Dentrix Ideas

Option to calculate/show discounts and write-offs on Treatment Plan

Add a column to the Treatment Planner that calculates and shows discounts or write-offs. Show credit adjustments as part of the treatment plan (cash discounts). Wants to be able to see adjustments as part of the treatment plan financing without adding the adjustments to the patients account until the treatment plan is completed--should have option to post automatically when the treatment plan is completed. Add options for the Treatment Planner to calculate discounts and taxes (similar to the Ledger, Enter Tax / Discount option). For calculating, there could be options for "Selected Procedures" for "Selected Case" or "Selected Visit". There should be options for any adjustments for the treatment plan to be included when the the treatment plan is printed, on the related reports. Offices have asked to be able to show discounts in the Presenter.
  • Guest
  • Jul 9 2019
  • Attach files
  • Buffy commented
    09 Jul 04:46
    I don't think Dentrix has figured this out but this can be worked around by creating a new fee schedule and adjusting it to be decreased by 5% (or whatever). then in the tx planner click to compare to fee schedule and select that one. both columns of fees will appear on the tx plan, your regular fees and the discounted amount.
  • Guest commented
    09 Jul 04:46
    when treatment planning it'd be great if we could enter a discount to show the patients actual amount rather than writing it in... without changing any UCR fees to show the original amounts.
  • Guest commented
    09 Jul 04:46
    When treatment planning, it would be helpful to be able to add in discount information to show patients what their actual out-of-pocket cost will be. For example, when treatment planning for a patient who would be eligible for a 10% senior discount, I would like to show them what they'd need to pay after the discount.
  • Guest commented
    09 Jul 04:46
    I don't understand why this isn't a thing yet
  • bergerdental@bergerfamilydental.com commented
    09 Jul 04:46
    Any update on the researching this enhancement? This is way-way-way overdue.
  • Guest commented
    09 Jul 04:46
    Is this still being researched? We want to be able to show a discount in the treatment planner. Please provide an option to apply a discount to the entire treatment plan. Thank you!
  • Guest commented
    09 Jul 04:46
    I would like to offer a treatment plan to our patients which show the fee - the estimated insurance payment = the patient estimate. The way Dentrix is currently set up, this is not possible when alternate benefits or downgrades are provided, which remap the patient's benefits and effect the entire mathematical calculation provided by the program. Let's bypass this when necessary and have the option for insurance payment estimates to be manually entered by staff, and the patient estimate to be also manually entered by staff. It would be even better if you could highlight and change the numbers right on the preview screen or within the modules provided.
  • Guest commented
    09 Jul 04:46
    I would like to offer a treatment plan to our patients which show the fee - the estimated insurance payment = the patient estimate. The way Dentrix is currently set up, this is not possible when alternate benefits or downgrades are provided, which remap the patient's benefits and effect the entire mathematical calculation provided by the program. Let's bypass this when necessary and have the option for insurance payment estimates to be manually entered by staff, and the patient estimate to be also manually entered by staff. It would be even better if you could highlight and change the numbers right on the preview screen or within the modules provided. There. Simple. Greatly appreciated.
  • Unknown Unknown commented
    09 Jul 04:46
    When entering a fee schedule where a discount is applied, would love to be able to enter normal fee, then the "discounted fee" and have the reflection show immediately without calculating manually. Thank you!
  • gail@ahprodental.com commented
    09 Jul 04:46
    Please allow a discount to be posted in the treatment plan. For patients without insurance, at times we will apply some sort of an adjustment (such as a senior courtesy) and we now cannot put it other than a note.
  • Kari Kern commented
    09 Jul 04:46
    When entering Pre-Treatment estimates allow us to enter in pt portion rather then insurance portion so it can account for insurance writeoffs
  • Guest commented
    09 Jul 04:46
    To be able to also view expected insurance payment in treatment planner consent forms (in document center) This would be beneficial for treatment that has been charged out in op and patient comes to the reception area to pay. We would all have the same reference point on how much patient out of pocket would be. See attached file
  • taylor commented
    09 Jul 04:46
    Dentrix needs to be more PPO friendly when it comes to an insurance/ patient portion standpoint. A solution would be to create a blue book with the PPO allowed fees, but still post our full amount to the ledger. Have your system estimate the patient portion off of the blue book amount listed. This is a feature of Softdent that I miss the most. It was so accurate when it came to insurance estimations with our PPO companies. Because, sometimes patients have two insurances that are PPO, and it is different fees. So trying to decide after both claims what should be in the ledger is a hassle. Please feel free to call me and let me go over this in detail with someone.
  • Unknown Unknown commented
    09 Jul 04:46
    There is no reason why we're unable to do this now! Waste of time
  • dmillerdds@CreekwoodDentalArts.com commented
    09 Jul 04:46
    Sometimes when we are TXPLing we want to charge a patient a different amount or 0 for a specific procedure. However, we want them to see the actual fee along with the discounted fee. It would be nice to have the option to manually change the patient amount but still leave the fee the same. Sort of like insurance where we can manually change the estimated insurance amount, however these patients don’t have insurance. This would be so the patients can see the value of what they are actually getting vs what they are paying. I hope this makes since.
  • Guest commented
    09 Jul 04:46
    I have a case where a patient has an extended time line of treatment due to her age. We want to be able to provide a courtesy adjustment to the fees in the future but only if the pt has all the tx with the doctor. If there are changes with staff at the front desk, there is no way to ensure that the adjustments will be made correctly in the future. The flags don't always get read and can get outdated quickly.
  • Carmel Brantz commented
    09 Jul 04:46
    Dentrix needs an option to have adjustments taken at the time the charge is recorded. IE: the same gross charges generated for all payers. However, some clients accounts should receive adjustment at time of service to agreed rates. Example Delta Dental... Leaving gross charges overstates AR. If you have two fee schedules, it will bill different rates for the same procedure code which is not correct billing proceedures.
  • Debbie Ellard commented
    09 Jul 04:46
    We would like to be able to enter the deductible and any insurance participation write off when posting a predetermination from insurance company.
  • office@ConnectDentalSpecialists.com commented
    09 Jul 04:46
    Admin since you are in the researching mode, possibly you need to see how the OPEN DENTAL software is doing it and just make it the same. They really have it down as a dental office needs it.
  • dr sanz commented
    09 Jul 04:46
    how many votes do you need to change it??????
  • Stephanie Sullivan commented
    09 Jul 04:46
    Instead of changing our fees in the treatment plan when giving a discount, allow us to post an adjustment to show it. This way the patient can see our full fee and the discount, rather than them seeing it after it has posted.
  • Guest commented
    09 Jul 04:46
    This is way way way overdue. I would have voted 1000 times if I could. In summary we should be able to 1)always submit our office UCR fees with insurance claims regardless of whether posting PPO Contracted Fees or the office UCR to the ledger - this is currently possible now thanks. and 2) Be able to Post the office full fee UCR to the ledger but still be able to print out treatment plans in treatment plan presenter that show in the column headings 1) the office full fee, 2) the patient's allowable insurance fee, 3) the calculated insurance portion (calculated based on the PPO FEE!!!!!! not the full UCR fee!!!!!), 4) the calculated patient's portion (again calculated based on the PPO fee!!!! no the full UCR fee!!!). It might even be nice to have a simple final column that simply does the mouth to show the patient their discounted difference. Simple and obvious. This is obvious!!!! Currently offices that need and want to post to the ledger at full office UCR fees ( for the many many reasons which are sited on this post) are stuck with treatment plan reports that are basing the insurance and patient's portion on the full UCR with only the insurance fee shown as a useless reference. This makes no sense. Please no more dumb whistle and bell useless novelties in future upgrades until this major substantive problem is solve and resolved in the next update!!!
  • Guest commented
    09 Jul 04:46
    TX plan notes driven from family file billing type (i.e. insurance or cash note at bottom of each TX plan) instead of having to manual input (a note that says for example, "Treatment plan prices are good for 90 days. Your insurance is filed as a courtesy and these are estimates based upon what your insurance indicates they may pay. You are responsible for amounts insurance does not pay." VERSUS for cash patients: "Treatment plan prices are good for 90 days." Billing type could drive the insertion of these notes easily. Thanks
  • Unknown Unknown commented
    09 Jul 04:46
    I want to be able to show a discount in the treatment planner.
  • Unknown Unknown commented
    09 Jul 04:46
    In the treatment planner it would be great to assign a total fee instead a fee per tooth.
  • Guest commented
    09 Jul 04:46
    Huge issue with Primary NONPPO and Secondary IS PPO- fees don't calculate correctly-The system only recognizes the primary fee
  • Valeria commented
    09 Jul 04:46
    under treatment plan when doctor wants to give patient a discount let it reflect so patient can see the amount charge and the discount given to them per the doctor's request
  • Guest commented
    09 Jul 04:46
    The treatment planner is incorrect. When insurance companies pay, they take the percentage they would pay and then subtract from that amount if the patient has a deductible. The way the treatment planner calculates now is the opposite. It takes out the deductible first and then takes out the percentage. In order to give patients correct treatment plans, we must type in what insurance will pay to force it to print out correctly. This is crippling to our office and MUST be addressed immediately. I process all payments from insurance and see that they calculate the percentage before the deductible. If we use the treatment planner the way that it is, we end up having to bill patients for the difference afterwards. The payments exactly match when we calculate it our way: percentage, then deductible. We need this to be automated and correct for our office to run efficiently as our patient load is increasing at a very fast pace. This is URGENT. **On a side note, for self pay patients, it would be great for us to be able to calculate a discount in the treatment planner module. Just as you have the spot for insurance where we can mark the amount insurance will pay, it can just be called "discount.**
  • Mindy commented
    09 Jul 04:46
    Insurance Fee, Patient Portion But not having the Insurance fee show up on the patient appt or ledger, still want the full fee on ledger.
  • Unknown Unknown commented
    09 Jul 04:46
    You are calculating insurance estimates incorrectly. The insurance company takes the deductible out of the first line item (procedure code billed) and then the remaining balance has the percentage payable calculated. For example: D2392 Composite 2 surfaces - $227.00 minus patient's deductible -$50.00 = $177.00 will be paid at 80% = $141.60 Insurance payment. You do not calculate the percentage payable before taking out the deductible!
  • Unknown Unknown commented
    09 Jul 04:46
    Go to "billing types", & update certain accounts to not have finance fees charged monthly, such as: certain friends/family accts, Orthodontics, etc. Instead of having to update every month. Thanks.
  • Unknown Unknown commented
    09 Jul 04:46
    We bill cash and load PPO rate. If I have primary and sec loaded into family file but primary PPO rate is higher than sec rate, it will load the higher rate. This is not helpful in giving patients accurate treatment plans.... In my opinion if two are loaded it should always record lesser fee into tooth chart/treatment planner so that the patient gets the correct out of pocket expense.
  • Unknown Unknown commented
    09 Jul 04:46
    I need a way for Dentrix to allow us to enter in the insurance fee schedule for the estimation purpose BUT allow us to use OUR fee schedule to post to the ledger/claims ETC. I want the patient and the insurance company to know our full fee (the ACTUAL charge) but allow this really expensive software we pay for to be able to do what it is suppose to with the insurance estimated payment info. Our walk out statements are never correct because of this. I update the fee schedules as I can for items that are 100% covered. Entering a payment table for every insurance plan listed with the 12 companies we are contracted to is not acceptable or a reasonable means to correct. This would take us months/years to complete this. Is there anyway for the computer to recognize that we are contracted with a particular company to show the correct fee to collect from the patient?
  • Dori commented
    09 Jul 04:46
    It would be very helpful if the planner would calculate in-network fees instead of just compare the fees. It is very time consuming to have to calculate for the patient.
  • Guest commented
    09 Jul 04:46
    If I bill a PPO allowable fee, that decreases the chance of increase in allowable fees for the following year. So, I always bill the insurance company my current office fee. Because I always bill the office fee, it makes it very difficult to tell the patient exactly what their coinsurance will be for each appointment. That requires my office staff to spend time calculating on a separate sheet of paper. I should be able to work with both fees but to give the patient information based on their allowable fees.
  • Unknown Unknown commented
    09 Jul 04:46
    When we write off an account we would like system to split the balance up showing credits under each producer and finance charges.
  • edwardprusdds@gmail.com commented
    09 Jul 04:46
    If you go through the trouble to delegate appts. for each procedure in proper sequence, that sequence should be visible in progress notes window as a similarly colored number in the left most column. It would also be valuable to have the same appear in the ledger screens for treatment planned work.
  • customercare@rivercitydentistry.net commented
    09 Jul 04:46
    i would like to see the estimated insurance portion in the patient ledger screen
  • Guest commented
    09 Jul 04:46
    Example: If you par w/Delta fee is 100, payment is 75 and par write off is 5, pay table would reflect Delta pays 80.
  • kelsie commented
    09 Jul 04:46
    I would love to be able to enter ppo fee schedules and then attach them to the insurance plan so that when we enter procedures onto the patients ledger or treatment plan, it posts our regular office fees, but then when we print the treatment plan, it calculates off the attached fee schedule. That way we can give patients quotes off of ppo fees and collect more accurately. Right now, if we attach a fee schedule to an insurance plan, those fees get posted to the ledger and treatment plan.
  • Unknown Unknown commented
    09 Jul 04:46
    The ability to run a report that shows the amount assigned to each adjustment type you have set up. Ie. If you have set up Cigna, Aetna, MetLife, etc as write offs, you should be able to run a report that shows the amounts assigned to each of those so that we can calculate the amount of write off for each insurance carrier for analysis. We need to be able to compare the write offs vs. the revenue for each insurance company!! Having all of the write offs we created lumped under "adjustment" on reports is NOT helpful. We should be able to tease out each of those write offs.
  • Unknown Unknown commented
    09 Jul 04:46
    Being able to customize all aspects of the treatment plan is vital. Mostly, the patient's portion to pay. Dentrix does not do the math right on 9 out of 10 estimates. It does not take alternate benefits into consideration and most every recommendation for a posterior tooth will have an alternate benefit clause. There needs to be a way that I can override Dentrix's calculations so I don't have to white out each Treatment Plan. Not only can white out be disputed by a patient, it looks very unprofessional. I also agree that there needs to be a way the discounts can be entered into the Treatment Plan, Customized, & able to 'Set Complete' when the Treatment is done. We can change the full fee, of course, to what we're going to charge the patient, but we like to show the patient what kind of discount they are getting and that we're doing them a courtesy.
  • Unknown Unknown commented
    09 Jul 04:46
    Being able to customize all aspects of the treatment plan is vital. Mostly, the patient's portion to pay. Dentrix does not do the math right on 9 out of 10 estimates. It does not take alternate benefits into consideration and most every recommendation for a posterior tooth will have an alternate benefit clause. There needs to be a way that I can override Dentrix's calculations so I don't have to white out each Treatment Plan. Not only can white out be disputed by a patient, it looks very unprofessional. I also agree that there needs to be a way the discounts can be entered into the Treatment Plan, Customized, & able to 'Set Complete' when the Treatment is done. We can change the full fee, of course, to what we're going to charge the patient, but we like to show the patient what kind of discount they are getting and that we're doing them a courtesy.
  • info@jmcnielfamilydentistry.com commented
    09 Jul 04:46
    Example: Fee = 120, ins pays at 80%, write is 20. In this example Insurance pays 80.00. Payment Table should reflect ins payment of 100, pt pay = 20.
  • Barbara Ames commented
    09 Jul 04:46
    A separate column in the treatment planner to allow for "adjustments" such as PPO adjustments or courtesy adjustments would be more than beneficial. Under contracts - an office may be required to allow for an alternate benefit other than what was completed and billed. Knowing this in advance, we need a way to show the patient that the amount ISN'T a patient payment and it also ISN'T an insurance payment. Currently, the only way to show that adjustment is after the payment is received and posted to the ledger. If I could give this a MILLION votes I would!
  • Julie commented
    09 Jul 04:46
    When patients are maxed with a PPO insurance company or when non-covered services are allowed to be charged at regular office fees, the treatment plans will print the PPO fee anyway as the patient is listed under a PPO fee schedule for all services. Is it possible to indicate in the insurance information so these fees can default to our office fees? It seems we are presenting treatment plans with unnecessary discount treatment which we have to honor later.
  • GChristopher commented
    09 Jul 04:46
    I feel like Martin Luther posting my 12 grievances on the church door. Sorry for the long list. Bottom line: PLEASE change the way Dentrix calculates estimates and do it the right way. We need to be posting FULL FEES for everyone and the estimator needs to calculate for write-offs and adjustments correctly. And the only way to do it correctly is to design it like an EOB: Calculating left to right, with column A. Submitted Fee, B. Contracted Fee, C. Allowed Amount, D. Deductible, and E. Percentage. This is the best and only way to do it and be accurate AND be prepared for the future inevitable day when everything will be digital and downloaded and we will need those columns because the insurance companies are already using them.
  • GChristopher commented
    09 Jul 04:46
    #12. Multiple doctors. This goes also along with needing to overhaul the insurance plan set up. Currently as Dentrix is design now, if we have an office where some doctors are contracted with a plan and some are not, then it creates a real nightmare with posting and with estimates and with claims. If a patient has to see the Non-PPO doctor then we have to remember to manually change the fees, but even worse, if we do, the estimate is still incorrect because it is calculating the insurance based on the “Payment Table” or “Fee Schedule” assigned to the insurance plan rather than an “Allowed Amount” or “Contracted Fee” table. And even for everyday situations, we have to create TWO of the same insurance plan in the computer, one for the PPO doctors and one for the Non-PPO doctors so that the correct fees are posted to the ledger and the estimates are accurate. The better solution is that EVERY patient is charged the same standard office fee, and within THE INSURANCE PLAN SET-UP there is a drop-down list where you can assign which providers are contracted and which are not. This way the Treatment Planner, Claim, and Ledger knows which fees to use when calculating the estimate and write-offs (or there even are any write-offs). This also assumes you have set up the program to calculate correctly using “Allowed Amount” tables and “Contracted Fee” tables rather than “Payment Tables”).
  • GChristopher commented
    09 Jul 04:46
    #11. With regards to more accurate estimates, it begins with the insurance setup, and this would also need a change and overhaul because it is unnecessarily complicated. It takes too long to set up a plan, especially if there are specific exclusions for a single procedure (like the Cone Beam issue above) or range of procedures. Ranges are fine, like the standard range of Preventive from D1000-D1999. But to add a single exception like Sealants, requires altering the original code and creating TWO additional lines of code: First capping off D1000-D1350, then adding the Sealant exception D1351-D1351 and finally adding ANOTHER code to finish the series D1352-D1999. Heaven forbid we have to put in more than one exception in there too! Why so complicated? It would be far more efficient and less time consuming to just have the 12 basic ranges with adjustable percentages and then a tab where we can put in single exceptions to the rule. This is how Daisy did it and I could put a whole plan together in less than a minute. With Dentrix it takes me forever to correct and “change” each individual line and add two additional lines for every exception. It can take half an hour or more on some plans to put them together!
  • GChristopher commented
    09 Jul 04:46
    #10. From an accounting and business perspective there is no tracking of how much we’ve written off during the year due to any particular PPO. We could, I suppose do multiple reports with side-by-side comparisons of different fee scenarios (I think I saw once that Dentrix had the ability to run production reports comparing various fee tables) but that is far too cumbersome and complicated than it needs to be. And besides, a business needs to know exactly what it is losing in the way of contracted write-offs so it can determine whether maintaining a relationship with that PPO is warranted. And above all else, our ledger should always match what the patient received from their insurance so there are no confusions or perceived deceptions. Patients are confused enough with insurance and we don’t need to further complicate things by having balances and ledgers and statements that don’t have the same numbers on them as what they get back from their insurance company. It creates confusion.
  • GChristopher commented
    09 Jul 04:46
    #9. Along with all this is the simple fact that our totals and claims in Dentrix do NOT match what the insurance or patient receives. We don’t see the true “total” charge anywhere. When calling insurance companies to investigate claims we are always asked “what is the claim total” which we NEVER know because our total in the Dentrix ledger does NOT match the insurance’s total.
  • GChristopher commented
    09 Jul 04:46
    #8. When PPO fees change and we have not yet updated those fees inside Dentrix for that plan and we are still only posting the old PPO fee, not full fee, but the computer is sending the full fee on the claims, then the plan will pay at the new approved fee and we will end up with credits on the patient’s account that don’t belong to the patient and again we have to retroactively add additional charges or adjustments to compensate. This happens especially for Diagnostic and Preventive procedures that are typically covered at 100%. Had we posted and estimated at our standard office fees and been calculating using “Contracted Fee” and “Allowed Amount” tables and columns, it would have accounted and adjusted for this. The estimated write-off may have ended up different but the patient’s estimate would still be 0% and we’d have the full fee posted to make the correct adjustment. This may not solve the problem entirely with some procedures like those covered at 80% and 50% but those are negligible and manageable and at least the full fee was posted to the ledger so the correct numbers show up.
  • GChristopher commented
    09 Jul 04:46
    #7. Remaining deductibles with plan payment exceptions problem: We had this recently pop up too. The insurance plan payment percentage table has 0% for certain diagnostic ranges, such as those in which Cone Beams fall into. However, we had a patient who’s plan DID pay for Cone Beams (rare, but it happens) and on the Pre-D we put the amount they were going to pay and updated the “Payment Table” which now added the Cone Beam as an overriding rule to the estimator. However, the deductible had NOT been met and applied to this procedure! Because the code range in the insurance plan said 0% and because Dentrix calculates BACKWARDS off the “Payment Table” rather than left to right taking the deductible out first, Dentrix was incorrectly calculating the estimate by still multiplying the deductible by 0%, essentially negating the point of using “Payment Tables” for this particular PPO plan. In order to fix this glitch I had to go in and add Cone Beams as an exception to the insurance plan range (thus having to take the time to alter the original range codes and add two more range codes) and put in the percentage they paid on Cone Beams and just deleted out the “Payment Table” entry since it no longer served a purpose as this was a PPO plan. If I’m going to have to make an exception to the insurance range regardless of the calculation method used then why not make it easier than it is (see issue #9) for adding exception and just stop with the “Payment Tables” altogether.
  • GChristopher commented
    09 Jul 04:46
    #6. Secondary Insurance. If one plan is on a PPO and the other is not we have even more problems. If family member #1 has the PPO as primary then their fees posted and estimated are different than family member #2 who has the Non-PPO plan as primary. This creates confusion among patients who want to know why one family member was charged more than another for the same procedure. It also creates problems when sending the claims because the Non-PPO plan is NOT set to send the special Dentrix claim type with full fees but rather sends the fee that is posted, like all Non-PPO plans would. And if the PPO was primary, then the fees posted to the ledger are the PPO fees and the secondary is getting a claim with a DIFFERENT total with DIFFERENT fees than the primary claim! This has happened more than once to us until we realized what was going on. We have now, again, committed accidental insurance fraud because we have charged one insurance company a different and greater amount than we charged the second. And the only way to solve this is to either set the secondary, Non-PPO plan to send full-fee claims like the primary (which it will then over-pay because the ledger only posts the PPO fee), or we have to remember to manually change the fees for this individual family member, every time they have work done, to the full fees so it posts correctly for both claims but will inaccurately calculated the estimate. It is a huge headache.
  • GChristopher commented
    09 Jul 04:46
    #5. Getting back to “Payment Tables” and “Contracted Fees” if, like in example #4, we decided to charge the patient less than our “Contracted Fee” or “Standard Fee” but there is an amount in the “Payment Table”, the computer overrides the standard calculation and uses the “Payment Table” amount and the estimate is wrong, suggesting the insurance will pay more than they actually will, because they are not actually going to pay the amount in the “Payment Table” they are going to pay a percentage of the “Allowed Amount” or “Contracted Fee” or “Submitted Fee” whichever is LESS. Had the computer been using those three tables, in the proper order then the estimate would have accurately accounted for the change in fee posted.
  • GChristopher commented
    09 Jul 04:46
    #4. If you bill one fee to the insurance and a different one to the patient, this constitutes “Over-Billing” and is insurance fraud! Now, one may argue that we aren’t “really” over billing because we’re just posting the fee after accounting for the PPO write-off. Well that’s great in a perfect world where every procedure follows the rules perfectly. BUT like the example in #3 if their plan has a special “Allowed Amount” and the insurance pays differently or has an incentive plan that allows for additional benefits and pays more, we now have credits to deal with that shouldn’t be there and adjustments have to be made and then explained to the patient or auditor why we had to retroactively change a posted fee or add additional fees to the ledger to compensate. The more likely scenario, which has now happened to us TWICE, is that we discount a fee for a particular patient because perhaps they had a cleaning but only four teeth remaining so we only charged half the normal price, but their claim was sent with the FULL FEE attached because it had the special Dentrix claim type attached and the insurance company paid in full! We have now committed fraud. We have over-billed the insurance. Albeit accidentally, but the law doesn’t care. So to correct it we have to go through the enormous trouble and pain of re-filing a corrected claim or retroactively charge the patient the full fee to be in compliance. Now if the patient’s balance is still $0 than they don’t really care or pay attention (though it uses up more of their benefits and if they paid attention to their EOB’s they’d see we charged the insurance more than we told them we charged on their walk-out statement and they might complain) but the more common problem is that their balance ends up with owing more and they see “additional charges” and then they really complain and want an explanation. However, the next scenario is more often the case and that is: If the procedure is a Non-Covered procedure, or if the plan is a secondary coverage and has a non-duplication clause, then the office does NOT have to take the write off and can bill the patient for the full fee, but because we only posted the PPO fee to the ledger our balance does not match the patient’s EOB, and we either have to retroactively charge more to their balance and have that unpleasant conversation with the patient or we take the hit and just collect the PPO fee which we weren’t obligated to take in the first place! All of which could have been avoided if we had just posted the Standard Office Fee to the ledger. (This is all assuming a scenario in which we didn’t have a Pre-D before-hand telling us this would happen which frequently occurs, or an inaccurate Pre-D that did not fully explain this would happen, which is often the case and weren’t able to manually change that fee before posting). And finally, if we were to try and solve this problem differently by posting the PPO Fee or Standard Full Fee so that the correct amount sent to the insurance was accounted for on the ledger, but then added a discount adjustment on the ledger for the reduced price, we would again be committing insurance fraud because we have now effectively discounted or written-off the patient’s co-insurance and/or deductible as well as over-billing. All this could have been avoided if we just always posted our Standard Fee for everyone, but we can’t do that and get a correct estimate in the Treatment Planner with Dentrix’s current setup because it does not account for contract write-offs and adjustments.
  • GChristopher commented
    09 Jul 04:46
    #3. Even if a doctor is contracted with a particular PPO, an individual’s plan within the PPO could have its own built-in “Allowed Amount”. Without using all three columns (Submited Fee, Contracted Fee, Allowed Amount) in that order, the estimate will never be correct. For example: Delta Dental TriCare program - If a doctor is contracted at Premiere level, or possibly even PPO level, they may have to write-off the difference between their Standard Office “Submitted Fee” and the “Contract Fee” but they do NOT have to write off the difference between that particular plan’s “Allowed Amount” for the given procedure. Even using Dentrix’s current setup will NOT account for this problem because using and posting the PPO fee won’t account for the plan’s internal “Allowed Amounts” which are then paid on a percentage. Sure, using “Payment Tables” would help but you run into the same problems as already mentioned in #2 and it can create accounting problems of insurance fraud “over billing” as I will get into next.
  • GChristopher commented
    09 Jul 04:46
    #2. The use of “Payment Tables” is a problem. We should be using “Allowed Amount” tables and “Contracted Fee” tables NOT payment tables. Using payment tables is one of the primary reasons Dentrix has to calculate estimates backwards instead of the normal left to right. And there are some PPO plans that have incentives, where the percentage for a procedure changes year to year. If Dentrix used “Allowed Amount” tables and “Contracted Fee” tables like an EOB uses then we wouldn’t have to adjust anything from year to year and multiple plans could share a single Allowed Amount table reducing the amount of work and adjusting we have to do and reduce estimate errors! Instead, I have to actively remember to hand calculate EVERY SINGLE patient and plan that has an incentive level on it and remember to change and adjust their “Payment Table” amounts when the new benefit year hits and their percentage changes or else all those estimates are now wrong. This goes for any PPO we are on as well; even if the percentages don’t change the “Contracted Fee” will change, but the “Payment Table” amount is still locking the estimate at the wrong amount and if I don’t catch it, the patient pays too much and I’m left with credits all over the place when the claim finally pays. In the world of insurance it is of little help to know the “actual” dollar amount the insurance will pay for an individual procedure, I need to know what it will ALLOW. Then, if I have the correct percentages and the correct remaining maximums and deductibles for the year already in the plan, any good software will correctly calculate what the insurance will “actually” pay for the service. For example: Cigna notoriously counts ALL Pre-Ds against each other. If I were to pay attention to the “actual” dollar amount they say they will pay on a Pre-D then all my estimates will be wrong. For all Cigna claims and Pre-D’s I have to remember to look at the “Allowed Amount” column to get an accurate estimate of what they will pay, because the patient might end up doing treatment ‘B’ before treatment ‘A’ and if Cigna and I were counting on them to do their treatment in the original order of things then all those estimates are wrong. Or if a treatment plan where to change and a fill ended up with more surfaces thus using up more of the benefits before they went on to treatment ‘B’ the estimates for ‘B’ would now be wrong if I had accidentally looked at or put in the “actual” amount into my Pre-D rather than figuring the “Allowed Amount” for the next procedures. And also, the next time a different patient with the same plan has that procedure, I won’t have accidentally put a random dollar amount into the “Payment Table” based on a different patient’s claim that may have maxed out. On the next patient they may have plenty of benefits remaining and I need to know what the insurance “would” pay if all benefits were available, thus an “Allowed Amount” column/table is much more accurate for calculating insurance estimates as these rarely change as often and are usually based on more consistent and stable UCR percentiles that I can easily obtain from Fair Health Consumer.org.
  • GChristopher commented
    09 Jul 04:46
    #1. We are fully in the digital age. Blue Cross has already stated they will no longer accept anything on paper and won’t even give the option for checks anymore. With each passing year more insurance companies are going to do this, so our records need to match their records. Our estimates and our claims and our ledgers should look like an EOB! They need to have the same columns one would find on eEOB or a paper EOB. Where else would this electronic data go if there is no column or box for it in Dentrix? That being said, the Treatment Plan Estimator and the claims should have the same columns as an EOB does: A. Submitted Fee/Amount, B. Contracted Fee/Amount, C. Allowed Fee/Amount, D. Deductible, and E Plan Percentage and should calculate from left to right like a normal EOB would and not in reverse way that it does now in Dentrix when accounting for deductibles, percentages and “Payment Tables” (you’ll see why that’s a problem in issue #7). Our old software, Daisy, did this exactly and beautifully. I figured Dentrix was just as good and was lead to believe this when we purchased it. We were extremely frustrated when after installing it we found that it couldn’t even do this basic task and considered cancelling it and returning it. I don’t know if Eagle Soft is just as bad since I’ve never used it, but interestingly the reason Daisy was so good and accurate at calculating insurance estimates (including secondary insurances) was because it is owned and created by an insurance company! DMC which is or was the owner of Delta Dental of Oregon (ODS now MODA) makes the Daisy software and thus knew how to correctly calculate insurance estimates and had all these tables in use, with correct and user friendly editable tables. If you were to look for a good example on how to do it, they would be it. (Although, now that I remember, even they omitted the “Contracted Fee” table in favor of a check-box “in or out of network” which caused headaches occasionally which I’ll explain below in problem #3.)
  • GChristopher commented
    09 Jul 04:46
    I'm breaking this up in multiple comments because this only allows for 5000 characters. Here we go: We need the Treatment Planner Estimator AND the Ledger to accurately reflect and show the contracted write-offs and discounts and calculate like an EOB would, left to right, with all the correct data and columns! First and foremost this goes to the primary accounting problem in the dental industry which is that no one should ever be posting PPO fees to their ledgers and especially not filing claims with PPO fees on them! This shoots everyone in the industry in the foot by inaccurately diluting the “average fee” for a service and thus the insurance carriers never adjust the PPO’s any higher! Everyone complains that the PPO’s are way too low, but this is why! Dentrix has its “work around” by using the special claim type that will send the office’s full, standard fee to the insurance, but it still leaves the PPO fee on the ledger and reflected on the version of the claim we see in the ledger; and because Dentrix won’t accurately account for the write-offs and adjustments in the Treatment Planner estimates, we have no choice but to use this inaccurate method of posting. This creates a myriad of problems which I will enumerate below.
  • Adrian Kuligowski commented
    09 Jul 04:46
    This would be a great enhancement to our software. I have at least a dozen offices that would love to see this feature added in a G5 update.
  • Unknown Unknown commented
    09 Jul 04:46
    yeah!!!
  • Unknown Unknown commented
    09 Jul 04:46
    I simply override the insurance estimate amount to include the write-off, directly within the procedure window, itself, and then deselect using insurance plans maximums. This is the only way I know right now to include write-offs in the patient's treatment plan.
  • Julie Schmidt commented
    09 Jul 04:46
    I cannot believe it has been 2 years in the making for this enhancement! Manually writing in the adjustments on the treatment plan is SO professional looking!!! We request a patients copay at the time of service and it is very inconvenient and time consuming when you have to figure out the adjustment for each procedure. This should be automatic and shown on the ledgar and treatment plan. Let's get with it dentrix.
  • Lisa Cameron commented
    09 Jul 04:46
    Providing an accurate quote of patient's part is an essential task. This improvement would allow us to create an accurate treatment plan with patient responsibility clearly on it, accounting for the adjustment, not crossed out and hand written. We're Sooo close, please make it happen!
  • Guest commented
    09 Jul 04:46
    The ability to show any discounts, like cash courtesies, is really needed on the treatment plan. Another nice addition would be to enter the patient's decision, such as, patient agrees to pay for treatment as it is performed; Pt agrees to pay patient share in advance to receive 5% cash courtesy; pt is a senior and agrees to pay patient share in advance to receive 10% cash/senior courtesy; etc.
  • Anonymous commented
    09 Jul 04:46
    This feature is far more I Important than any other feature that is requested.
  • Regina commented
    09 Jul 04:46
    very much needed in the treatment plan.
  • Julie commented
    09 Jul 04:46
    This is a must have, without this the treatment planner is an outdated module. Yes, there are work arounds...but why not listen to us out here and get it up to date. Isn't the motto..."Work smarter not harder"
  • Unknown Unknown commented
    09 Jul 04:46
    Ok lets make it happen!!!
  • Erin commented
    09 Jul 04:46
    This would be great!
  • Melissa commented
    09 Jul 04:46
    I work around this issue by "updating the payment table" using the write off amount plus the insurance payment for each procedure code. Then when I print the tx plan for anyone with the same plan the insurance column includes the write off. It's time consuming and a work in progress but worth it. Start with your most popular in-network insurance plan.
  • Guest commented
    09 Jul 04:46
    UGH....when is this going to happen already???
  • Guest commented
    09 Jul 04:46
    It would be nice also if on the treatment plan it read from left to right---Standard fee-PPO fee(if contracted with)----primary insurance---secondary insurance---patient portion on the far right of the page!! Not in the middle it makes it hard for that patient to find their estimated portion.
  • missy commented
    09 Jul 04:46
    really could use this feature, something that would show our fee schedule but auto adjust to a contracted insurance company schedule and show the estimated write offs
  • Miranda LaSha commented
    09 Jul 04:46
    A feature that allows me to manually put a discount into the treatment plan & treatment planner for patients who do not have insurance is a crucial feature! This is something we need on a regular basis ie senior discount, courtesy discount, cash patient discount etc. Please review!
  • Sean commented
    09 Jul 04:46
    A way to show a discount on a treatment plan for patients who don't have insurance would be great!
  • Wanda Ayala commented
    09 Jul 04:46
    I think that if you are an office that accepts insurance, discounts are not to be given. This is considered insurance fraud. As I went to a few insurance coding courses this was a big issue. I understand that in your office you do what you want, but trust me it will catch up to you. So maybe work on the enhancements like the one to be able to enter more medical alerts and not be limited in the ability to do so.
  • carlson commented
    09 Jul 04:46
    This is a feature we would use daily in our office. I tried making my own procedure code to treatment plan a discount so I could adjust the price accordingly, but it won't let me put a negative number in a procedure code. If there was any kind of reasonable work around, we would use it often!
  • Anonymous commented
    09 Jul 04:46
    This enhancement would be a great for an office that gives the patient a Sr Courtesy, Full payment Courtesy, and Full Case Courtesy. Sometimes just showing that Courtesy on the TP is enough to push the patient into accepting the TX.
  • Lori commented
    09 Jul 04:46
    This is a MUST! We need to show the patient the actual amount the Ins. will pay based on their allowances and writeoffs, etc! The the Patient Portion of the Treatment Planner will be accurate!
  • LD commented
    09 Jul 04:46
    Thanks. We'll look into it.
  • Guest commented
    09 Jul 04:46
    LD: Have you investigated using the DX2007F claim format? This allows patient treatment plans, estimates and Ledger balances to use a network-contracted Fee Schedule (set in the Patient's Family File), while the sent claims will reflect your Usual\Customary Fee Schedule (set in the Plan's Insurance Data settings).
  • LD commented
    09 Jul 04:46
    It would be nice to calculate this so that the estimate of the patient's portion is more accurate. We need to submit our normal fee to the insurance co. so they can calculate the fees charged in our area more accurately. If we submit the contract fee, it gives the insurance co. inacurate figures. However, Dentrix doesn't take into consideration the write off portion when calculating the patient portion estimate resulting in having to credit back the balance or going through each treatment plan item and calculating the patient portion manually.
  • Anonymous commented
    09 Jul 04:46
    I would like ti if the estimates for insurance plans that we are networked with could reflect ins adj. That would help us to collect the correct amt rather than over-collecting and refunding
  • Anonymous commented
    09 Jul 04:46
    It would be nice to calculate the correct write off in the coverage table and also to view the writeoff for each procedure in the patient's ledger. We need a column to add our office fees, a column to enter the insurance company's allowed fees and a column to see exactly what the patient owes (without having to use a calculator).
  • Guest commented
    09 Jul 04:46
    We use the DX2007F claim format also. This solves most of the problems in that estimates are based on the patient's fee schedule and these are the actual fees posted in the Ledger while the insusrance company is "billed" our UCR fee.
  • Guest commented
    09 Jul 04:46
    This would be of huge benefit for sure! Patient's want to see a discount noted on their printed treatment plan and it helps other team members who might schedule treatment to be aware of the discount.
  • front office commented
    09 Jul 04:46
    I agree you need this feature. It gives the patient a better presentation of how much the dentist is actually writing off.
  • Guest commented
    09 Jul 04:46
    I'm not sure if it would help the previous commenters, but we use the DX2007F claim format. The patient's fee schedule is set to their insurance's schedule (in the Family File), while the Insurance fee schedule is set to our office fees (in Insurance Data). This way, the patient sees an estimate based on their actual costs and negotiated fees, while the office fees are submitted on the claim forms.
  • Anonymous commented
    09 Jul 04:46
    I agree. This would allow us to more accurately quote a patient's estimated balance. Currently, the difference between the office fee and the insurance contract fee is pushed into the patients estimated portion which is inaccurate and can add up to hundreds of dollars that we have to refund or credit to their account.
  • Ann commented
    09 Jul 04:47
    And....fields should be able to be manipulated by the user. Also a field for "Allowances" for insurance companies that practices participate with.
  • Brittany commented
    09 Jul 04:47
    I agree it would be most beneficial to have a seperate column in the coverage table that we would be able to add our allowable fee with the different insurance companies. I would also like allowable fee to show up on the dental insurance claim screen in the ledger under estimated insurance portion. That way I can track when the insurance pays on the claim that the insurance is giving me the correct write off amounts. It would be great to have it print out on the patients statements so they can understand where out calculations are coming from. PLEASE DO THIS UPGRADE!!!
  • Guest commented
    09 Jul 04:47
    Our walk outs are so confusing because the system doesn't calculate the correct way. I belive there is a way to do this but it doesn't seem very clear in the Dentrix instructions with the fee schedules vs the payment tables. I always want my patients to know OUR full fee and what we are adjusting off for belonging to thier PPO.
  • Anonymous commented
    09 Jul 04:47
    Being able to show the treatment plan at the office's full fee and show accurate insurance estimates based on the insurance fee schedule is HUGE!!!! A few additional fields need to be added-the insurance "allowable" fee and the "write-off" column.
  • Office Manager commented
    09 Jul 04:47
    This is really essential for those of us who are in a PPO. Presenting the treatment plan is time consuming when you have to figure the write off for each procedure, mark it out on the treatment plan, and handwrite in the patients actual owed amount..Not to mention treatment plans look very unprofessional when they have to have so much marked out. Dentrix really needs to look at this and put in on their "under review" list.
  • Office Manager commented
    09 Jul 04:47
    This is a must have!!! Another software I used to work with had allowance tables that attached to an insurance plan so when a treatment plan was entered the allowed charge, write off and accurate patient portion were printed on the treatment plan!!! No more hand writing on TX plans Dentrix !!! PLEASE
  • zach brumbach commented
    09 Jul 04:47
    I want to keep track of my adjustments/write offs and also be able give a patient an accurate estimate as a result of a PPO insurance contract. You just need to add a column in the Treatment Planner that calculates the estimate based on the PPO fee schedule. At this time you can not do both.
  • Guest commented
    09 Jul 04:47
    It would also be very beneficial if on statements and walk-out statements an explanation could print like "Claims are submitted with our office fees, however we have charged your account based on contracted fees with your insurance carrier."
  • Troy Walton commented
    09 Jul 04:47
    I think this calculation would be ideal in the coverage table. For example, have a column with office fee and column with insurance allowable. The percentages could be determined from allowable and have the ability to calculate write off and show it to the patient. It would also be helpful the have a column in the coverage table to show what insurance would owe and what the patient owes in another column.
  • Denise commented
    09 Jul 04:47
    Dr. wants to be able to show and manually change a patient's fee in a column next to the column provided with the coordinating fee schedule. example Service U/C fee patient pays Resin 2 surface posterior $221.00 $79.00
  • Jennifer Alexander commented
    09 Jul 04:47
    This goes along with the idea of attaching adjustments to specific procedures in the ledger, which was also suggested. Great idea!
  • Robert Gregg DDS commented
    09 Jul 04:47
    THESE IDEA'S AND IMPROVEMENTS ARE GREAT BUT TREATMENT PLAN RUNS TO SLOW AND NEEDS TO BE EASIER TO OPERATE.
  • Guest commented
    24 Jul 16:35

    In addition to this, it would be great if you could apply any credits the patient has on their account.