Hi,
I have a problem with insurance setup, we use PPO percentage for all plans except with Medicaid plans. I've noticed that the 'Claims shows UCR' checkbox in the insurance setup gets unchecked when 'PPO percentage' is selected. Typically, when the patient has one insurance and it is setup as PPO percentage, the billed fee is the UCR fee, so whether the checkbox is checked or not is irrelevant although having it there would not hurt, but I have to check it manually even though the default I have set up is to bill using UCR.
The problem occurs when the patient has Medicaid as secondary and for some reason the procedures were added to the account before the PPO plan is entered. The billed fee is the Medicaid fee, the PPO plan bills the billed fee not the UCR and we get underpaid by the PPO plan for that claim.
Am I missing something or is this a bug?
Thanks.
Camelia