Andre's Service Types and How to Modify Yours for Better Estimates In Eaglesoft
Updated February 11, 2024
So many practices have asked me if I have an Insurance Breakdown Form. There are several that have been posted in the Eaglesoft Field Guide and across the web. I never really used anything other than the Employer screen in Eaglesoft. What gathering info from a carrier’s website or while on the phone with a representative, I’d transcribe information directly into the fields in the Employer screen. How is that possible? Eaglesoft doesn’t have a place to put information about Sleep Appliances! There’s no way to note if Periodontal Maintenance is covered differently from Scaling and Root Planing! We there is if you use Service Types.
Categories of coverage change from Employer plan to Employer plan and in some states, carriers have categories of coverage like “Preventive Non-covered” (Example: a third prophy in a calendar year).
Setting up Eaglesoft to calculate “Coverage Categories” beyond the three basic “Preventive, Basic & Major” gives the practice a leg up to understanding the breakdowns from carriers. It’s also essential that when the office calls, gets a fax back, or check benefits on a website that there is a place in your PMS to enter that information. What is the good of “knowing” that Occlusal Guards are covered under an Employer plan when, by default, Occlusal Guards are attached to the Service Type “Adjunctive”. The office may have the Adjunctive Service Type set to 0% by default. Simple. Create a Service Type called Occlusal Guards and set it to the percentage covered by that Employer plan.
I do NOT suggest that office add ALL the Service Types listed in the blog post. I ONLY suggest that offices add those Service Types that they would have on their breakdown form.
To edit the list of Service Types go to List>General Setup>Service Types>New or Edit
Below is a list of some of Service Types I have added to offices during my Skill Development days in offices across the country:
Service Types:
Adjunctive
Administrative
Anesthesia – General
Anesthesia - Nitrous
Diagnostic- General
Diagnostic – FMX
Diagnostic - CBCT
Diagnostic – Miscellaneous (for posting working images or imaging known to be “non-covered” by insurance carriers)
Endodontic (you may choose to create a second Endo category if you find that molars are cover as a secondary category)
Guard – Occlusal
Guard - Sleep
Implant – Body (for the surgical placement of the implant body)
Implant – Restorative (for the restoration over an implant)
Oral Surgery (you may choose to create a second Oral Surgery category if you find that “simple” vs “surgical” extractions are covered differently)
Orthodontics – Child
Orthodontics – Adult
Periodontics - General
Periodontics – Maintenance
Preventive
Preventive – Non-covered
Preventive – Fluoride 0-14
Preventive – Fluoride 15-18
Preventive – Fluoride 19+
Preventive – Sealants – Molar
Preventive – Sealants – Premolar
Preventive - Primary
Products (for over-the-counter items dispensed by the office (some of which may be taxable)
Prosthodontics - Fixed – Multi (for bridgework)
Prosthodontics - Fixed – Single (for single crowns)
Prosthodontics - Maxillofacial
Prosthodontics – Removable*
Prosthodontics - Removable – Adj/Repair*
Restorative – Basic
Restorative – Post Resin (you may choose to create another category if you find that premolars are cover as another category)
*Pro Tip: Edit your existing “Prosthodontics – Removable” and change to “Prosthodontics - Removable – Adj/Repair”. That way you only have to change the Service types of actual Dentures and not all the adjustments and repairs, it’s less work.
After creating these Service Types, you must attach them to the Service Codes (File>Service Codes>Edit)
Now when updating Employers, you will have more categories of Coverage (Service Types) to enter coverage percentages (see pic)
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
