Is there a query for Ins. plan benefits for procedures?

[Rickliftig]

We've been entering in our EOBs carefully for the last six months and so I know that OD has tracked these #'s. A couple of questions:

1) when we generate an estimate now, are the tracked amounts then used in creating the estimate?
2) Is there a report to show what each plan is paying per procedure?
3) I know that there was some banter about an insurance blue book... I assume this is what I am talking about... how would I query/access these numbers/pages for our use?

[jordansparks]

1. Sort of. Not unless you have attached an allowed fee schedule to the plan. And in this case, the number from the EOB would flow into the TP at the time you enter it. So there would just be one number. It's not going to look at the entire history and make any sort of intelligent decision based on that history. Just look in the allowed fee sched to see what it's doing. You can automate the generation and attachment of allowed fee schedules to your ins plans by going to Modules, Setup. In the Family module section, check the box for "Automatically generate allowed fee schedules for category percentage plans. Also, you can manage all your fee schedules much more easily than in the past. In Setup, Fee Schedules, see the new enhanced tool button at the bottom to review and stay on top of all your allowed fee schedules.
2. See #1.
3. See #1. Yes, the "blue book" feature is complete.

[Rickliftig]

I think I get it. Looking in the list of fee schedules... there are many multiples (listed with insurance company only) - of course these are generated by each employer-based plan. But I'm still wondering how I would see the info as to what was allowed, historically ofr X employer in Y plan?

Thanks in advance.

[jordansparks]

Not exact multiples, I hope. No two auto-generated fee schedules should be identical. It's based on the carrier, not the carrier/employer combo.

You are indeed asking for a query since we have not built a tool into the program that specifically does that. There would be some joining of tables.