Dear Dentrix Team,
I’m writing to request an enhancement to simplify out-of-network patient responsibility estimates.
Currently, Dentrix allows us to enter a “paid amount” within the Payment Table and Allowed Amount section under the Dental Benefits and Coverage tab, and that paid amount can then be factored into the coverage estimator. However, the limitation is that we must first manually calculate the paid amount ourselves by applying the coinsurance to the out-of-network allowed amount. We then have to enter that calculated paid amount for each procedure before the estimate will reflect the correct patient responsibility. Of course in order for it to be fully correct, the deductible must be entered in the coverage information and the calculator will factor that in with the paid amount for the first procedure until the deductible is met.
For example, if our office fee is $130 and the out-of-network allowed amount is $100, and the patient has a $50 deductible with 80% coverage, the calculation would be:
$100 allowed amount - $50 deductible = $50
$50 x 80% = $40 estimated insurance payment
The patient responsibility should then be calculated as the difference between our office fee and the estimated insurance payment:
$130 office fee - $40 insurance payment = $90 patient portion
Currently, Dentrix will not calculate this automatically unless we first manually calculate the coinsurance on the allowed amount and then enter the resulting insurance payment as the “paid amount.” This means we have to do the math separately for every procedure. For example, if I know the insurance will be paying 80% of $100, I must enter in $80 in the "paid" amount to get the calculator to produce a good estimate. I know that if I have the deductible assigned accordingly, the estimator will factor that into the procedure. There area all sorts of allowed amounts when you are out of network and we are always gathering more so doing the math on them all day long is just a waste of time.
Instead, we would like the ability to enter the out-of-network allowed amount directly and have Dentrix automatically calculate the estimated insurance portion, patient responsibility, and the difference between the office fee and the estimated insurance payment.
This would save time, reduce the chance of calculation errors, and allow us to provide more accurate out-of-network treatment estimates to patients.
Please let us know if this is a feature Dentrix could consider implementing.
Thank you for your time and consideration.
Sherry
Office Manager / RDH
Unknown Unknown
