Setting Up Insurance > Using the Insurance Bluebook

Understanding the Bluebook Entries for List Window

The plan estimation type-specific columns displayed in the Bluebook entries for List window are:

• Tag:Updates when you change estimation information in the Insurance plan window, change your fees, or update a bluebook amount.

• Code:Procedure code.

• Description:Procedure code description.

• Ins Pymt:Procedure code insurance payment amount.

• Allowed:Maximum fee an insurance plan accepts for a procedure or the usual and customary rate (UCR).
  This column is displayed for percentage, PPO, PPO percentage, Medicare percentage, and Medicare flat fee plan estimation types.

• %:Percentage entered on the Coverage tab of the Insurance plan window.
  This column is displayed for percentage, PPO percentage, and Medicare percentage plan estimation types.

• Plan Fee:Fee schedule or insurance payment.
  The insurance payment plus the copayment is displayed for plans requiring a per-procedure copayment.
  This column is displayed for DMO/Capitation and Medicaid plan estimation types.

• Copay:The copayment entered on the Coverage tab of the Insurance plan window is displayed in this column.
  This column is displayed for DMO/Capitation, Medicaid, PPO, and Medicare flat fee plans.
  
  Note: When a PPO or Medicare flat fee plan is selected, the value in this column is the difference between the insurance payment and the allowed amount. The write-off is automatically calculated as the difference between the allowed amount and your fee.

• Fee:Insurance payment plus the copay.

• Date:Bluebook entry date.

• Ded:If the copayment is applied to the deductible, Y is displayed in this column.
  If the copayment is not applied to the deductible, N is displayed in this column.

• Notes:If notes are associated with the bluebook entry, Y is displayed in this column.
  If no notes are associated with the bluebook entry, N is displayed in this column.