Setting Up Insurance > Handling Insurance Plan Information
Some Medicare plans pay:
Participating providers based on the plan’s allowed amounts.
A flat fee per procedure.
A percentage of the plan’s allowed amount.
Write off the difference between the plan’s allowed amount and the practice fee. This amount is displayed as an adjustment in the patient's Transactions window.
Medicare plans:
Typically provide medical coverage.
Often cover oral surgery procedures.
Medicare is always a patient’s primary insurance coverage, even if the patient is covered by another plan.
To estimate insurance payments for flat fee Medicare plans:
Set up accurate payment values in the bluebook for all procedures.
If there is no bluebook entry for the flat fee PPO insurance plan, the percentages specified in the Coverage tab of the Insurance plan record are used.
If the plan pays something other than a percentage of your fees, set up bluebook entries. If the fees equal the allotted amount, you do not need to set up a bluebook entry.