Enabling or disabling payment tables for insurance estimates

You can allow the amounts entered for procedures in payment tables to override percentages in coverage tables for insurance estimates, or you can prevent payment tables from affecting insurance estimates.

Notes:

  • Changing the payment table option affects all locations in your organization.

  • Viewing the ledger options, including the payment table setting, requires the "Preview ledger options" security right.

  • Enabling or disabling payment tables for insurance estimates requires the "Manage ledger options" security right.

To enable or disable payment tables

  1. On the Settings menu, select Ledger Options.

    The Ledger Options page opens.

  2. Select the Ledger Rules tab.

  3. Under Insurance Estimates & Write-Offs, set the Enable Payment Tables switch to one of the following statuses:

    • Yes - Payment tables can be used for calculating insurance estimates in your organization.

      Notes:

      • If there is an override at the procedure level, that amount is used as the insurance portion instead of the amount in the payment table.

      • If the procedure exists in the payment table, that amount is used as the insurance portion.

      • The write-off for the remaining amount is based on the coverage table.

      • Whether or not payment tables are used, the insurance portion cannot exceed the procedure amount, the patient portion is equal to the procedure amount minus the sum of the insurance portion and the write-off amount, and estimates take used benefits and deductibles into account.

      • When you are viewing estimate details, if a payment table is in use for a procedure, that procedure’s amount is orange, and if you click the amount, a Payment Table In Use pop-up message appears for your reference.

    • No - Payment tables do not affect insurance estimates.

      Note: A message appears in the payment tables of insurance plans to indicate that payment tables do not affect insurance estimates.

  4. Click (or tap) Save.