Attach Insurance Maximums, Age and Frequency

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
Released

Insurance

Jun 18, 2020

Admin response

Thank you all for the suggestions! We are happy to inform you that this feature will be available in our upcoming fall release of G7.4. Insurance estimate calculations will be included in a future release. If you would like a sneak peek at the features coming, please feel free to visit our "What's New" page. https://www.dentrix.com/products/dentrix/whats-new

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Chase Elliott commented

23 Aug, 2022 10:18pm

So this is NOT available in enterprise! If you are referring enterprise customers to this portal to put in suggestions and this is for the core product that is upsetting to be polite.

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Maggie England commented

1 Jul, 2022 09:50pm

Open Dental is far superior when it comes to this feature and how user friendly it is. Please, please, please consider getting someone from Open Dental to help with this, as well as the Open Dental Treatment plan module!!!! It would make EVERYONE'S life so much better!!!!

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Guest commented

1 Feb, 2022 11:32pm

I think this feature that already exist could be improved upon. it's nice that the info is in there, but it doesn't provide a pop up when scheduling codes with frequency limitations. we were so excited about this feature and were sad to find out it really was nothing more than a good place to put things but that you still have to look it up each time before scheduling. would be nice if it would affect the treatment plans as well so it reflects correctly is a patient will have to pay out of pocket because something is not covered due to being done too soon.

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Guest commented

18 Sep, 2020 01:03pm

This fall???? This is a standard feature in Open Dental.

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Guest commented

24 Jun, 2020 09:21pm

Are you ALSO planning to add a field that identifies insurance as an EPO (Exclusive Provider Organization) - this would be HUGE with the new update! As
it is something that gets missed frequently and then we do not get payment!

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Guest commented

23 Jun, 2020 02:38pm

Another suggestion with regards to the above listed enhancement would be to separate out some of the x-ray codes; i.e. PA's are sometimes covered under basic and not prevent. so. it would be great to separate PA's from the BW category.
In addition, it would be terrific if in the clinical chart you could right click on the tooth number to see ALL history on a tooth.!!! This has been available in Eaglesoft for years and is a great tool to avoid frequency issues on replacement clauses quickly.

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Guest commented

22 Jun, 2020 04:08pm

This is exactly what I think would bring Dentrix insurance table to the next level!

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Guest commented

18 Jun, 2020 04:54pm

I agree, something similar to Open Dental insurance module would be awesome. I like how there's is set up. It makes it easy to put in individual code limitations and frequencies and even a screen for common code frequencies (preventative codes) I almost miss Open Dental for this specific feature.

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Guest commented

18 Jun, 2020 12:28pm

This will be a great help! When will the G7.4 be available?

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Guest commented

17 Jun, 2020 11:54pm

Would this be for Dentrix enterprise as well?

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Lucretia Frederich commented

17 Jun, 2020 09:48pm

This would help so much and be a great time saver on the backend! Just needs to not be too cumbersome for the person entering the data.

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Guest commented

16 Jun, 2020 07:05pm

YESSSS!!! This would be amazing!

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Guest commented

16 Jun, 2020 01:42pm

SOFTDENT HAS HAD THIS FOR YEARS

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Guest commented

15 Jun, 2020 07:56pm

Yes, please.

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Guest commented

15 Jun, 2020 06:46pm

YES! YES! YES!

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Unknown Unknown commented

15 Jun, 2020 03:27pm

Yes please, This would help a lot.

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Guest commented

15 Jun, 2020 03:27pm

Yes, please!

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Guest commented

15 Jun, 2020 02:35pm

I love this idea!!!! This would help the office so much to know if there are limitations and if they have already reached them.

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Guest commented

15 Jun, 2020 02:03pm

Yes, this would be FANTASTIC!!!

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Guest commented

15 Jun, 2020 12:20pm

What a great help this would be!!! YES

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