Dentrix Ideas

Attach Insurance Maximums, Age and Frequency Limitations to Coverage Table Categories or Individual Procedures.

Need to be able to attach insurance maximums/limitations to individual procedure codes and/or categories (could be done with coverage tables). Both monetary maximums and a maximum number of times the code will be covered each year, as in the case of prophies, bitewings, etc. Also age limtes. Should tie into the Continuing Care system so a warning message comes up if an appointment is scheduled before insurance will pay for it, and a patient will be flagged when their insurance will once more pay for a procedure. Also needed in the case of crowns and other procedures that will not be covered within five years of the initial placement. Would also like to setup separate lifetime and annual maximums for certain categories, such as orthodontic and perio work, and flag any procedures or categories that should not be counted against any maximum. Display these limitation in the Treatment Planner and on the Route Slip. Need to be able to specify which services the Maximum applies to. [4068]
  • Guest
  • Jul 9 2019
  • Planned
  • Attach files
  • wendy commented
    09 Jul 04:35
    It is very important for clinical and billing staff to have this information. Each drop box provides the option of # of months it is allowed, # of years it is allowed, or if it is allowed # of times per period (see example attached).
  • Unknown Unknown commented
    09 Jul 04:35
    GREAT IDEA!
  • Unknown Unknown commented
    09 Jul 04:35
    This would be spectacular!!
  • Betty commented
    09 Jul 04:35
    Only thing I would add is if it could tell if frequencies were 'separate' or 'in addition to'. Examples: 2 prophylaxis and 2 perio maintenances (PMT) or only 2 total procedures total. Or are panoramic xrays in addition to FMX or are they separate frequencies?
  • Guest commented
    09 Jul 04:35
    age frequencies are also very important for some procedures too, I currently use the notes in the dentrix payment table but than need to check that manually and determine patient portion using this.
  • Guest commented
    09 Jul 04:35
    Any idea how long this will be in development for. Also will this have max for separate procedure groups????
  • Kathy commented
    09 Jul 04:35
    something I have wanted for years. ps I would also suggest that in addition there be a "notes" field attached to each procedure code for each 3rd party plan as there are sometimes some very creative bs limitations it would be impossible to keep track of other wise. Thank you!!
  • Guest commented
    09 Jul 04:35
    It would be nice if we could tag a certain patient due to age limitation especially for Flouride. we have many families whenre it is covered for some but not the others
  • Julie commented
    09 Jul 04:35
    Absolutely needs to be a priority.
  • Unknown Unknown commented
    09 Jul 04:35
    Yes please! Definitely need to be able to customize the coverage better and frequencies would be awesome too!
  • Guest commented
    09 Jul 04:35
    This is suppose to be top of the line program! We need to separate Ortho Max from General Max. Please do it as soon as possible.
  • Unknown Unknown commented
    09 Jul 04:35
    Yeah! We need to add individual procedure's coverage. Some insurance pay @ 80% for single crown/ comp @ 70% its better if we have different way to add insurance coverage. Also,if we can separate max for ortho and regular max.
  • Unknown Unknown commented
    09 Jul 04:35
    This is a MUST! We all agree at our office...
  • Anonymous commented
    09 Jul 04:35
    Any waiting periods for procedures and effective date of insurance coverage is a must.
  • Katie commented
    09 Jul 04:35
    This would be so fantastic. Right now we keep notes in the pt file and this would be a fantastic function!
  • info@pacificmoderndentistry.com commented
    09 Jul 04:35
    Considering Recall is the backbone of any dental practice!!, this should be high priority!
  • Guest commented
    09 Jul 04:35
    ALSO, work harder at keeping up with the new insurance contracts. Some now have unlimited benefits for diagnostic and/or preventive services which can have a huge impact on a patient's maximum
  • info@fisherpointedental.com commented
    09 Jul 04:35
    i would also use all my votes for this if i could .. great idea
  • Unknown Unknown commented
    09 Jul 04:35
    We also need Scaling root planning limits
  • Guest commented
    09 Jul 04:35
    THIS WOULD BE EXCELLENT!!! IT IS SO DIFFICULT TO READ EVERYTHING IN THE NOTE SECTION, BECAUSE IT'S ALL BUNDLED UP.
  • Paula commented
    09 Jul 04:35
    YES! I would use all of my votes for this, daily, if this website would let me.
  • Unknown Unknown commented
    09 Jul 04:36
    Because most insurance plans have a separate lifetime max benefit for ortho, it would be good if there was a separate box to enter the ortho max. That way when a claim is paid by insurance, the amount paid would come off the ortho benefit, rather than the regular annual max.
  • Judy commented
    09 Jul 04:36
    We need different maximum options for insurance. One for basic work, one for major work. With an option per patient or per family.
  • financial@drscottanderson.com commented
    09 Jul 04:36
    Example: Dentrix will show a patient maxed when they aren't, because some insurances have seperate maximums for different categories. If we could add maximums per category, similar to how the deductible is done.
  • CYNDY commented
    09 Jul 04:36
    SOFTDENT SHOWS WHAT PT BALANCE WILL BE ON APPT. SCHEDULED SOOO HANDY. AND SHOWS LAST PRO, BWX, FMX WITHOUT HAVING TO LOOK IN CONTINUING CARE.
  • Unknown Unknown commented
    09 Jul 04:36
    For downgrade we adjust the payment table to reflex the difference. But the limitations connected to the categories would be most helpful to see quickly and help the clinical side see what the insurance really allows.
  • Jessica commented
    09 Jul 04:36
    We agree. This needs to be addressed ASAP!!!
  • Guest commented
    09 Jul 04:36
    we are in 2018 and Dentrix cannot show our downgrades yet but most of other programs do. It's sad :(
  • Doris Zercher commented
    09 Jul 04:36
    Yes this would be a great help.
  • Unknown Unknown commented
    09 Jul 04:36
    This has always been an issue for me as well. Many plans pay alternate benefits, have downgrades and most ALL have frequency limitations. Patients don't have little to no idea what their dental benefits are. They rely on ME to provide explanations of their coverage. If our system gave us the ability to check mark these things and alert us when needed it would save a tremendous amount of time!!! I have used Easy Dental for 19 years now and not once has this been taken into account. It is sad that this original posting has been in question since 2009!
  • Unknown Unknown commented
    09 Jul 04:36
    YAY!!
  • cdpartners20@gmail.com commented
    09 Jul 04:36
    Insurance limits procedures by age. It would be nice to be able to put an age limit in for for procedures such as sealants, fluoride and ortho.
  • Rachelle commented
    09 Jul 04:36
    Seriously y'all, this really needs to happen. Other dental software has had it for years BECAUSE IT IS IMPORTANT.
  • Guest commented
    09 Jul 04:36
    This has always been my constant struggle with the software. Many plans pay alternate benefits, have downgrades and frequency limitations on their plan. About 80% of patients don't understand their benefits and rely on our help to provide assistance with it. If our system gave us the ability to check mark these things and alert us when needed it would save a tremendous amount of time! I have been working with this program for 4+ years now and not once has this been taken into account. It is sad that this original posting has been in question since 2009! :(
  • Anonymous commented
    09 Jul 04:36
    It would be nice to be able to show Ortho Max and Amounts USED as well as keeping track of that without interfering with the regular dental maximum. We are a General Dentist Practice that does Ortho and it would be nice to be able to keep better track of Ortho Benefits used within the family file and the ledger.
  • office@cypressdentalmonterey.com commented
    09 Jul 04:36
    If you can add some alert that pops up or is somewhere that alerts us in the insurance data. This Information: Downgrades done to Composite fillings to Amalgam fees Waiting periods Fee schedule plan only, does not pay on percentages
  • info@4dentalhealth.com commented
    09 Jul 04:36
    It is becoming more common to see the pano frequency as 5 yrs. We would like to be able to rely on our Continuing Care box but it is defaulting to 3 yrs. We need a way to choose 3 or 5 yrs, or even No frequency.
  • Guest commented
    09 Jul 04:36
    would be nice to have in the insurance plan coverage options that can define limitations. some insurances pay for adult fluoride. some insurances only allow a panorex every 5 years vs 3 years. some insurances do not apply preventive services to the calendar year. if attached to each code we could have a limitation option.
  • taylor commented
    09 Jul 04:36
    There needs to be a way to make notes on each claim, separate from the claim status note. For instance, it would be nice to make notes as far as why a claim was denied, as in, insurance maxed out, frequency limitations, etc
  • Guest commented
    09 Jul 04:36
    We need a way for the system to automatically recognize if a procedure is not covered due to age. We are a pediatric office and many times fluoride, sealants, ortho, etc. are only covered up to a certain age. We would like to have a box that we can check if there are age restrictions on a specific code so that the estimate comes up appropriately.
  • Alisa commented
    09 Jul 04:36
    The user has a Patient whose Insurance has a separate Lifetime Maximum for Orthodontic work. We would like to track this separately from the patients annual maximum in coverage table. This will then show max on treatment plan when orthodontic codes are entered. Currently it only computes percentage for allowable amount but this is sometimes more than the maximum amount.
  • Mel commented
    09 Jul 04:36
    Ledgers need to update and track insurance frequencies such as 2/yr vs 2/12 months so we automatically know if the patient is eligible. It's a constant hassle trying to manually count and keep up with these things. The "coverage table" doesn't include frequencies and/or limitations. The "Benefit Breakdown/ Frequency Template" might be the same thing but not sure. We also need a "Downgrade Conversion Table" to perfectly calculate the so-called "alternate benefit" amounts.
  • Mel commented
    09 Jul 04:36
    When posting a payment, it would be great to automatically check a box like when you check the "update payment table", but instead it would say "insurance maxed" or "insurance stipulated frequency" when the payment was zero or less than expected, and this would show up on the corresponding line in the ledger or claim payment somehow. We don't want to have to manually add notes like these to the insurance claim status notes section. Insurance used to take 2% of my time. Now it takes up 95%.
  • Kelly commented
    09 Jul 04:36
    I am honestly blown away that dentrix does not have ortho treatment plans, payment plans, and at a minimum a separate ortho maximum under the benefit table. I have worked with various other software programs over 25 years and all have this option. This makes accounting, billing, and treatment planning very difficult and inaccurate. Additionally, if your associate docs are paid on production it makes the process brutal.
  • Melaine commented
    09 Jul 04:36
    To have an option to have preventive services not apply to maximum benefits. Several plans allow for preventive without it being deducted from the maximum benefits. It would be nice to have a check box, does not apply to annual maximum.
  • Guest commented
    09 Jul 04:36
    I have several plans which allow different maximums for subscriber, spouse and child. It would be great to be able to enter that
  • Unknown Unknown commented
    09 Jul 04:36
    So I have an insurance plan, which has a different maximum for the diagnostic/preventative services, and basic and major services. At this time, the insurance coverage table only allows ONE maximum to be put in. What is the best way for me to input this information? Is there a way to override this, or a way to put in both maximum amounts? The option for multiple deductibles is available at this time, but not for the maximums.
  • Lori commented
    09 Jul 04:36
    For things like fluoride and sealants, which may be covered for children but not for adults, we should be able to indicate an age limit by code in the system so that treatment plans are accurate for all family members.
  • Unknown Unknown commented
    09 Jul 04:36
    Ortho limits and coverage.
  • Guest commented
    09 Jul 04:36
    I'd like to see an option to add insurance limitations such as missing tooth clause, downgrades and frequency. These notes should be tied to that specific plan/group. This feature will help save us on calling insurance for every patient when we want to know how often xrays or cleanings are covered.
  • Guest commented
    09 Jul 04:36
    I also agree that this feature should be enabled as soon as possible! we need to have a notes section for the specific insurance that will allow us to easily view frequencies and limitations from the family file!
  • Guest commented
    09 Jul 04:36
    I also agree that this feature should be enabled as soon as possible! we need to have a notes section for the specific insurance that will allow us to easily view frequencies and limitations from the family file!
  • Unknown Unknown commented
    09 Jul 04:36
    It would be nice to have an option in the coverage table to be able to put prev and diag frequencies into the table. This way we are alerted if our patient is elig or not elig for certain services (bwx, fl, fmx, etc)
  • Ashley Credle commented
    09 Jul 04:36
    It would be easier to have a separate orthodontic lifetime max selection to be able to send claims using just the ortho max that way payments can post to that max and not the general annual max. Currently we can not attach payments to our ortho patients because it takes away from their general max. Which results in inaccurate insurance claim aging report and balances.
  • support@hadafamilydental.com commented
    09 Jul 04:36
    Have a separate maximum for orthodontic procedures and have orthodontic procedure codes pull from that maximum. All insurance plans that have orthodontic coverage have a lifetime orthodontic maximum.
  • Unknown Unknown commented
    09 Jul 04:36
    For example: Delta Dental Individual plans only allow one perio maint per year, but the pt needs to come in twice a year. I do not want the pt to receive the service, we collect the copayment and bill the ins only to find out they only pay once a year and we should have collect the entire visit from the pt. We have an average pt pop age of 69, so we have a lot of patient that pass way before we collect the rest of the payment. I know this is very sad and I hate to have to figure this out. (09:58:34) Jade A. said to you:
  • Nicole commented
    09 Jul 04:36
    There are several individual plans out there and not all are by percentage. It would be great to be able to add a fee schedule plan that shows what the patient is responsible for without having to enter what insurance is going to reimburse. Example: Patient is responsible for $800 of the partial. I know I can enter the Payment Table but then I would need to figure out exactly what our fee schedule is with this insurance for every procedure. There needs to be a faster, more streamlined way to accommodate all of these new individual plans.
  • Valerie commented
    09 Jul 04:36
    I think this is the BEST and most LOGICAL request i've read. Im Sure that Most if not ALL Dental Practices use this question when getting benefits from INS companies!
  • Unknown Unknown commented
    09 Jul 04:36
    It would be nice if Dentrix would implement these ideas.. originally posted in 2009 ?? This is seriously way past overdue !!
  • seacrestdental2@gmail.com commented
    09 Jul 04:36
    I would be helpful if there was a part of Dentrix where it could be noted the policy has a missing tooth clause. This would help in the accuracy of treatment plans.
  • hasseydental@comcast.net commented
    09 Jul 04:36
    It would be nice if on patient family file, patient insurance if it would show in that area the renewal date. Also if it would subtract from the yearly maximum and show remaining max. 3 votes 3 votes
  • Amy commented
    09 Jul 04:36
    In our state, we are not required to give a write off for non-covered services, so in the treatment planner, if we know a service will be excluded, we have to manually change the fees back to full fee. The problem is when you update the fee schedule each year across the board, it changes those manually entered fees back to the person's default fee schedule (Delta, Cigna, etc) rather than leaving them full fee. There is an "override dental insurance estimate" section to tell the program that the insurance will pay $0 (or a certain dollar amount), but would like to make it so that you can lock "amounts" for non-covered services in place so they are not effected by fee schedule updates.
  • Anonymous commented
    09 Jul 04:36
    The options to exclude procedures from the insurance maximum. i.e. military retiree does not apply preventive procedures to the maximum
  • taylor commented
    09 Jul 04:36
    It would be nice to have a separate orthodontic max listed, that doesn't affect the individual max.
  • Unknown Unknown commented
    09 Jul 04:36
    age limits on the fluoride, sealants and also frequencies along with teeth number like softdent
  • Heather commented
    09 Jul 04:36
    There should be an area dedicated to the Orthodontic Lifetime Maximum within the insurance coverage table so that we can create accurate treatment plans for patients.
  • Guest commented
    09 Jul 04:36
    Insurance frequency limits-would love to be able to set frequencies for certain procedures under an insurance plan and have Dentrix track this so we don't have claims being denied for being too early. May take some data input on the dental office end but it is worth it.
  • Mollie commented
    09 Jul 04:36
    We do a lot of ortho in our office. Dentrix needs to show the maximum for ortho separately so it does not look like it's taking from the annual max for other services.
  • pvpdosmiles@gmail.com commented
    09 Jul 04:36
    When entering an insurance breakdown, (I work in Pedo), a place to enter age limits would be awesome. This would need to reflect when posting and doing treatment plans. Especially for Fluoride and Sealants. A section that could include, age limitations, tooth limitations, and waiting period limitations. I use Softdent as well as Dentrix and Softdent offers this and it is very useful.
  • Guest commented
    09 Jul 04:36
    this is actually a very serious issue. Along with only being able to put 2 insurances in we are not able to inform the patient correctly unless we do a spread sheet. These to me are the two most important areas for updates. I actually think that if a practice was audited that this would come out not in our favor.
  • Guest commented
    09 Jul 04:36
    I hope this feature is able to be incorporated soon. It is very time consuming to create a separate estimate and half the time I don't provide it from dentrix because so many insurances have frequency limitations, alternate benefit provisions (downgrades on crowns, fillings etc), replacement clauses etc.. As an example, I used to work with Ace Dental Software and they were able to apply a button under the insurance breakdown screen that flagged and calculated when a posterior filling was downgraded from a composite to an amalgam. That was helpful and very beneficial to the practice. With the way insurances are, these are the most standard and most frequented problems when providing a pre-treatment estimate. We can do so much with the Dentrix program but this should've been included with the program years ago to save a headache of requests and comments about adding it.
  • Drmala@comcast.net commented
    09 Jul 04:36
    There are many new plans coming from the Obamacare dental insurance arena that are very different than traditional insurance. The ability to have more than 5 coverage tables would be more beneficial at this time. These plans are very specific and different for adults versus children, so in one family two different coverage tables is generally needed.
  • Courtney commented
    09 Jul 04:36
    this feature should also include downgrades on specify tooth numbers. for instance some insurance companies will only downgrade on molar teeth only not bicuspids. Currently we only have access to enter these into the payment table which will downgrade all posterior composites leaving the patient with a credit/balance when they have a composite done on a bicuspid.
  • Unknown Unknown commented
    09 Jul 04:36
    Delta Dental is changing some of their insurance plans. The new plans have two plan maximums and co-pays are charged per visit rather than per procedure
  • Unknown Unknown commented
    09 Jul 04:36
    Hoping for a way to correctly reflect balance on invoice when edi is sent in to insurance company and they responds in real time with the amount that will be paid to the dentist. That amount is not the same as the invoice as IE: frequencies etc. Looking for a way to change insurance portion to patient portion for accuracy . Example: sent a submission to sunlife for 2 codes for total of $111.20. Sunlife will not pay one of the codes and will pay 67.20 of other code. Software is saying pt owes 22.34 when in reality they owe $50.74.
  • Kimberly commented
    09 Jul 04:36
    Would like to have 2 different maxes one for dental and one for ortho so when you get a payment it will show how much ortho was used and not sure ortho in the dental benefits which can be very misleading.
  • Christina commented
    09 Jul 04:36
    a way to reflect in the coverage table an annual maximum for orthodontic services separate from the plan maximum with a separate deductible applying to the ortho services
  • Serita commented
    09 Jul 04:36
    Dentrix really needs a way to set up a separate annual max. It also wouldn't hurt setting up a way to calculate when the yearly frequency of specific procedures are met.
  • melonie commented
    09 Jul 04:36
    In the Insurance Coverage table it would be nice if there was an age limitation box. (for sealants/fluoride/ortho)
  • Guest commented
    09 Jul 04:36
    As insurance plans continue to change we would like to add Procedure Frequency Limitations for reference to save time scheduling and with claims.
  • Sandy commented
    09 Jul 04:36
    adding frequencies and age limitation to a patients insurance so that you may get a more accurate treatment plan
  • Hazim commented
    09 Jul 04:36
    Some specific procedures are not covered by an insurance plan and thus the insurance fee doesn't have to be used. Instead the office fee can be used.
  • Guest commented
    09 Jul 04:36
    With the overwhelming rise of dental benefits plans we need an option, procedure by procedure, to signify a covered procedure vs. a non-covered procedure and the associated fee. You can manually change the fee for a non-covered procedure (i.e. office fee) within the "Amount" field. However, when you go to the Tx Planner and Update fees for All Patients the procedure fee then reverts back to the contract fee/covered service fee and it has to be manually change again. This is due to a patient/policy being associated with a contracted fee schedule in the Family File. My staff does not know the fee change has happened, post-set completes the procedure and the contracted rate is posted in the Ledger as if it were a covered procedure. This is a HUGE loss of production/collections that our practice has ever legal right to collect from the patient for non-covered services even if they have a dental benefit policy. A drop down box in the "Edit or Delete Procedure" Window to select the office fee schedule with a check box to override the "Amount" field would easily work.
  • Guest commented
    09 Jul 04:36
    It would be very helpful to have an option while entering insurance to 1. have all preventive services not be applied to the annual maximum due to having some patients with unlimited preventive but $1000 max on basic and major 2. check a box if the insurance has a missing tooth clause and be able to enter the missing teeth #'s - thus dentrix not calculating anything for those missing teeth 3. check a box for a waiting period and enter the time frame for certain benefits (basic/major/ortho) thus dentrix not calculating anything for those services until the waiting period has ended 4. calculate patient portion (including the account balance) within the appointment information window - this would allow us to let our patient's know what their portions are going to be for the visit instead of going into their payment table and calculating it by hand & then going into the insurance notes to check frequencies to make sure we aren't including coverage for a service such as Fluoride that is only covered once per year and this is their second cleaning of they year so the Fluoride wont be covered this time. Also, if we could set maximums for certain procedure codes preventing patients getting scheduled for services before their insurance will allow it (such as... D0120: 2 per CY, 2 per 12 months, 1 per 6 months, D1206: 1 per 12 months, 1 per 6 months, 2 per CY, D1351: 1 per 36 months, 1 per 60 months, 1 per lifetime, etc.)
  • L Simon commented
    09 Jul 04:36
    Any update on this research? This would be a great feature, long time waiting.
  • Jamie Cook commented
    09 Jul 04:36
    It would be great to have a place for other staff to see what the plan benefits are like Fluoride 1 time a year, age limit or BW's every 2 years. Would help eliminate some daily calls to insurance if policy information could be easily updated and stored.
  • staffmmdental@gmail.com commented
    09 Jul 04:36
    we would like to create a flag for certain insurance plans. if the plan has an unusual frequency limit ( such as 1 in 6 months) on preventative services. if we can create a flag and attach it to that plan in the system, the flag would show up when attempting to schedule any patient who has that particular plan attached to their family file. this could help w scheduling errors and disgruntled patients when they receive a denied claim for providing a service even 1 day too soon. thank you for considering this suggestion.
  • Amanda commented
    09 Jul 04:36
    Add the ability to create a coverage book that allows us to enter alternate benefits or downgrades. For example if a patient is needing a 1 surface composite filling (composite fee $164) on a molar tooth but the insurance will only cover 80% of an amalgam filling (amalgam fee $144) on molar teeth. Treatment plan should be able to show fee $144, insurance portion (80%) $115.20, patient portion (20%) $28.80. this would help save time when treatment planning instead of having to manually adjust the treatment plan fees.
  • Regina commented
    09 Jul 04:36
    I totally agree! Cigna and a new Delta plan in our area allows for different maximums for family members, depending on how long they have had the insurance. There is no way to enter in current Dentrix system. This is a NEED.
  • Unknown Unknown commented
    09 Jul 04:36
    This is definitely a much needed feature. Insurance companies have frequencies and limitations that should be showing up in a treatment plan estimate or in the ledger but dont because our option for customizing is limited, I spend more time double checking estimates and balances than I do anything else. It would also be nice if the computer would flag you if the policy in the family file didn't match the eligibility verified through eservices, so we could just check if the member is active & note if there acct needs to be updated.
  • Guest commented
    09 Jul 04:36
    this is a long time waiting I can't believe after all these years that this isn't fixed when other dental programs can do it no problem
  • Guest commented
    09 Jul 04:36
    I created an excell sheet for that. You have to update it when you raise rates or get a new fee schedule if you are a PPO provider. As Jane S stated you base the percentage on the Amalgam rates.
  • Guest commented
    09 Jul 04:36
    Yes, PLEASE allow us to list a SEPARATE annual max to ORTHO only for those of us that are General Dentists that also provide ortho treatment. In the insurance world, ortho has always had a separate annual max outside of the general annual allowance and it would be nice to be able to provide treatment plans that reflect that separation.
  • Unknown Unknown commented
    09 Jul 04:36
    It would be very helpful with adult medicaid to be able to enter a maximum for preventative and separate maximum for restorative
  • Monica Robinett @ Moore&Pascarella commented
    09 Jul 04:36
    It would be helpful if an ortho lifetime maximum field could be added to the insurance file. Then have the category of ortho codes link to that maximum. That way when ortho payments were received, it would not look like the patient had maximized their general dentistry benefits.
  • Jenny commented
    09 Jul 04:36
    Wow I cant believe how old this request is, and still nothing has changed. I wonder how many votes it needs before they will listen. A more comprehensive coverage table is very much needed. It is actually why I came on here. Our office has always added all of the more comprehensive insurance mumbo jumbo to the notes section of the coverage table. Unfortunately every once in a while someone reviewing it in the back will clear the box on accident and we have to call the insurance company and start all over again.
  • jrmothershed@yahoo.com commented
    09 Jul 04:36
    When we post a virtual Credit card as an insurance payment it does not update the remaining insurance maximum. After 15 minutes with Dentrix we are told our only option is to run the payment as a credit card, DELETE it from the ledger and then post it in the insurance claim as a payment. DELETE!????? 1. This will skew our end of day totals when we match up our Visa/Mastercard/ checks. 2. Do you realize the margin for error when running thousands of dollars of credit card payments only to delete them!? 3. This work around does not work and there has got to be an option to run the card thru the claims and close them out that way or somehow post the card payment directly into the claim. The rep agreed that this was not the best system. Please get up to speed with the insurance companies and correct this HUGE issue. Could you please contact our office to discuss in greater detail!
  • kristin@gulchdentalstudio.com commented
    09 Jul 04:36
    We cannot compare our fees to our contracted rates, therefor our dentist will not even allow us to enter the contracted rates into the system because he is then unable to track his write-offs. This makes it impossible to keep track of the patient's specific plan information and maximize patient benefits. We are literally LOSING money every year because if this flaw in the program.
  • Unknown Unknown commented
    09 Jul 04:36
    There needs to be a place for a separate lifetime maximum for orthodontic treatment, so that we can keep track of ortho $$, and present correct treatment plans. Dentrix also needs to know to use this maximum for orthodontic procedure codes. We are a general practice that does orthodontics.
  • stephanie commented
    09 Jul 04:36
    Need to be able to add a maximum for orthodontics separately than their reg annual max.
  • Guest commented
    09 Jul 04:36
    Having a separate max designated for ortho/OS etc. Not everything is taken out of that original max. We would really like to keep track of things accurately!
  • Dianna Agar commented
    09 Jul 04:36
    We are seeing insurances not apply the maximum to preventative services. How can we set this up so that the maximum stays correct?
  • Guest commented
    09 Jul 04:36
    This not having limits to put in for separate basic and major and scaling and x rays is getting really old. Come on Dentrix the last comment on this from ADMIN is over two years old! If you were able to create in the program all the space that you did for deductibles you surely could put this same type of area in for plan maximums. This is an on going problem. I would like to see you figure out a patient's portion when they are having full mouth extractions and dentures, there is no way on your system to come up with the correct patient portion for the patient. Having a computer system is suppose to save us time and help get things correct for the patient, however certain area really need to be upgraded to the current date.
  • Guest commented
    09 Jul 04:36
    It would also be helpful to have a place to put the effective date. This will help with waiting periods and with deciding primary versus secondary (birthday rule or length of time on plan).
  • Howard F... Goldberg commented
    09 Jul 04:36
    On the Dental Coverage Tables, please add more options. I could load up to 12 different percentage tables, but there is only room for 5.
  • Guest commented
    09 Jul 04:36
    Insurances that have limitations on panorex you have to go into every patient with that insurance and change the frequency limitations. The program should be able to go into the insurance field and change it for any patient that is connected to that insurance.
  • Chen commented
    09 Jul 04:36
    When we collect payments, sometimes we think certain procedures could be covered, but finally not covered due to frequency limitations or age limitations. It takes us a lot of time and energy to take handwriting notes for patients about the frequency and age limitations. I'm thinking that if Dentrix can add frequency or age limitations to insurance coverage table, so that Dentrix can automatically tell us whether the treatment procedure is covered or not due to the limitation, and what's the coverage percentage.
  • Guest commented
    09 Jul 04:36
    Ability to add a new or duplicated plan indicating somehow that this is an Ortho plan wherein they have a lifetime maximum as opposed to annual max. Currently we need to train to duplicate plan often times in caps as a visual indicator it's ortho etc. lots of extra work.
  • Guest commented
    09 Jul 04:36
    It would be nice to have the option of separating patients annual ins max for preventive money used for patients who have separate benefits from annual max. Same goes for ortho insurance payements. Currently system shows more money used on max. Thus calculates treatment plans wrong for the remainder of the year.
  • Unknown Unknown commented
    09 Jul 04:36
    Our office does Ortho as well as general dentistry. I love the option of the future due payment plan but it would also be helpful to have a separate Ortho Max section by the insurance data, with a way to deduct ortho payments from the ortho max. As it is now, when we post an ortho payment it looks as if it is using the dental maximum.
  • info@oliverdentalimplants.com commented
    09 Jul 04:36
    Maximums: We need to be able to place individual maximum's on certain procedures. Insurance companies are now allowing different max for implants. This can throw a treatment plan off very quickly.
  • Unknown Unknown commented
    09 Jul 04:36
    If there are limitations from insurance companies on fillings or crowns it would be helpful if we could somehow include that in our insurance information input so that the treatment plan does not print that insurance will cover for the filling/crown.
  • Unknown Unknown commented
    09 Jul 04:36
    Some procedure charges, mostly Preventative and Diagnostic, no longer count against/ figure in to, the amount for the patient's Yearly Maximum. Therefore, the "Amount Used" under Insurance in the Family File is not always accurate. Can you develop a way to incorporate this feature into Dentrix? Thanks
  • Briana commented
    09 Jul 04:36
    A place that allows us to enter any addition to a maximum that only applied to the specific patient/policy. We have many patients whose insurance policy has a compounding maximum, where each year they are with the company they receive an extra $100 to their max. Wishing that there was a place to change it only for the patient instead of the whole entire policy
  • hayniedmd@earthlink.net commented
    09 Jul 04:36
    There is only one maximum allowed currently. Ortho has a separate maximum so does TMJ. Also many ins comp. don't count preventive services against the max. Dentrix takes all payments from ins and applies it all, preventive or not. Need more ins details. Lori
  • Unknown Unknown commented
    09 Jul 04:36
    There should be a separate insurance benefit tracker for ortho benefits available and used. So many general dentists are now doing Invisalign or some other form of ortho and currently there is no way to track those bemefits.
  • drhowe@brianhowedds.com commented
    09 Jul 04:36
    When we set up ins info we should be able to enter fluoride to be covered with age limitations and then when we set complete the computer should know the correct coverage for that specific patient.
  • Smile@ArvadaDentalExcellence.com commented
    09 Jul 04:36
    ALSO, add the ability to separate the Ortho max from the general annual insurance max as they are typically separate on insurance policies!
  • Melanie DuBois commented
    09 Jul 04:36
    Any idea as to when we will have a Dentrix update that will give us ortho maximums?
  • Janis Laffin commented
    09 Jul 04:36
    Sometimes I run into a problem with fees for dual-coverage claims. I would like there to be a setting in the claim format section of the practice definitions so that, for dually-covered patients only, the fee that is posted to the claim, ledger and treatment plan would reflect the provider's standard fee rather than the contract fees for either of their insurance plans. Since the insurance adjustments can vary from situation to situation with dual coverage, it would be incredibly helpful to be able to manage this manually. I could manually change the insurance plan within their family file to reflect the standard fees but then everyone else who is covered by that plan would also reflect the office fee, which I would not want.
  • Julie commented
    09 Jul 04:36
    There should be a report that generates a number of patients that have a certain insurance coverage/ insurance carrier. This would help us evaluate our participation in a coverage group.
  • Tiffany commented
    09 Jul 04:36
    How to change the % in the coverage table for insurance. by patient or family and not for all the patients linked to a Plan name. For example this patient is on a incentive plan and I need to change there % coverage to 100% but not every one linked to this insurance plan is at 1000% yet? I hope someone can help
  • Debbie commented
    09 Jul 04:36
    The insurance information under coverage table there should be a way to select whether or not the preventative deducts from the maximum allowance. We have several policies that it does not and having this option would allow for more accurate treatment planning.
  • Unknown Unknown commented
    09 Jul 04:36
    this would be amazing, especially for routine things like Perio Maintenance, there is currently no easy way to see in the ledger if an appt will be covered by insurance based on frequency without clicking through notes first, then counting back months to see when ins last paid.
  • Guest commented
    09 Jul 04:36
    We need to have the ability to add insurance maximums for major and maximums for basic. We have been having an increase in insurance companies that are having two different maximums based on major vs basic.
  • info@floridafamilydentistry.com commented
    09 Jul 04:36
    I would like to see Dentrix add in the insurance information to tract frequency limitations for prophy, exams, x-rays and etc
  • Unknown Unknown commented
    09 Jul 04:36
    Under coverage table, add ortho maximum/ded
  • Beth Etheridge commented
    09 Jul 04:36
    We scan an insurance breakdown sheet into the Doc. Ctr. for each patient. It is on a form that is easy for assistants to quickly check the patient's insurance summary. We are using esync with insurance companies that have the capability. They vary in information provided. We would like a space to enter that information which includes items like: missing tooth clause, history, frequencies or specifics to the plan. We would just tab through and enter the appropriate coverage.
  • Unknown Unknown commented
    09 Jul 04:36
    In the coverage tables, there should be an ortho maximum and deductible box as well as lifetime max.
  • Paul Kuhlman, DDS commented
    09 Jul 04:36
    Hi Brad -- we talked about this at the Business of Dentistry in Orlando, and it continues to be my my number one enhancement request! Thank you!
  • Shannon M commented
    09 Jul 04:36
    It would be wonderful to have the option to make it so that pts preventive services do not go towards the annual max. Would save lots of time and energy for this option to be available. Thank you
  • Guest commented
    09 Jul 04:36
    We have been coming across more dental plans now that do not factor in the preventative treatment against the yearly plan maximum. It would be so helpful if this was an option for the payment table some how in the insurance coverage table. Otherwise now we just have to flag these accounts and manually add the claim amounts up each year to see if they have actually met the maximum.
  • Unknown Unknown commented
    09 Jul 04:36
    Apply insurance benefits on Treatment Plan from top to bottom of the procedure list. Right now, insurance benefits are first applied to procedures listed at the bottom of the treatment plan. If a patient will run out of benefits, the procedures at the top of the list show that they are not covered. This makes the treatment plan very confusing to patients.
  • Unknown Unknown commented
    09 Jul 04:36
    Have a way to have primary and secondary insurance in family file but have the second insurance show 0 coverage. This way when an office does not work with secondary insurance but wants to submit for patient it will break down correctly in ledger. We should be able to change ins breakdown for specific patient, not all patients connected to insurance.
  • Unknown Unknown commented
    09 Jul 04:36
    The coverage table should be able to reflect ins plans were Diagnostic & Preventive services come out of a different fund. Or were Implants come out of a different fund. Example: Delta CO D&P covered @100% when pd. does not effect the patients $1500.00 max. D&P comes out of a different fund.
  • Guest commented
    09 Jul 04:36
    For example code D2929, coverage is 100% if on an anterior tooth, but 80% for a posterior tooth. Need an option to be able to change the payment table fee by tooth#
  • Guest commented
    09 Jul 04:36
    Use the payment table to solve this problem. Enter the amount they pay for amalgams into the payment table for the composite filling codes. Then your tx plan will be accurate.
  • Lanette commented
    09 Jul 04:36
    a separate ann. max for preventive and standard. Some insurance companies now have for example: $500 ann. max on prev. and a separate $1000 for standard procedures. Also some preventive isn't applied to the ann. max.
  • Mberry commented
    09 Jul 04:36
    Addition to ins....... Ortho always has separate max, ded and age limit. please add a feature to the insurance coverage.
  • Lupe commented
    09 Jul 04:36
    Some insurance plans do not apply diagnostic/preventative services to the annual max. When treatment plans are printed the Ins. Est. & Est. Pt's Portion are not correct. We need to be able to edit this instead of writing it out on the Tx Plans. Plus it will help track the available max on dentrix
  • Michael commented
    09 Jul 04:36
    Eaglesoft has a feature to always post office fee to patient and has an estimated collection category. (I have a picture available.) This allows the reporting to estimate more accurately the production and show the patient what the actual cost is if the insurance denies. Collections can then charge the actual cost not negotiated.
  • Guest commented
    09 Jul 04:36
    Ortho maximums would be awesome instead of having to have two patient accounts! Also, having the ability to calculate frequencies for exams, xrays, fluoride, prophy would be highly helpful and time saving!
  • Unknown Unknown commented
    09 Jul 04:36
    Dentrix needs to allow for a separate area for orthodontics maximums. It also needs to allow for ongoing insurance payments to take place without closing out the claims and utilizing the patients general benefits.
  • Isabel Landero commented
    09 Jul 04:36
    There are some patients with the same group number but they are on incentive plans. Some patients are at 70% - 100%. Can you find an easier way of entering this information instead of each patient being individually entered? There should be a way of entering patient insurance information individually and also as a batch action to modify all the patients in the same group number.
  • Unknown Unknown commented
    09 Jul 04:36
    We have had trouble entering some of our patient's new insurance plans since the Affordable Care Act, specifically pediatric benefits. Some plans have pediatric benefits that are completely different than the adult benefits (example: no yearly maximums for children, yearly out-of-pocket maximums for children only, different coverage percentages for adults vs. children,etc). We have not been able to find a way to enter these plans aside from entering the adult benefits as normal and flagging the children's charts. Since these plans are becoming more common with pediatric dental coverage being a requirement of ACA medical plans, it would be nice to have a way to enter this.
  • Guest commented
    09 Jul 04:36
    Particularly want age limit and frequency on procedures. We want this to better estimate cost of patient treatment. If fluoride not covered after age 14, need to know that cost will be patient responsibility at checkout. If dentures are paid for every 10 years and patient needs new dentures, wouild like treatment plan to show patient is responsible.
  • Guest commented
    09 Jul 04:36
    In the payment table you can enter 0.00 for implant placement and it will override the percentage entered in the coverage table.
  • Unknown Unknown commented
    09 Jul 04:36
    It would be nice to be able to change the coverage for particular codes instead entire categories, i.e. implant placement not covered but implant crown is, but it's all at 0% or all at 50%- frustrating!
  • Katy commented
    09 Jul 04:36
    PLEASE add this! more and more insurance policies are making certain preventative procedures exempt from the maximum. It is crucial to our practice that we give accurate estimates to our patients and it feels like dentrix is stuck in the 90s.
  • Amie commented
    09 Jul 04:36
    Please add this feature soon!
  • Unknown Unknown commented
    09 Jul 04:36
    Get with the program Dentrix! I'm a former Softdent user and this was a function in their programming and it was awesome! My RDH's didn't have to stop and come ask the front desk about ins coverage everytime they wanted to add a Flouride TX or FMX or whatever, it would automatically pop up and warn them that that pt had already meet the frequency limit or was over the age limit for the service. This function is VERY important when tracking eligiblitly for certain services and whether we needed to collect for those services up front, instead of waiting a month for it to be denied on a claim, which made our accounting more efficient!
  • Unknown Unknown commented
    09 Jul 04:36
    This would be great help in our office!
  • Guest commented
    09 Jul 04:36
    What is "open dental" that Anonymous is referring to
  • Dr Barry Rosenthal commented
    09 Jul 04:36
    I haven't read through all comments to see if any one added this suggestion pertaining to this request..... Some insurances preventative is not deducted from maximum. I wish there was a way to prevent that work from being deducted from maximum when entering payments
  • Unknown Unknown commented
    09 Jul 04:36
    I agree that this feature would be extremely helpful in our office.
  • Shannan commented
    09 Jul 04:36
    This is vital to practice operations! Please do not delay any longer.
  • Guest commented
    09 Jul 04:36
    I requested this about one year ago, but it has been on my mind for a much longer time period. I spoke to Trojan today and they are very willing to integrate the information we need but it is up to Dentrix to work with them for this feature.
  • Guest commented
    09 Jul 04:36
    I really like the idea of flagging procedures for interval limitations. All your comments were of interest.
  • Guest commented
    09 Jul 04:36
    This is becoming an increasing big problem. Alaska Medicaid has three different levels of service: emergent, enhanced, and dentures. Emergent and denture completion are not considered as part of the $1150 enhanced maximum for the fiscal year, July 1 through June 30. MetLife has plans that do not consider exams, bitewing xrays, and cleanings as part of the patient's yearly maximum. Unless this is resolved, dental offices cannot clearly be confident in the ability to determine where a patient is in relationship to his/her maximum. We also need to be to flag procedures for replacement dates such as crowns that cannot be replaced for 5 or 7 years. Also this affects treatment planning as well. We need to be able to treatment plan accurately with separate limits for basic and major services. PLEASE FIX THIS!
  • kayla commented
    09 Jul 04:36
    where you enter your insurance is not user friendly to begin with. especially when entering in a new plan
  • Vonnie commented
    09 Jul 04:36
    This request was made long ago! What is the delay?? This is a huge need!
  • Claire B commented
    09 Jul 04:36
    In addition to age limits, it would be nice if there were a spot to put frequency limitations. More and more insurance companies are limiting the frequency for resins on the same tooth. It would save time if the Treatment Planner automatically adjusted the insurance portion based on frequency allowance.
  • Guest commented
    09 Jul 04:36
    This is getting more and more frustrating, the more approvals I do for patients the more frustrating and unsatisfactory this program is. How are we to give a good estimate using this computer system when you can't put in a separate limit for basic and for major. Example I just did a big estimate for a patient that is having extractions and a denture, he had 2000.00 for basic and a separate limit of 2000.00 for major, by time I got the extractions in it eats up the one limit we can put in and doesn't give a good estimate. As much as I don't like to I was forced to take the limit our entirely or when they are in for treatment the ledger will not split properly with out the two limits in. Let's get into the 21st century and get the program updated. pleeeeeeaaaaasssseee
  • Unknown Unknown commented
    09 Jul 04:36
    I am amazed that Dentrix has not yet addressed this! EAGLESOFT AND SOFTDENT have had this option for years. X-Ray limits should be an easy to add radio button on the Insurance coverage field E.g. PAN/FMX 3 yrs or 5 yrs; just click the button and connect it to the ADA code as well as the D1120, D1110 and the D4910 codes. Insurance frequencies are vital to the running of any dental practice and this should be a no brainer for any dental software system.
  • Judy commented
    09 Jul 04:36
    I agree with this. Right now I have to put all the info for ortho in the guarantor box in the ledger. Really needs to have separate table.
  • Guest commented
    09 Jul 04:36
    It would also be beneficial to have the amount reduced at the time of service not after receiving the payment. Things cross in the mail easily, so we will sometimes get an approval and tell the patient what their portion will be then a claim payment comes in and then this reduces the limits. Other systems take the amount off at time of service so this doesn't happen. Way too much to keep track of with not having separate limits and then not being updated at time of service.
  • Guest commented
    09 Jul 04:36
    I have used up my votes for the day, which seems crazy as a limit. This is a very important need. Currently we have to write all this down and scan it into the doc center so the information is readily available. We then have to review accounts prior to appointment time to be sure of the patient share to be collected. This should be automatic with a good customizable insurance profile.
  • Buckley Dental commented
    09 Jul 04:36
    This would be 1,000% helpful!!! I hope that you all will put this on the next upgrade, please!
  • Guest commented
    09 Jul 04:36
    I commented on this 11/23/11 and have come a long way in my position in the company since than, I have so much more knowledge of dentrix and the dental field since than, I can't even behin to think that this is not under review. UNFORTUNATELY insurance drives treatment and we need something to be working on our side when it comes to frequencies and limitations. I would like to say all my patients buy into treatment based of necessity, but that so is not the case, in these economic times especially dollar signed and their out of pocket vs what the out of pocket could be later on if they dont do treatment is the driving factor. Dentrix its time to review this!!!
  • Myung commented
    09 Jul 04:36
    Just though I would share what we do to have this information on hand. I set up a clinical note in the chart titled insurance. I set up a template with prompts to record the various frequencies and limitations we want for our office. Once we complete one for an insurance company/patient it is part of the Clinical Record which we copy and paste into the note section of the insurance plan. It has worked very well for us, however it would be great if Dentrix came up with an added system to accomodate this information. Myung Fix from Gayle James DDS
  • Andrea commented
    09 Jul 04:36
    This is a great idea. I can't believe it's not even under review yet???? This would make Dentrix much more user friendly and cut down on the ammount of time we use doing things on paper. Please put this into consideration
  • Issaquah Valley Dental Care commented
    09 Jul 04:36
    Really need to have separate ortho benefits and payments.
  • Guest commented
    09 Jul 04:36
    I can't believe that this suggestion was made in 2009 and is not even "under review". This is a much needed feature, especially for paperless offices and offices that do both general and ortho. We are always having to look up age limits on sealants, ortho, fluoride, etc. It would be so nice to be able to put this in per fee schedule vs per patient. Dentrix, there are "upgrades" that have been made to G5 that were much less important than adding this feature. Please listen to your users and add what is actually needed next time.
  • Buckley Dental commented
    09 Jul 04:36
    I agree with the comment below, this is a must especially with an insurance driven practice!: I think, rather than have to make a note about frequency limitations, it would be nice to be able to enter the frequency limitation and have Dentrix recognize that perimeter - or note that nothing was entered in that perimeter. Then, as you try to sumbit the claim, a pop up would instantly alert you to let the patient know that they would not be eligible for benefits on that claim.
  • Jaime Anderson commented
    09 Jul 04:36
    Absolutely! Some insurances require a suffix to identify the patient. Right now there's not a way to do this that I'm aware of.
  • Guest commented
    09 Jul 04:36
    Ryan, The way i read it is that they want them all to be on the same plan, but they want separate ID numbers for each person.
  • Guest commented
    09 Jul 04:36
    Article # 23752 provides a way to do it currently, but I think there is certainly room for improvement in that process too!
  • Christine commented
    09 Jul 04:36
    We provide ortho in our practice, need a separate maximum usage for ortho. Ortho has a separate maximum per year from other treatment. Currenlty it is subtracting from regular treatment, and miscalculates treatment plans and money left for the year.
  • Guest commented
    09 Jul 04:36
    Trevor, I am curious as to why this enhancement (Insurance maximums, limits for coverage table categories) request is not a priority. There are over 1100 votes! Having dentrix alert us when a patient has maxed out their benefits from just our office or scheduled a 3rd cleaning that insurance will not cover. When scheduling a patient we don't think to click into the family file to see how much benefits are remaining or the ledger to see how many prophy cleanings they have used to date. I don't understand why this is not under "review".
  • Gail Gomez commented
    09 Jul 04:36
    Same goes for general dentistry max and ortho max. Treatments plans are inaccurate for ortho treatment because it calculates using the same maximum which is annual for general and lifetime for ortho. Very confusing to patients.
  • Paul Kuhlman commented
    09 Jul 04:36
    Of course, this info would best be obtained if the insurance companies would make it available for eSynch or Eligibility Check to allow us to update electronically at anytime. Write your Congressman to demand electronic transparency of health-care poilicies because insurance wont do this until they are forced to.
  • Unknown Unknown commented
    09 Jul 04:36
    When Preventative Care does not apply to the maximum it would be nice if we had the option to keep that separate .
  • Angelo Martinez commented
    09 Jul 04:36
    I Agree!
  • Guest commented
    09 Jul 04:36
    Also, DOWNGRADING: Posterior Composites to Amalgams, Full Porcelain to Full Cast... etc.
  • Guest commented
    09 Jul 04:36
    Also allow us to print out the insurance breakdown that we have in the system (detailed) for the patient with insurance used and which benefits where utilized. So it is clear for the patient.
  • Guest commented
    09 Jul 04:36
    There is such a demand for this enhancement, how many votes do you need? 1032 votes tells me this is an important request for everyone. I think this is more important than some of the other "accepted" requests. I can't tell you how many times we encounter someone maxing out the day before treatment.
  • Hal Hirsch commented
    09 Jul 04:36
    It would still be an improvement to have a "frequency table" where you fill in the fields rather than typing it all into the notes field.
  • Guest commented
    09 Jul 04:36
    This is the most desired enhancement request for our office. We have 6+ providers and a full time staff member who calls on insurance. We are constantly having to hand calculate Invisalign cases and accounts for patient's that have ins. for which preventive services do not accrue toward their maximum. The current Insurance/Ledger setup is so inefficient I can't believe they haven't solved this problem. It isn't even "under review" according to the status.
  • kmbdmd commented
    09 Jul 04:36
    This should be tied into the treatment plan so that we know before a procedure is scheduled; also, if a tooth was restored in any way within the past 2 years, a note should pop up when any new restorative treatment is planned.
  • Guest commented
    09 Jul 04:36
    This would be so helpful. There are countless insurance companies that do no pay a percentage of preventative/basic/major, but rather a certain dollar amount. It would be helpful to alternate the coverage table to adjust their patient portion based off a fee schedule rather than percentage table. (Sorry if any of these comments are a repeat.) Also freqency limitations are huge, so many insurance companies have gone to 2 exam/prophy per calendar year versus the 6 months. The "notes" of the insurance table is where I put that information, but I can't check that for every patient calling to schedule a recall appointment. It would be a helpful feature if it was built into dentrist so that if you tried to schedule too soon it would alert you. Dentrix please help us work together to make these much needed improvements. Thank you!
  • Guest commented
    09 Jul 04:36
    This is a great idea... there is so much more that could be done with the insurance benefits module to make our estimates more accurate.
  • Guest commented
    09 Jul 04:36
    I agree with Valarie. In place of notes, there should be a way to simply have dentrix recognize the frequency. We perform preventative procedures on a routine basis and the ability to enter frequencies directly into dentrix would allow our front office staff to focus on other jobs rather than having to backtrack through patient notes just to find out if a cleaning is going to be covered. Furthermore, if this feature becomes available, I would like to see a warning pop-up directly on the appointment book which states some thing along the lines of "Scheduling this appointment will exceede the plan allowance for Prophylaxis. Proceed anyways?" Simple yet effective.
  • stephen hale, dds commented
    09 Jul 04:36
    This would allow for much more accurate fee quotes to patients and less time and effort spent on collections, very much needed! In addition to this, different maximums for prev, basic, major would be very helpful. More and more insurance plans are seperating these out and having seperate maximums for each.
  • stephen hale, dds commented
    09 Jul 04:36
    This would allow for much more accurate fee quotes to patients and less time and effort spent on collects, very much needed! In addition to this, different maximums for prev, basic, major would be very jelpful. More and more insurance plans are seperating these out and having seperate maximums for each.
  • stephen hale, dds commented
    09 Jul 04:36
    This would allow for much more accurate fee quotes to patients and less time and effort spent on collects, very much needed! In addition to this, different maximums for prev, basic, major would be very jelpful. More and more insurance plans are seperating these out and having seperate maximums for each.
  • stephen hale, dds commented
    09 Jul 04:36
    This would allow for much more accurate fee quotes to patients and less time and effort spent on collects, very much needed! In addition to this, different maximums for prev, basic, major would be very jelpful. More and more insurance plans are seperating these out and having seperate maximums for each.
  • stephen hale, dds commented
    09 Jul 04:36
    This would allow for much more accurate fee quotes to patients and less time and effort spent on collects, very much needed! In addition to this, different maximums for prev, basic, major would be very jelpful. More and more insurance plans are seperating these out and having seperate maximums for each.
  • Guest commented
    09 Jul 04:36
    For some reason this really important feature would eliminate scheduling and billing errors - Please address this Dentrix!!
  • Guest commented
    09 Jul 04:36
    I think, rather than have to make a note about frequency limitations, it would be nice to be able to enter the frequency limitation and have Dentrix recognize that perimeter - or note that nothing was entered in that perimeter. Then, as you try to sumbit the claim, a pop up would instantly alert you to let the patient know that they would not be eligible for benefits on that claim.
  • Guest commented
    09 Jul 04:36
    I have been asking for this function for 9 years. Why this is not an important need...I just don't understand. Why even ask about assignment of benefits if the ledger does not acknowledge that you do not accept assignment of benefits. The pt reimbursement could still be noted.
  • Cindy Lemley commented
    09 Jul 04:36
    THIS IS VERY NEEDED!!!! It would make insurance claims, etc. less of a headache... please consider this in the near future!!!
  • Comfort Family Dental commented
    09 Jul 04:36
    Samantha's comments are exactly right. We have the same problem in our office and would really like to be able to keep the insurance claim open until it is paid in full. Our patients do monthly payments and once we receive the first insurance payment, we have to manually correct their statement.
  • Samantha commented
    09 Jul 04:36
    This is a must feature because we are a general office, but we also do a lot of ortho. A seperate lifetime maximum for these ortho patients is needed. Looking back to see how much is left is a great feature. Also, keeping the claim open, because as we all know these insurance companies pay monthly or quarterly for these claims. Patients pay their half up front. When insurance makes their first payment the claim closes and ends up in the patient balance due, when we are still waiting on insurance to come in.
  • Guest commented
    09 Jul 04:36
    YES PLEASE!! This is a constant issued for us. We are a very large, 6 provider practice and we deal with this glitch every day. It is so difficult for us and our patients because there estimates are NEVER correct. If we could just set it up so that the treatment planner would not calculate the secondary until the primary is used it would be a huge time saver.
  • Guest commented
    09 Jul 04:36
    I strongly agree with this one. We have a 6 Provider practice and waste a significant amount of time hand calculation every patient that has an ins. plan where preventive care does not accrue toward the maximum. Please add this.
  • Guest commented
    09 Jul 04:36
    Anonymous, To enter notes in the current design of Dentrix, my suggestion (which I believe dovetails with Eugenia T.'s comment) is to enter a note in the Coverage Table. Two ways to enter the note: - Office Manager | Maintenance | Reference | Insurance Maintenance... | (select the plan) | Cov. Table... | Notes (button in bottom-left corner) - Family File | (select patient with insurance plan) | Double-click Insurance Information block | Coverage Table | Notes (button in bottom-left corner) Where do those notes show up? In Ledger, double-click a claim. The first portion of the note appear in the Insurance Plan Note block in the lower-right corner of the Insurance Information dialog. Double-click the note block to see the complete note. In the Treatment Planner, two ways to view the note: Either from the 'Insurance' menu, or from the toolbar buttons, select 'Primary Dental Insurance Notes' or 'Secondary Dental Insurance Notes'
  • Anonymous commented
    09 Jul 04:36
    new to dentrix from softdent -- softdent at least allowed us to add a note in the insurance section that showed on our routing slip based on the insurance plan -- not requiring entering it in each family file. Is there a better way to do this?
  • Linda Howard commented
    09 Jul 04:36
    Having another benefit window for ortho would be great, and also showing if there is a deductible which applies to ortho.
  • Alex commented
    09 Jul 04:36
    As a part of this, have the frequency limit tied to the maximum so that if a tx is done less than the limit, it automatically shows as not covered.
  • Peter commented
    09 Jul 04:36
    YES PLEASE!
  • alecia commented
    09 Jul 04:36
    An extra field in either the chart or family file easily accessed by both reception and hygienists when reviewing charts. We are missing out on maximizing patients insurance benefits when it is so hard to find this information, especially for a chartless practice like ours. This is needed ASAP!
  • Sully commented
    09 Jul 04:36
    Also the maximum for the year should change when the Insurance Data Benefit Renewal comes up which 80% of the time is January but we have several April, June & Octobers. Currently to my knowlege this only updates after you close out a month, it does not make sense, so we have to updates maximums for the following year manually and of course, if the pateint goes to a specialist they use some of the max there...
  • Amanda Fannin commented
    09 Jul 04:36
    Several companies and new ones adding 2011 will now seperate maximum from any preventive treatment. Please add this feature.....
  • Eugenia T. commented
    09 Jul 04:36
    We do need to be able to enter frequency for prophys, exams and periodonta maintanences in Family File in Primary Insurance Coverage Table section. All we need is two/three fields to be able to enter how many cleanings and exams plan covers and what is the frequency (2 anytime or one per 6 months) and have it tracked. So, wnen we post third cleaning and create ins. claim it figures patient portion accordingly.
  • Guest commented
    09 Jul 04:36
    Yes! Frequency limits are an important aspect in calculating copays. We use Trojan and can always see the limits, but haviing the Freq limits factored into Dentrix calculations on the ledger and tx planner would eliminate so many errors and losses.
  • Sue commented
    09 Jul 04:36
    This would be an awesome addition, we also spend more time than should be on monitoring the frrequeny limits manually with notes, and our own handwritten system on pt charts. We also are starting to get plans that do deduct from thepatients annual maximum benefits for preventative care. There doesn't appear to be a way to monitor the seperate benifits except manually.
  • Guest commented
    09 Jul 04:36
    Is this in the works at all for the next upgrade?
  • Myung commented
    09 Jul 04:36
    In the meantime if you need an idea to get around this....I set up a clinical note template with prompts on the various frequencies or other limitations on a plan. We then copy and paste it into the note section under "insurance coverage". Hope this helps.
  • Teal McKinney commented
    09 Jul 04:36
    I agree...it takes time and remembering to do so to go back and add back to the annual max once insurance has paid on a prev/diag claim. It would be as simple as adding a box in the coverage table to say no accumulation, or something similar. However, it would be very helpful since there does seem to be quite a few insurance companies that offer that.
  • Rachel Kreeger commented
    09 Jul 04:36
    This would be very helpful for front desk receptionists and hygiene assistants when scheduling recare appointments and sealant appointments. Please work on this improvement soon!
  • Rachel Kreeger commented
    09 Jul 04:36
    This would be very helpful for front desk receptionists and hygiene assistants when scheduling recare appointments and sealant appointments. Please work on this improvement soon!
  • Guest commented
    09 Jul 04:36
    Thanks, that's a big help.
  • Guest commented
    09 Jul 04:36
    In the current program, the best place to put those is to open the Coverage Table and click Notes. These then can also be visible in the Treatment Planner (by clicking the option to view the Dental Insurance Notes), or in the Ledger | Insurance Claims | Insurance Plan Note.
  • Heidi commented
    09 Jul 04:36
    For offices providing orthodontc care for their patients, a separate ortho maximum window would be wonderful. Treatment planning ortho can be an issue.
  • Carla commented
    09 Jul 04:36
    If you put this info in the notes section under the coverage table that ins pays on seat or prep date it will show up on the ins claim and then you will know.
  • Guest commented
    09 Jul 04:36
    Yes, this is very important. Right now we are putting this into "Patient Notes" of the family file and we copy it down for each family member. What a drag.
  • Guest commented
    09 Jul 04:36
    Ideally this would include long-range limitations like the frequency interval for a full mouth radiographic survey, or the replacement interval for crowns or fillings.
  • Rheba Kyling commented
    09 Jul 04:36
    My suggestion is to add a column in the coverage table that has frequency limits available for whatever services we choose. Perhaps a box to click to add it. This is so important to help reduce billing. There is nothing at all useful for this situation. Thanks!
  • Amanda Schulman Lackey commented
    09 Jul 04:36
    Adding the change to Dentrix for the insurance estimate to be zero when the assignment of benefits is to the patient would be great for knowing immediately if the box was accidently checked or unchecked. It would also be great for the patients who have assignment of benefits to the office on routine appointments and for extensive treatment pay in full having the insurance reimburse them. So setting the coverage table to 0 would not work. I also have patients that want to know an estimate of what the insurance will reimburse them on their appointment and I can not do that without the coverage table being accurate. So it would be nice if the treatment planner still estimated the insurance payment but when a claim is created with assignment of benefits going to the patient the estimate was just zero.
  • Debbie Roach commented
    09 Jul 04:36
    It would be nice to have the age limit for each plan intergrated somehow too. That way if there is ortho coverage on a plan but only to age 19, the treatment planner wouldn't think there is coverage if the pt. is an adult
  • Guest commented
    09 Jul 04:36
    Yes, I like this. Adding frequency limitations to the coverage table is a great idea! It would definitly help us considering this is a frequent reason for an unexpected account balance after insurance pays.
  • Guest commented
    09 Jul 04:36
    Right now we have to keep track manually. Big Pain. Now have three plans doing it.
  • Guest commented
    09 Jul 04:36
    YES!!! We too are a general dentist but we do a lot of Invisalign and are in desperate need for this feature to be implemented! I was just thinking of this the other day. How come nobody has suggested this before and it is not a priority? Our ledger amounts are upside down because of it - it shows that patient with ortho owes money they don't due to different maximums for yealy than ortho. DEFINITELY SHOULD BE CONSIDERED BEFORE G5 IS RELEASED! Also, when the ortho claim comes in we should have the ability to keep it open for future payments and track it on the aging report and not close it with one payment because we all know most insurances pay over a period of time not a bulk payment upfront.
  • Guest commented
    09 Jul 04:36
    change your coverage table to 0
  • Vicki commented
    09 Jul 04:36
    We are a General practice with ortho and it is very confusing within the ledger because ortho/regular charges are combined within the ledger. Would love to see a separate ledger to show ortho charges but the separate ortho max would be great also. Love this idea!
  • Theresa Larson commented
    09 Jul 04:36
    I would love to have this as well, Plus I have a few insurance plans that pay the first $200 at 100% and then you meet a deductible then they pay the rest at 50% until you reach a yearly max. I would love to be able to put that into the system without having to manually figure it each time they come in.
  • Chris Davidson commented
    09 Jul 04:36
    Would love this, also this would make giving the pt a more accurate tx plan easier.
  • Jennifer commented
    09 Jul 04:36
    I like this too as we frequently have to send a statment if the person checking out a patient doesn't catch that for example insurance will only cover 1 fluoride per year and when they check out it shows they don't owe for it. Same with PMT's some cover 2 per year some 4 per year. Good one to post!
  • Emily Gable Robinson commented
    15 Jul 00:13

    Please please please work at this ASAP!!