Fillings wrong Fee
Fillings wrong Fee
When we treatment plan fillings the Allowed column is pulling the wrong fee for most of the insurances. Crowns, root canals other codes I have checked are pulling the correct fee, only fillings. I have checked the fee schedules and they are right. Example: Metlife Fee for 2 surf comp = $130, Tx plan pulls $94 in the allowed column so then all figures after that are incorrect. What is going on?
Re: Fillings wrong Fee
Many settings can affect allowed amounts. It is difficult to say what exactly is causing the problem without having one of our technicians do some troubleshooting.
A few things you can check:
1. Is the Blue Book feature turned on?
2. Are the fees in the fee schedules correct? (It sounds like you already checked this one.)
3. If the problem is for Category Percentage Plans, are the correct Out of Network fee schedules selected for them?
4. If the problem is for PPO plans, are the correct Fee Schedules selected for them?
If all of these settings seem correct, and you are still having this issue, please call support at 503-363-5432, or see our contact page for other ways to contact us, https://www.opendental.com/contact.html.
A few things you can check:
1. Is the Blue Book feature turned on?
2. Are the fees in the fee schedules correct? (It sounds like you already checked this one.)
3. If the problem is for Category Percentage Plans, are the correct Out of Network fee schedules selected for them?
4. If the problem is for PPO plans, are the correct Fee Schedules selected for them?
If all of these settings seem correct, and you are still having this issue, please call support at 503-363-5432, or see our contact page for other ways to contact us, https://www.opendental.com/contact.html.
Re: Fillings wrong Fee
I think we found that the Don't Substitute Codes isn't being checked. Is there a way to make that automatically checked?
Re: Fillings wrong Fee
We don't currently have a way to change the default for that setting when a new insurance plan is created, but there is a feature request for that if you would like to vote on it. It is feature request #8701. Please see our manual for more details about feature requests, https://www.opendental.com/manual/featurerequests.html.
Re: Fillings wrong Fee
Is that box normally checked or not? The Don't Substitute Codes button.
Re: Fillings wrong Fee
When a new insurance plan is created, the box is unchecked by default.