Insurance Plan History

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boboffice
Posts: 89
Joined: Sun Mar 29, 2009 7:11 am
Location: Poway, San Diego County, CA

Insurance Plan History

Post by boboffice » Fri Dec 05, 2014 8:39 am

Hello from sunny San Diego! I am hoping this forum can help me resolve a problem with the Plans for Family function found under the Add Insurance dropdown. I understand the reason that inactive plans that have been dropped are shown here. However, this creates a problem with the accuracy of the amount of current subscribers on any one carrier. We are considering going out-of-network on some insurance carriers and therefore need an accurate count of how many people (and who) we are affecting. For example, on this screen https://www.dropbox.com/s/rbsa151g0mi2x ... 5%20AM.png, a patient who has had two Principal plans is shown. There are no active insurance plans (as you can see from behind the pop-up window). The patient is archived. There are no outstanding claims.

Even so, this name still shows up (twice!) in the dropdown list on the Insurance Carriers/Ins Plan Subscribers, adding to the total. Currently, the only way to get an accurate count of which ACTIVE patients are on whatever carrier is by hand, one by one.

It seems to me the simple solution would be to only show the active patients on the dropdown list (or allow a checkbox to choose all versus active). Or, allow me to remove a patient from a historical plan once I'm sure I don't want it anymore. Is there a simple solution I'm missing? Thanks!
Robert Marcus DMD
Univ. of CT '93
Poway, CA

tgriswold
Posts: 122
Joined: Fri Jun 07, 2013 8:52 am

Re: Insurance Plan History

Post by tgriswold » Fri Dec 12, 2014 5:36 pm

That patient is always going to be linked to that plan historically. This is because all of his old claims need an insurance plan to point to when you review those past claims.

In database terms, an insurance plan being currently linked to a patient is shown by the existence of an entry in the patplan table. So the tables go Patient -> PatPlan -> InsSub -> InsPlan -> Carrier. It sounds like you are wanting a report to tell you one of two things: 1.) How many distinct patients are currently attached to a plan (currently covered and shows in family module). 2.) How many distinct subscribers currently are attached to a plan (currently covered and shows in family module).

The number for #1 can be seen in query #122 on the query examples page of our website http://opendentalsoft.com:1942/ODQueryL ... yList.aspx. At quick glance I don't see a query on that page for #2, but it wouldn't be a hard modification to make. OpenDental can also write you a custom query to find the information you are looking for. Information about our query request process can be found on this page http://www.opendental.com/manual/queryoverview.html
Travis Griswold
Open Dental Software
http://www.opendental.com

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