downgrade treatment estimates

[jkruckman16]

I am trying to get the treatment estimate to come up correct w/ delta downgrade on post. composite fills. We are a new clinic and do not have all the allowed fees as of today.( i know I need these to get a correct tx plan ) I used open dental over a year ago and I made a "delta downgrade " fee schedule and it seemed to work, almost to the penny, correctly. Now I can not remember how I did it ? Can someone give me some examples of how there clinic can get an accurate estimate? 952-679-4461

[Jorgebon]

Are you a Delta DPO dentist or are you Delta Premier only dentist?

[jkruckman16]

we are Delta PPO provider

[Jorgebon]

As a Delta PPO dentist, you agree to accept the PPO fee schedule that Delta has for your area. Your best option is to call Delta and request the schedule. In my area, Delta downgrades composite restorations to the equivalent amalgam restoration. That means you should have a few things set up in Open Dental. First you need to enter in Lists/Procedure codes from the main menu and look up the posterior composite resins. Double click on the procedure description and in the window that pops up enter the equivalent amalgam code where it says INS Subst Code. Another thing you should be sure is that all Delta plans do not have a check mark in the "Don't Substitute Codes" box in the Edit insurance plan window. You should also set each Delta plan as PPO Percentage. Once you get the fee schedule from Delta, enter all the fees. Everything should work.