Downgrade on premolars?

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Downgrade on premolars?

Postby Third Coast » Tue May 24, 2016 4:30 pm

Is there currently a way to set the posterior composites to automatically downgrade to amalgams on PREMOLARS?
Currently we are calculating ourselves and entering the estimated insurance amount manually into the "Insurance Estimate" box of the "Edit Claim Procedure" window.

Also, is there still not a way to seperate the downgrades for a crown vs a filling?
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Re: Downgrade on premolars?

Postby Arna » Tue May 24, 2016 5:37 pm

Open Dental calculates downgrades posterior composites to amalgams automatically, as long as the 'Don't substitute codes' box is not checked in the insurance plan setup (it's not checked, by default). There also needs to be fees for the amalgam codes in the insurance fee schedules so that Open Dental knows what numbers to use (you'd be surprised how many people don't have these entered, hence no downgrades).
http://opendental.com/manual/downgrades.html

Downgrades are still an all or nothing concept as far as insurance plans go. Either all substitution codes are enforced in for the plan in question, or none are. Feature requests 3677 and 4199 are asking for this functionality. Go ahead and add some votes to that feature request if it's something that is important to you.
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Re: Downgrade on premolars?

Postby Third Coast » Wed May 25, 2016 8:01 am

My understanding is that it does this automatically for MOLARS not for PREMOLARS, so I was wondering if there was a way to set it to downgrade automatically for premolars. We do have it set to automatically substitute for molars, I guess we should probably just select "Always" in the substitue insurance code section, and this would address my concern?
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Re: Downgrade on premolars?

Postby Arna » Wed May 25, 2016 9:38 am

Third Coast wrote:My understanding is that it does this automatically for MOLARS not for PREMOLARS, so I was wondering if there was a way to set it to downgrade automatically for premolars. We do have it set to automatically substitute for molars, I guess we should probably just select "Always" in the substitue insurance code section, and this would address my concern?


Yes. Always will pick up premolars, too.
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Re: Downgrade on premolars?

Postby Third Coast » Wed May 25, 2016 2:44 pm

Okay, great thanks. I guess I wasn't thinking that those composite codes are limited to posterior teeth to begin with.
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Re: Downgrade on premolars?

Postby brunswicksmiles » Mon Jul 09, 2018 11:13 am

I have been asking for a request that I can choose which teeth have alternate benefits, such as pre-molar or molar. Some plans and patients have downgrades on molars and not on pre-molars, If there was a check box in each procedure whereI can uncheck if there is no downgrade and leave checked if there is would make treatment planning a lot easier and would save plenty of time.
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