The Insurance Coverage Tables Report lists the dental insurance plans in your Dentrix Enterprise database and the details of their corresponding coverage tables.
|
Why: |
To ensure that the coverage tables have been set up correctly for each insurance plan |
When: |
After Dentrix Enterprise setup, and as needed |
Note: Generating a report in Office Manager requires the "Reports" security right. Viewing or printing a report in the Batch Processor requires the "Batch Processor, Print/Display Reports" security right.
To generate the Insurance Coverage Tables Report
In Office Manager, on the Reports menu, point to Reference, and then click Insurance Coverage Tables.
Notes:
Whether the reference reports appear on the menu or not is determined by a setting.
Also, this option is available only if your user account has been granted the "Reports" security right.
The Insurance Coverage Tables dialog box appears.
Set up the following options:
Report Date - By default, today's date appears in the box, but you can enter a different date. The specified date appears at the top of the report.
Select Insurance Carrier - To specify which insurance carriers appear on the report, do one of the following:
To include all insurance carriers, leave <ALL> entered for both From and To.
To include a specific range of insurance carriers, select the starting insurance carrier (alphabetically by name) of the range for From and the ending insurance carrier of the range for To.
To include a specific insurance carrier, select the same carrier for From and To.
To include an open-ended range of insurance carriers, select a carrier for either From or To, and leave <ALL> entered for the other option.
To select a insurance carrier for From or To, do the following:
Click
the corresponding search button 
.
The Select Dental Insurance Plan dialog box appears.
Under Search By, leave the Carrier Name option selected.
In the Enter Carrier Name box, enter all or part of a carrier name.
Click
the search button .
Any matching insurance carriers appear in the list.
Select the correct insurance carrier.
Click OK.
Click OK to send the report to the Batch Processor.
Preview and then print the report, or print the report without previewing it.
Important information this report provides
For each insurance plan on the report, the following plan information appears:
Insurance Plan Details - The name, mailing address, group name, and group number of the insurance plan.
The following coverage information for each procedure code range of the insurance plan's coverage table appears:
Cov % - The percentage that is covered by insurance.
Deductible - The type of deductible (None, Standard, Preventive, or Other).
Co Pay - The co-pay amount (for capitation plans only).
Pre Auth? - Whether a pre-authorization is required or not.
Co-Payments Used in Calculations? - Whether co-payments are considered or not in the calculation for the insurance portion of a procedure.
Co-Pay Calculated For Ins Portion:
If co-payments are considered, one of the following methods is used to calculate the insurance portion of a procedure:
Total Fee x Coverage %.
(Total Fee - Co-Pay) x Cov %.
(Total Fee x Cov %) - Co-Pay.
If co-payments are not considered, "None" appears.
