Setting Up Insurance > Handling Insurance Plan Information > Understanding Flat Fee Plans
The following table explains the insurance estimation calculations used for dental and medical flat fee plans. The calculations show the estimations when the deductible is subtracted first or last.
The calculations are based upon the following example: The fee is $88, the allowed amount is $75, the bluebook insurance payment is $60, the coverage is 80%, the copayment is $30, and the deductible is $25.
The insurance estimation calculations used for dental and medical flat fee plans are:
|
Plan Type |
Calculations |
|
Dental Flat Fee Plan Bluebook Entry No Deductible |
The estimated insurance payment equals the insurance payment entered in the bluebook. |
|
Dental Flat Fee Plan Bluebook Entry Deductible Subtracted First |
The deductible is automatically subtracted from the insurance payment entered in the bluebook. |
|
Dental Flat Fee Plan Bluebook Entry Deductible Subtracted Last |
The deductible is automatically subtracted from the insurance payment entered in the bluebook. |
|
Dental Flat Fee Plan No Bluebook Entry No Deductible |
The coverage percentage is automatically multiplied by the fee. |
|
Dental Flat Fee Plan No Bluebook Entry Deductible Subtracted First |
The deductible is automatically subtracted from the fee. The difference is multiplied by the coverage percentage. |
|
Dental Flat Fee Plan No Bluebook Entry Deductible Subtracted Last |
The coverage percentage is automatically multiplied by the fee. The deductible is subtracted from the product. |
|
Medical Flat Fee Plan Bluebook Entry Deductibles Do Not Apply |
The allowed amount is subtracted from the fee. The difference is the write-off amount. The write-off amount is added to the insurance payment entered in the bluebook. |
|
Medical Flat Fee Plan No Bluebook Entry Deductibles Do Not Apply |
The coverage percentage is automatically multiplied by the fee. |