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