Setting Up Insurance > Handling Insurance Plan Information > Understanding Medicaid Plans
The following table explains the insurance estimation calculations used for dental and medical flat fee Medicaid 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 flat fee Medicaid plans are:
|
Plan Type |
Calculations |
|
Dental Medicaid Plan Bluebook Entry No Deductible |
The estimated insurance payment equals the insurance payment entered in the bluebook. |
|
Dental Medicaid Plan Bluebook Entry Deductible Subtracted First |
The deductible is automatically subtracted from the estimated insurance payment entered in the bluebook. The difference is added to the estimated write-off amount. |
|
Dental Medicaid Plan Bluebook Entry Deductible Subtracted Last |
The deductible is automatically subtracted from the estimated insurance payment entered in the bluebook. |
|
Dental Medicaid Plan No Bluebook Entry No Deductible |
The copay is automatically subtracted from the fee. |
|
Dental Medicaid Plan No Bluebook Entry Deductible Subtracted First |
The copay is automatically subtracted from the fee. The $25 deductible is subtracted from the difference. |
|
Dental Medicaid Plan No Bluebook Entry Deductible Subtracted Last |
The copay is automatically subtracted from the fee. The $25 deductible is subtracted from the difference. |
|
Medical Medicaid Plan Bluebook Entry Deductibles Do Not Apply |
The estimated insurance payment equals the insurance payment entered in the bluebook. |
|
Medical Medicaid Plan No Bluebook Entry Deductibles Do Not Apply |
The copay is automatically subtracted from the fee. |