Claims & Pretreatment Authorizations

[alexei]

1: One thing I really miss from my previous software is a freeform field in each claim for status notes-- not the notes that you send to the ins. company, but the notes about what's going on with the claim. For instance, "5/20: received request for xrays, sent by mail" or "5/20: Ins. company says they have no record of receiving claim, resending" etc. The area also had a button for inserting today's date, which was handy.

2: There seems to be something odd going on with the pretreatment estimates. For example, I have a procedure for $200. The insurance company pays at 80%, with a $50 ded. applied before %, so it should pay 80% of $150 = $120. The program calculates this correctly: it has an "Est" line with all the right amounts. However, when I make a preauthorization, it adds a PreA line with the wrong estimate ($110 - it doesn't subtract the deductible before % like it should). What's worse is that even after I enter the correct values from the Pretreatment Estimate from the Ins. company, though the right amount is inserted under "Ins Pay", the "Ins Est" remains wrong, and that's what you see on the main treatment plans screen, and that's what's printed on the treatment plan.

Ideally, I think, when you the values from the Pretreatment Estimate should be put under Ins Est and not Ins Pay. Also, a field for the preauthorization number (to be sent with the claim) would be nice.

PS: I'm still on 5.6, so if this has been corrected since, please ignore!

[jordansparks]

You should put that value in the override insurance estimate field. It should work perfectly 100% of the time.