How to simplify EOB entries and patient write offs
What do you do if the Insurance co (non-PPO) doesn't exactly pay what they are expected to pay ? You have promised to charge the patient a certain amount and you want to stick to it. The difference is not great but you want to "write off this difference" so the patient does not get disappointed . You don't want to call the patient and upset them for the small difference.
OD does have a button that will allow you to write off the entire amount and have no patient portion, but that is too aggressive, we only want to write of the difference between expect ins payment and actual without using a calculator while entering the EOB.
If you are not PPO participant it is very difficult to estimate the exact reimbursement from the insurance company for the specific procedure. The ability to see the exact write off or charge back to the patient after the EOB is received is very important.
The difference between the “”insurance Expected”” and “”insurance payment” is the issue and currently is automatically added to the patient portion. The Office manager should have a choice to see the difference between the expected ins payment and the actual payment and this difference should be vissible on the payment area and you should have an option to either “write off the difference “ and thus not add to the patient portion or add this difference to the patient portion. Doing all this without a calculator in hand .
Example crown fee is 1200.00 expected (promised) patient portion is 600 insurance expected is 600. Insurance does not pay its share but only pays 572.00 but you do not want to charge the patient as you promised his share to be only 600.00. In the payment by procedure area you enter the payment from the insurance to be 572.00 , OD calculates that the difference is 28.00 and shows it to you and you have the option of leaving it alone or overwriting this amount by 0.00 thus it will add the entire 28.00 to the writeoff thus not altering the promised patient portion. If you choose to leave the 28.00 to exist and not over write it then it will add it to the patient portion and show you that the patient portion will now be 628.00 all on the same summary line.
Do you feel this will be a nice enhancement and make EOB entries to go smoother ???
For users or potential users.
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