Insurance remaining amount

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teethdood
Posts: 267
Joined: Sun Jul 29, 2007 12:39 am
Location: Visalia, CA
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Insurance remaining amount

Post by teethdood » Thu Oct 25, 2012 7:31 am

Let's say the patient has $1500 annual max.
I billed out a surgical ext $200 at 50% coverage. Open Dental shows $1400 remaining. OK

EOB comes back saying surg ext covered max is $150, 50% is $75. EOB is entered in. Ins remaining should be $1425. It doesn't do this. It still shows $1400. This is just an example because I'm finding out that my patients still have ins remaining by calling the ins company even though OD says $0. Am I doing/seeing it wrong? Thanks
Philip H. Doan, DDS
http://www.kaweahdental.com/

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jsalmon
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Joined: Tue Nov 30, 2010 12:33 pm
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Re: Insurance remaining amount

Post by jsalmon » Thu Oct 25, 2012 10:38 am

The "Ins Pay" section on the claim needs to say $75.00. Once a claim is marked received, the remaining ins is calculated off of what the insurance has paid, not the estimates. It sounds like yours is still looking at the estimates. I would double click on one of the claims in question and verify that the Ins Pay column on all the claim procs are set correctly. Also that they all have the status of "Recd" and that the Claim Status itself is "Received". If all that matches up, you might give us a call. I'm sure one of our techs can spot the problem.
The best thing about a boolean is even if you are wrong, you are only off by a bit.

Jason Salmon
Open Dental Software
http://www.opendental.com

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