond my reach :lol:

According to OD, I have 85% of my OON patients in 17 plans. Can I just create an all encompassing treatment plan for a patient that participates with one of these carriers and then just enter it? Seems like 17 EOBs and I've got 85% covered. I don't think that's fraudulent.

I'd just love to be able to upload that into OD. Imagine: a carrier, a plan and a zip code. One OD click and here you go.

Aah, the thought of miracles on Easter morning.

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