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Insurance Estimates

Posted: Wed Jan 09, 2008 4:30 pm
by asanders
We've been using OD in my startup for a year now and we love it.

Anyhow, we obviously have a year's worth of data for insurance. Even though we call and check benefits and percentages, is there a way for us to customize it further? For instance, even though a certain company says they reimburse At 50%, 80%, whatever, is it possible for us to run a report that will tell us the true percentages on average they're paying.

If I know that instead of 50%, an ins. co. is actually paying 42%, then I could input that into the computer for treatment planning? It would really help us cut down on statements and A/R.

Clear as mud?

Posted: Wed Jan 09, 2008 4:55 pm
by Jorgebon
What we've done in our office is make fee schedules for each insurance company. We obviously obtain fee schedules from all those insurance companies where we have contracts. In those that we don't have contracts, we build an allowed fee schedule from past experience until we have at least the most used codes. We can give most of our patients an estimate which is accurate. In the rare event that we see a patient with some strange plan we don't have fees for, we normally ask them to pay for their treatment and they can seek reimbursement if they want.

Posted: Wed Jan 09, 2008 5:14 pm
by jordansparks
That's listed on the future versions page as the Coverage Book or Blue Book.

Posted: Wed Jan 09, 2008 5:33 pm
by asanders
Thanks fellas. That would be a huge benefit to my practice. Any idea when we can expect it?

Posted: Thu Jan 10, 2008 6:10 am
by jordansparks
I would not plan on it happening immediately. Try Jorge's solution for the mid term.