Dental Health Maintenance Organizations (D-HMO) have many client companies which purchase employee dental coverage plans. Their coverage is usually referred to as “managed care” because treatment generally follows a set of care guidelines provided through the D-HMO's network of providers. In most cases, D-HMOs have many fee schedules available for use. Because each individual plan can utilize a different fee schedule from another, Managed Care fee schedules are attached to insurance plans rather than individual carriers.
Ensure the desired fee schedule is designated as a Managed Care fee schedule.
Ensure the Managed Care plan is entered with the employer field indicated as “No Employer”. Many times, insurance carriers have co-pay variations for the same plan. For example, “Carrier A” may have several co-pay variations of “Plan L”. It is advised to use the Managed Care fee schedule name in the “Cap Fee ID” field.
Click the word “Setup” and choose the “Fee Schedules” and “Fee Schedule Assignments” options from the drop-down box.
First search to ensure the plan and fee schedule are not already attached together. To investigate if the fee schedule is assigned to a plan, complete the appropriate plan-specific “Search” fields at the top of the screen, and click the Srch button. A listing of matches for the search criteria is returned in the middle of the screen.
To attach a fee schedule to a plan, complete the appropriate plan-specific “Add New” fields at the bottom of the screen, and click the Add button.