NOTE: PPO fee schedules are attached to insurance carriers rather than individual plans. Attachment of a PPO fee schedule to a plan will not return the expected financial result to the patient record.
Managed Care fee schedules may be attached to plans.
Office type schedules are attached only to patients. The fee schedule will be indicated on the patient overview screen as the preferred schedule.
PPO Schedule – Attached to Carrier
Insurance carriers have many client companies which purchase employee dental coverage plans. In most cases, insurance carriers have only fee schedule for all plans. The fee schedules should be designated by the insurance carrier as Preferred Provider Organization (PPO). When entering the fee schedules into Denticon, ensure the desired fee schedule type is designated as a PPO fee schedule.
Ensure the dental insurance carrier is entered.
Click the word “Setup” and choose the “Fee Schedules” and “Fee Schedule Assignments” options from the drop-down box.
First search to ensure the carrier and fee schedule are not already attached together. To investigate if the fee schedule is assigned to a carrier, select the appropriate carrier by clicking on the 'Filter Icon' and a listing of matches for the search criteria is returned in the middle of the screen.
To attach a fee schedule to a carrier, click the Assign New Fee Schedule button.
Managed Care Schedule – Attached to Plan
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, select the appropriate plan by clicking on the 'Filter Icon' and a listing of matches for the search criteria is returned in the middle of the screen.
To attach a fee schedule to a carrier, click the Assign New Fee Schedule button.
Carrier Assignment
Plan Assignment