Change code category for different insurance

[teamhowey]

In most insurance plans, build-ups are considered part of major or crown & bridge and covers at 50%. We have one insurance that covers them as basic and at 80%. Is there a way to change the coverage for build-ups for that one company?

Thanks

[Jorgebon]

In our office, we added subcategories to be able to solve this kind of problem. Go to SETUP/INSURANCE CATEGORIES and add a category for codes 2900-2999 (we call it other restorative). Place it below the restorative category in the list, so it becomes a subcategory under restorative. Then when you go and define an insurance plan's percentages you can assign a percentage for the subcategory of Other Restorative in the "Other Benefits" window that is different from the percentage for Restorative.
We did the same thing for other subcategories, such as Posterior Composites, Cosmetic, Prostho Repairs, implants, etc. Once you do that, you can basically define any Percentage type plan.
When you have exceptions such as a plan that covers root canals in anteriors and premolars, but not molars, you can assign a percentage for endo and then go into "other benefits" and assign 0% to 3330.
Jorge Bonilla, DMD