Setting Up Insurance > Using the Insurance Bluebook

Editing Bluebook Entries

The insurance plan’s estimation type dictates which fields are displayed when you open the Bluebook entries for window.

• If you change a code’s fee schedule 0 amount in the ADA/Transaction Codes window, all bluebook entries associated with the code are automatically updated.

• The insurance payment amount must be less than the allowed amount.

To edit a bluebook entry:

1. Select List > Bluebook. The Bluebook entries for Plan window is displayed.

2. Select a plan from the Plan drop-down list.

3. Click Edit. The Bluebook entries for window is displayed in EDIT mode.

4. If you are editing a percentage, percentage PPO, or Medicare percentage plan, select an option:

5. Type a new insurance payment amount in the Insurance Payment field:The Allowed Amount field is automatically populated with the new payment amount divided by the percentage.

6. Type a new amount in the Allowed Amount field:The Insurance Payment field is automatically populated with the lowest amount: either the code’s fee schedule 0 amount or the allowed amount multiplied by the percentage covered value.

7. Type a new percent in the Percent Covered field:The Insurance Payment field is automatically populated with the lowest amount: either the code’s fee schedule 0 amount or the allowed amount multiplied by the percentage covered value.

5. If you are editing a flat fee plan, type a new insurance payment amount in the Insurance Payment field.

6. If you are editing a DMO/Capitation or Medicaid plan, select an option:

7. Type a new insurance payment amount in the Insurance Payment field:The Copay field is automatically populated with the plan fee amount, minus the insurance payment amount.

8. Type a new plan fee amount in the Plan Fee field:The Copay field is automatically populated with the plan fee amount, minus the insurance payment amount.

7. If you are editing a flat fee PPO or flat fee Medicare plan, select an option:

8. Type a new insurance payment amount in the Insurance Payment field:The Copay field is automatically populated with the allowed amount, minus the insurance payment amount.

7. Type a new allowed amount in the Allowed Amount field:The Copay field is automatically populated with the plan fee amount, minus the insurance payment amount.

8. Select Apply to Deductible to apply the amount to the patient's deductible.

9. Select Upgraded Procedure (write-off amount applied to patient balance) to add the write-off amount (the difference between the allowed amount and the fee) to the Pat. Pays amount.

10. Type any notes in the Notes field.

11. If an appointment is made for this procedure and for a patient covered by this plan, the note is displayed in the Assistant.

11. Click OK.

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