Basic Overview Definition:
A patient's remaining maximum amount will update when services are posted to the ledger.
Details:
Denticon reduces the Individual Maximum Reminder (Ind. Max. Rem.) amount when services are posted to the Ledger from any source and when the amount under the Estimated Insurance (Est Ins) column is greater than $0.00 (Est Ins $X.XX > Check Value $0.00).
If the payment received from insurance is less, the difference is added back to the Ind. Max. Rem. If the payment received from insurance is more, the difference is subtracted from the Ind. Max. Rem.
Examples:
Example Setup
As of January 1st, 20XX (1/1/XX), the Ind. Max. Rem of an account is $1000.00
On 1/10/XX a procedure is posted to the Ledger with insurance coverage where the Estimated Insurance Amount (Est Ins Amt) = $990.00.
Ind. Max. Rem was reduced to $10.00 ($1,000 - $990.00 = $10.00).
Scenario A
On 1/20/XX the Insurance company paid $990.00.
Because the payment ($990.00) was equal to the estimate ($990.00) Ind. Max. Rem was not changed.
Scenario B
On 1/20/XX the Insurance company paid $880.00.
Because the payment ($800.00) was less than the estimate ($990.00) Ind. Max. Rem was will increase by the difference $190.00 ($990.00 - $800.00 = $190.00).
Ind. Max. Rem will increase to $200.00 ($10.00 + 190.00 = $200.00).
Scenario C
On 1/20/XX the Insurance company paid $1,000.00
Because the payment ($1,000.00) was greater than the estimate ($990.00) Ind. Max. Rem will be reduced by difference $10.00 ($1,000 - $990.00 = $10.00).
Ind. Max. Rem will decrease to $0.00 ($10.00 - $10.00 = $0.00).
Article Version 1.1 2026.7.20