Changed Fees, Now Insurance Estimate Always $0

[lennox]

We changed our fees recently via manual update. My wife (the dentist) went through each fee she wanted to change and modified them. She changed fees across the board, but now it seems that any restorative work that is added comes up with $0 for insurance estimate.

Since she does not do amalgam fillings, she obsoleted this procedure and put $0 for price (I've just figured this out as I am typing).

After this, all insurance estimates for fillings (not all restorative, D2391-D2394 for sure, maybe some others) came up at $0.00, though the correct charge price came up. By restoring the prices (though leaving as obsolete) for the amalgam procedures (D2140,D2150,D2160,D2161), the estimates came out correct again.

My original question was going to be why is the insurance estimate $0.00, but I guess I've now figured that out -- OD is basing the insurance payment on a % of an alternate procedure. Is there a way to change this? I did notice a checkbox in the insurance set up: "Use Alternate Code" & "Don't Substitute Code". I haven't had a chance to play with that yet. Is this where this is set up? Also, where can I go to find a list of what substitutions are made if you don't click "Don't Substitute Codes", and what codes are different if you do check "Use Alternate Code"?

OD Version: 7.0.11.0
Thanks & Happy New Year

Lennox

PS: Thanks, Jordan, for a great piece of software!

[jordansparks]

Right, it's substitution codes kicking in. The "use alternate code" does not apply to this situation. I think the only substitution codes that we have preset are the posterior composites.

[lennox]

Aha! Thank you. Now I see how to fix this properly -- by eliminating the substitute codes for those four procedures in List-Procedure Code and editing the individual codes that are effected.

I had gone in and changed the amalg. cost to be the same -- which works, but may cause confusion again in the future if she changes the costs..

I cannot believe you answered on New Years Eve. You're awesome, Jordan.

Thanks Again,
and once again: Happy New Years to all!

Lennox