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Updating Insurance Plan Information

When a patient's insurance plan information or benefits change, updates also need to be made within Open Dental. The steps to take depend on the scenario.

Dropping a Plan: If a patient has a brand new plan, employer, carrier, etc., we recommend Dropping the Plan, not changing an existing plan. Dropping a plan will not change historical information, but changing plan information can. If in doubt, drop the plan, don't change it.

WARNING: When editing plan information via the Edit Insurance Plan window, always make sure the correct radio button for 'create' or 'change' is selected.

Create new plan if needed: When Insurance Plan Information Fields change, a brand new plan is created.
Change plan for all subscribers: When Insurance Plan Information Fields change, the plan will change for all subscribers.

Change Employer Name
If an employer's name changes, update it via the Employer List. It will be updated for all patients with the plan.

  1. In the Main Menu, click Lists, Employers.
  2. Double click the employer to open the Edit Employer window.
  3. Change the name.
  4. Click OK to save.

Note: If employer information is changed from within the Edit Insurance Plan window, a new employer is created.

Change Carrier Information (e.g. address, phone)
Always change carrier contact information via the Insurance Carrier List. It will be updated for all patients with the plan.

  1. In the Main Menu, click Lists, Insurance Carriers.
  2. Double click the carrier to open the Edit Carrier window.
  3. Change the details.
  4. Click OK to save.

Note: If carrier information is changed from within the Edit Insurance Plan window, a new carrier is created.

Change Plan Information for All Subscribers
When multiple subscribers have the same plan, you can change plan information for all subscribers at once. Usually this is only done when plan information is incomplete or inaccurate. Most changes will not affect historical estimates or claims. Changes can made via the Insurance Plan List or from a subscribing patient's Edit Insurance Plan window.

Note: If there is a new carrier for all subscribers on a plan, do not just change the carrier for all subscribers because this will affect historical claims. Instead create a new plan, then move subscribers to the new plan. See Moving Subscribers.

From the Insurance Plan List:

  1. In the Main Menu, click Lists, Insurance Plans.
  2. Double click the insurance plan to open a modified version of the Edit Insurance Plan window (Only Insurance Plan and Benefit Information shows).
  3. Change any insurance plan information or benefit percentages.
  4. Click OK to save.

From a subscribing patient:

  1. Select the patient.
  2. In the Family module, double click the insurance plan to open the Edit Insurance Plan window.
  3. Make sure 'Change plan for all subscribers' is selected.
  4. Change any insurance plan information or benefit percentages.
  5. Click OK to save.

Change Plan for a Single Subscriber
Follow these steps to change plan information and/or benefits for one subscriber only. These steps will create a new insurance plan.

Note: If there is a new carrier, do not just change the carrier because this will affect historical claims. Instead drop the old plan then create a new plan.

  1. Select the patient.
  2. In the Family module, double click the insurance plan to open the Edit Insurance Plan window.
  3. Select the 'Create new Plan if needed' radio button.
  4. Change the insurance plan and benefits as needed.
  5. Click OK to save.

Move Subscribers from One Plan to Another Plan
Moving subscribers is useful at the beginning of a benefit year when insurance plans may change for a group of subscribers. It will move subscribers of one plan to another plan, and drop the old plan. The move is irreversible. See Move Subscribers.

Check/Change Fee Schedule Assignments for Multiple Insurance Plans
Use the Check Ins Plan Fee tool to check which fee schedules are assigned to insurance plans and, if needed, quickly change the assigned fee schedule. Fee schedules can be changed for multiple plans at once. See Check Ins Plan Fee for more detailed steps and the password that is required.

  1. In the Main Menu, click Setup, Fee Schedules.
  2. Next to Check Ins Plan Fee Schedules, click Go.
  3. Review the fee schedules used by each plan.
  4. Select the insurance plan(s) to assign a new fee schedule.
  5. Click the New Fee Schedule dropdown to select the new fee schedule.
  6. Click Change to change the fee schedule for all selected insurance plans. A password is required.

 

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