Tuesday, May 7, 2019

Deductibles, Benefits, and the Treatment Case Report

Do your Treatment Case Reports fail to address common insurance questions from your patients? For instance, it's the end of the year and you have a patient who wants to know what it would cost to have her treatment done now, with this year’s insurance payments factored in, as opposed to what it would cost next year after her benefits renew.

With a simple change in the report's setup, you can create two versions of the report: one that factors in deductibles and maximums paid, and one that doesn’t. So you can easily show patients what their benefits will cover this year, and what will be covered next year.

To create a report that factors in a patient's current deductible and/or benefits paid, in the Treatment Planner, select the appropriate treatment case, click the Print button, and select Print Treatment Case.

In the Insurance group box, check the Use Dental Plan Maximums and Deductibles box. Set other report options as desired and click OK.


Then, print a second version of the report with the Use Dental Plan Maximums and Deductibles option unchecked. You can then present both reports to the patient and use them to compare what the treatment would cost this  year and what it would cost next year, helping your patients decide which option works best for them.

For example, Adrian Farmer has dental insurance with a $50 annual deductible and a yearly maximum individual benefit of $2,500. Unfortunately, because of major dental work at the first of the year, she has maxed out her insurance coverage. It's now November, and her wisdom teeth are bothering her. She's wondering what it would cost to have them removed before the year ends; or, if she should wait until next year when her insurance benefits renew.

You create a treatment plan to remove her wisdom teeth, and you generate two Treatment Case Reports, to show Adrian the difference in price.

This first report incorporates the Use Dental Plan Maximums and Deductibles option. Because her insurance is maxed out, this report shows that her insurance won't pay for the treatment, and she would have to pay the total cost.


This second report has turned off the Use Dental Plan Maximums and Deductibles option, so the report ignores the maximum benefit limit and deductibles owed. This allows you to show her the coverage breakdown for the procedures and gives her a ballpark estimate of what the insurance will likely pay, next year.


One simple change in how you set up the Treatment Case Report can give Adrian the information she needs to make an informed decision.

For more information about using his helpful option:

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