Applying updated insurance estimates to unpaid procedures

By default, Dentrix Ascend automatically calculates the estimated primary and secondary insurance portions, write-off, and guarantor portion for each procedure as needed when it is posted or edited or when actions that cause transfers of responsibility to occur, such as patient and insurance payments. When changes that affect insurance estimates occur at the organization or location level, the estimates for unpaid procedures are not recalculated automatically; however, Dentrix Ascend does notify you that updated insurance estimates available are when you access an applicable patient's record. Changes to the following can trigger this notification:

• The Coverage Table attached to an insurance plan.

• The Coverage Start or Coverage End date on a patient's Insurance Information page.

• The Maximum Benefits or Required Deductibles for an insurance plan.

• The Max allowable amount fee schedule for an insurance plan (modifying the fee schedule or switching to a different fee schedule).

• The Coordination of Benefits for a secondary insurance plan.

• The Billing Provider from the Insurance Defaults page.

• The Contracted with status on a provider's User Account Information page.

To recalculate insurance estimates for unpaid procedures

1. If updated insurance estimates are available, the Ins. est. update available flag appears when you access of the following pages in a patient's record:

   • How to get there

     1. If the correct patient is not already selected, use the Patient Search box to access the patient's record.

        Note: You can include inactive patients in the search results by setting the Include inactive patients switch to On.

     2. Do one of the following:

        • On the Patient menu, under General, click (or tap) Overview. The patient's Overview page opens. Click (or tap) the Ledger box.

          

        • On the Patient menu, under Financial, click (or tap) Ledger.

        The patient's Ledger page opens.

     The Ledger page.

     

   • How to get there

     1. If the correct patient is not already selected, use the Patient Search box to access the patient's record.

        Note: You can include inactive patients in the search results by setting the Include inactive patients switch to On.

     2. Do one of the following:

        • On the Patient menu, under General, click (or tap) Overview. The patient's Overview page opens. Click (or tap) the Ledger box.

          

        • On the Patient menu, under Financial, click (or tap) Ledger.

        The patient's Ledger page opens.

     3. Click (or tap) the amount in the Patient Portion box.

        

        One of the following occurs:

        • If you are viewing the Ledger with the patient view, the Patient Portion page opens.

        • If you are viewing the Ledger with the guarantor view, the Guarantor Portion page opens.

     The Patient Portion or Guarantor Portion page (Ledger).

     

   • How to get there

     1. If the correct patient is not already selected, use the Patient Search box to access the patient's record.

        Note: You can include inactive patients in the search results by setting the Include inactive patients switch to On.

     2. Do one of the following:

        • On the Patient menu, under General, click (or tap) Overview. The patient's Overview page opens. The Treatment Plan box displays the patient's treatment plans. Click (or tap) a treatment plan. Skip step C.

          

        • On the Patient menu, under Clinical, click (or tap) Treatment Planner.

        The patient's clinical record opens with the Tx Planner tab selected.

     3. Under Active, select a case.

        The procedures that belong to the selected case appear.

     4. Click (or tap) Preview.

        The treatment plan appears.

     5. Click (or tap) the amount next to Estimated guarantor portion.

        The Guarantor Portion page opens.

     The Guarantor Portion page (Treatment Planner).

     

2. Click Ins. est. update available.

   The Insurance Estimate Update Available pop-up box appears.

   

3. Click Update.

   Note: Updating the estimates for unpaid procedures does not update the estimates for procedures that have automatic insurance estimates turned off, so the estimates for those procedures may need to be updated manually.