Accurate, reliable insurance estimates

Insurance estimates: a comparison of Ascend, Dentrix and EagleSoft

One of the biggest struggles in almost every dental practice is to provide patients with an accurate insurance estimate. Often, Insuranceoffices enter only their standard fee schedule into their dental software even though they have joined several PPO plans. This causes the front desk team to make their best guess on how much to really collect from patients because they know the estimates are wrong. I have seen one practice even use a calculator for each patient checking out that had restorative or major treatment because they were so dissatisfied with their computer-generated treatment plans.

For the few offices that have entered PPO fee schedules into their dental software to deal with this problem, they also face struggles when entering adjustments and hate it when they have to enter an undercharge because the insurance plan fee is actually higher than expected. Getting the adjustments entered correctly requires a calculator and quiet, and a very sharp insurance manager. And, when an undercharge is applied, patients are often suspect and to explain why this positive adjustment is on their account takes someone with excellent communication skills and a solid understanding of insurance.

Considering these two options, I have recommended Dentrix training that offices enter the PPO fees (see my article outlining the pros and cons of each option) for the last few years placing the higher value on accurate insurance estimates and the team seeing a net production number on the day sheet. However, out of fear, more and more dental offices are choosing to stick with their standard fees only.

So, I was thrilled to find that Dentrix Ascend’s approach to insurance estimates provides you with a “you can have your cake and eat it too” situation. Ascend allows you to enter the PPO fees but only applies them to the insurance estimate, not into the ledger. This is a huge benefit. This gives your patients an accurate insurance estimate on their treatment plan, but doesn’t enter these reduced fees into the ledger. That allows your insurance manager to simply follow the EOB and enter the total adjustment without additional calculations or the worry of undercharging patients.

Here is the comparison between Ascend, Dentrix G series and EagleSoft regarding insurance estimates:

Dentrix Ascend Dentrix G series EagleSoft
You can enter PPO fee schedules Yes Yes Yes
With PPO fees entered, full fee goes into the ledger Yes No – PPO fees go into the ledger No- PPO fees go into the ledger
With PPO fees entered, you get a good insurance estimate Yes Yes Yes
With PPO fees entered, you can follow the EOB adjustment easily Yes No – you must calculate each one No – you must calculate each one

No matter which software you are using, you can get an accurate insurance estimate. However, both Dentrix G series and EagleSoft achieve this by replacing the standard fees for a patient with the PPO fees. So, you need to be prepared to calculate the adjustments accordingly. And, training for your insurance manager is essential.

The great news is that the way Dentrix Ascend handles insurance estimates allows offices to provide an accurate treatment plan and collect the right amount every time, without the extra work of dealing with the PPO fees in the ledger. If you are struggling with your insurance estimates- and especially if you are a multi-location group, this is a great reason to seriously consider switching to Ascend.

Check out my Free Resources

If you’re managing a dental practice and want organized systems for easier dental staff training, then check out my Collections System and how to Set Up a Recall System. Once these internal systems are in place, you may want to focus on marketing with a system for New Patient Referral Tracking and handling patient complaints.

And, if you’re interested in a comprehensive approach to run your dental practice and train your team, visit Dental Staff Training Levels.

The key is to continue making changes until you achieve the staff expense ratio that allows your practice to run profitably.

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AUTHOR: Jill Nesbitt
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