Tuesday, October 6, 2015

Understanding How the Fee Schedule is Used in Dentrix

The Fee Schedule is the basis of the insurance estimate calculation. Patients can be assigned a fee schedule in one of three ways:

  • By provider settings
  • By patient settings
  • By assigned insurance carrier settings

By default, the patient is assigned their primary provider's UCR fee schedule as set up in the Office Manager > Maintenance > Practice Setup > Practice Resource Setup dialog box by selecting a provider and clicking Edit to open the Provider Information dialog box.



You can also manually assign a fee schedule to the patient in the Family File's Patient Information dialog box, by double-clicking the Patient Information block.

Note: Use the patient fee schedule option if the patient is assigned a special fee schedule for any reason other than insurance (for example, if the patient is a family member or a VIP patient.)



You can also manually assign a fee schedule to an insurance group from the Office Manager > Reference > Insurance Maintenance, by selecting an insurance carrier and clicking Ins Data to open the Dental Insurance Plan Information dialog box.


If multiple fee schedules have been assigned to the patient, Dentrix uses the following hierarchy to determine which fee schedule should be used:
  • If the patient has been assigned an individualized fee schedule in the patient information block of the Family File, that fee schedule is used.
  • If the patient has not been assigned an individualized fee schedule, but has been assigned an insurance plan where a fee schedule is attached, then the insurance fee schedule is used.
  • If the patient has not been assigned an individualized fee schedule or insurance fee schedule, then the patient's primary provider's fee schedule is used.

You can get more information about how Dentix calculates insurance by attending the Creating More Accurate Insurance Estimates with Dentrix course at this week's Business of Dentistry Conference. We hope to see you there!

No comments: