Setting Up Insurance > Handling Insurance Plan Information
Some PPO plans pay:
Participating providers based on the plan’s allowed amounts.
A flat fee per procedure.
A percentage of the allowed amount .
Write off the difference between the plan’s allowed amount and the practice fee. Typically, you can bill the patient the difference between the insurance payment and the insurance plan’s allowed amount.
You can also automatically handle any risk and development write-off required by a PPO.
The write-off:
Is subtracted from the claim estimated insurance payment.
Does not change the allowed amounts for the plan.
Does not affect your regular write-offs or patient copays.
To estimate insurance payments for flat fee PPO 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, use the percentages specified on the Coverage tab of the Insurance plan window.
Specify whether a deductible applies to each procedural class when entering dental PPO plans.