How to deal with non-assignment insurance

[sprange]

In my office I have quite a few patients with insurance plans that are not assignable. It works for me because I get paid right away and they can wait for their reimbursement. The problem I have is how to best setup their insurance. Enter 0% for each category? When we do this its not as easy to tell the patient what to expect from the insurance company. However if we enter the value (say 80%), then after the electronic claim is submitted they have to change the insurance estimate to 0 and mark the claim as received. If this doesn't happen we run into problems. Is there some easier way that I'm overlooking? Thanks!

[Arna]

I am making the assumption that we are dealing with a PPO Plan Type here. Setting the percentage of coverage for all benefits to 0% will work.
Open Dental will perform the following calculations for a PPO Plan Type:
1. Provider Assigned Fee - Insurance Fee (Normal Fee Schedule Type) = Writeoff
2. Insurance Fee - Copay Fee = Insurance Estimate
3. Insurance Estimate x Coverage Percentage = Insurance Pay
4. Provider Assigned Fee - Writeoff - Insurance Pay = Patient Portion.
In your case, if you assign 0% coverage for all spans, the only calculation that will come in to play is the writeoff. If you don't want writeoffs to deduct, you can choose to not assign a fee schedule to that plan. This will make your treatment plans and claims reflect the patient responsibility for the start.
Remember to also change the assignment of benefits within the 'Edit Insurance Plan' window. It is in the upper left hand corner in the Subscriber Information. Unchecking the Assignment of benefits will note on the claim that the payment is intended for the patient.
If I lost you at all and you would like for me to show you this, please don't hesitate to contact our support line. We'll help you set up your plans
You may also find our insurance webinars useful. They are recorded and available here: http://opendental.com/manual/webinars.html

[Arna]

AND after all of that, I see that you are in BC?
Pretty much the same, but the part about the writeoffs doesn't really apply in Canada. That makes it much easier. Just set to 0%, yes.

[sprange]

Thanks Arna! Lucky for us there are no PPOs in Canada (yet) so I don't have to deal with writeoffs. So with the insurance portion set to 0%, after the claim is electronically sent does my staff have to do anything? I seem to recall that if the claim status isn't changed/etc it will still be marked as a claim that hasn't been paid. Of course we collect the entire fee from the patient.

Sean

[Arna]

Sorry you slipped through the cracks on me, Sean.
0% claims will still show up in your outstanding insurance claims report. You should Enter Payment by procedure ($0) which will mark the claim as received.