Setting Up Insurance > Handling Insurance Plan Information > Understanding Percentage Plans
The following table explains the insurance estimation calculations used for dental and medical percentage 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 percentage plans are:
|
Plan Type |
Calculations |
|
Dental Percentage Plan Bluebook Entry No Deductible |
The estimated insurance payment equals the insurance payment entered in the bluebook. |
|
Dental Percentage Plan Bluebook Entry Deductible Subtracted First |
The deductible is automatically subtracted from the allowed amount. The difference is multiplied by the procedural percentage amount. |
|
Dental Percentage Plan Bluebook Entry Deductible Subtracted Last |
The coverage percentage is automatically multiplied by the allowed amount. The deductible is subtracted from the product. |
|
Dental Percentage Plan No Bluebook Entry No Deductible |
The coverage percentage is automatically multiplied by the fee. |
|
Dental Percentage Plan No Bluebook Entry Deductible Subtracted First |
The deductible is automatically subtracted from the fee. The difference is multiplied by the coverage percentage. |
|
Dental Percentage Plan No Bluebook Entry Deductible Subtracted Last |
The coverage percentage is automatically multiplied by the fee. The deductible is subtracted from the product. |
|
Medical Percentage Plan Bluebook Entry Deductibles Do Not Apply |
The estimated insurance payment equals the insurance payment entered in the bluebook. |
|
Medical Percentage Plan No Bluebook Entry Deductibles Do Not Apply |
The coverage percentage is automatically multiplied by the fee. |