A SIMPLE WAY TO DOWNGRADE POSTERIOR COMPOSITES
Posterior Resins are typically one simple deviation from most Employer plan percentage coverage. These four codes are covered at a percentage of another procedure (amalgam) but, there is a very simple way to get these four codes to calculate estimated coverage.
For In-Network Providers the process is very simple.
Get a list of Allowances for Amalgams.
Create a Coverage Book that will be used for ALL Employers under a specific In-Network Insurance Company.
Add all four Posterior Composite Codes to the Coverage Book.
In the UCR Column enter the allowable fees for each corresponding Amalgam equivalent.
In the Coverage column, use the drop down to select Ignore. This option will use the percentage in each individual Employer field to apply a percentage for estimation.
Apply the deductible (in most cases)
I do suggest that office create Service Types for Posterior Resins.
Start with creating a new Service Types (File>General Setup>Service Types) for Restorative – Post Resin.
As you create these types you can set a Default Percentages of coverage. I would set them at 80%. I would also mark that the Deductible Applies.
DISCLAIMER:
This is a resource guide and all decisions on each dental office setup should remain the sole decision of the dentist/owner of the practice. Eaglesoft is a registered trademark of Patterson Dental Company. All other software or products mentioned are the property of their respective owners. Although Andre Shirdan was an employee of Patterson Dental, he is not associated with Eaglesoft or Patterson Dental Company or endorsed by Patterson or any other Company Mentioned in this blog
