In the treatment planner, the deductible is taken from the highest-cost procedure (in this case, covered at 50%). However, there are a couple of codes that are covered at 80%. The insurance will take the deductible from the higher covered (by %) codes and ultimately pay less on the total claim. I'd like this to show on the treatment plan correctly. I thought about multiple visits as well as a workaround - but it does seem like an extra step or possible confusion for the patient about cost. It seems odd that insurance will always choose one method (it's cheaper for them!) and yet Dentrix can't do it - or hasn't been updated to meet that need over the decades it's been in use.
Dentrix: D2392 $200 x.8 = $160
D2740 $2000 -$50 x.5 = $975
Total ins estimate = $1135
Insurance: D2392 $200-$50 x.8 = $120
D2740 $2000 x .5 = $1000
Total actual ins. Payment = $1120
The patient is actually responsible for an additional $15 - but can’t show this on the treatment plan before billing.
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