Setting up a Medicaid Insurance Plan

[atd]

I'm trying to setup a Medicaid insurance plan. I have the fee schedule entered and do not want the difference between the insurance estimate and the full fee to show on the patient's balance since it will be written off. The instructions in the user manual say to do the following:

1) Set Plan Type to Medicaid of Flat Copay - Done
2) Check the boxes for "writeoff" and "use UCR". This is where I'm having a problem - where is the writeoff box?

I also chose the Medicaid fee schedule from the "Carrier Allowed Amounts" dropdown list.

I must be doing something wrong because the difference between the fee schedule and the billed amount is being added to the patient balance. I'm guessing it has something to do with the writeoff box I can't find. Can someone point me in the right direction?

Thank you

[jordansparks]

I just edited that page in the manual. Sorry about the confusion. I think the problem was that you used the Carrier Allowed Amounts fee schedule. This is wrong. Leave it blank. Just choose the Medicaid fee schedule as the ordinary fee schedule for the ins plan.

[atd]

Thank you, I made the changes you suggested. I have a couple of more questions about this though:

1) If the fee schedule amount ends up being incorrect (sometimes they change), how do you fix it so it doesn't affect the patient balance for services already entered? For example, if I enter a payment that is higher than the insurance estimate, it shows a credit on the patient's account. I tried changing the insurance estimate on the "edit claim procedure" window, but it doesn't change the insurance estimate for the service, therefore it's still affecting the patient balance. Similarly, if the paid amount is less than the insurance estimate then it shows the patient owing the difference. However, in that case I can enter a writeoff to fix it.

2) The charges on the account screen and the daily production reports now show the Medicaid fees rather than the Standard Fee. Is there still a way to print reports that show the Gross production and the Medicaid Insurance estimate for these accounts? We need to track Gross production for our dentists in addition to being able to calculate the Medicaid insurance estimates accurately for our Accounts Receivable.

Thanks!

[jordansparks]

1. You need to know how to override the insurance estimate sometimes. The override insurance estimate box in the edit claim procedure window doesn't work? Too complicated to get into on a forum. We would have to see your screen.

2. Gross production IS the medicaid fee. Our definition of production is "work for which you expect to be paid". If you do work for a reduced rate, then as far as we are concerned, you did less production. I suppose one option would be to set them up as an PPO plan with 100% coverage on everything. Then, your regular fees would be used on the procedures, and the difference written off. This would allow you to run the PPO reports to track production before the writeoffs.