Please create within your system to calculate the difference btw practice fee and out of net work fee schedule so that the amount over the OON fee schedule is calculated to the patient % / portion owed.
example- 100, 80 50 coverage, with ins. fee schedule/blue book attached, system should calculate that the amount owed by patient.
Exam- $45.00 (practice fee) , $25.00 ins. allowed amount (OON fee schedule)
100% covered exam pt would be responsible for $20.00
($20.00 is the non covered amount over ucr/network fee)
Build up $250.00 (practice fee), $200.00 allowed by ins @ 50%
pt would be responsible for $150.00 -
I realize this may seem confusing, but I know that it is possible as the system we previously use did calculate the OON/over UCR.
Per Dentrix rep., I was notified that the above scenario was not possible-dentrix currently does not functionality to do the task mentioned above.
Guest
Thank you for the suggestion.
