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Fee Schedules

DentOffice allows unlimited fee schedules. Fee schedules names are setup in the Definitions window. From there you can changes the names, add new fee schedules, or hide fee schedules. The fees themselves are changed in the Procedure Code section.

Here are some of the main uses of fee schedules:

* The office standard fees. Set up this fee schedule as the first one in your list. Assign this fee schedule to all Providers.

* PPO fee schedules. You are contracted with a carrier and they supply you with their fee schedule. Name the fee schedule to include the name of the carrier. Assign this fee schedule to any Insurance Plan covered by this PPO. Check the box in the Insurance Plan for 'Claims show UCR fee, not billed fee.' Now, when you print treatment plans, they will show the PPO fee, yet your claims will show the UCR fee as most PPO's request. See Insurance Plan Types for more information on PPO's.

* Non-contracted. For instance, you know the fee schedule for a plan, but you are not contractually obligated to follow it. Set up a new fee schedule with these fees. In the Insurance Plan edit window, set the Fee Schedule to your standard fee schedule and set the Carrier Allowed Amounts to your newly created fee schedule. All fees will then show as your standard fees, but when calculating estimates, the allowed amount will be used in the ClaimProcs window when entering Insurance Payments. There is also a button in the ClaimProcs window that lets you update the fees as they come back from the insurance company. So you can use this strategy even if you don't know their fee schedule ahead of time.

* HMO or Capitation. Use your standard fee schedule for the patient and the Insurance Plan. Set up fee schedules for the patient co-pay portion. Most fees would be empty or zero. But some would have the patient portion, like 5 or 10 dollars. In the Insurance Plan window, set the Patient Copay Amounts to the appropriate newly created fee schedule. Make sure the plan type is Capitation.