Different types of Insurance Plans require different settings. When entering insurance plan information, there are four different plan type options and several areas that affect fee schedules.

The links below explain which plan types to use for different insurance plan scenarios and how to set fee schedules and other settings.

For additional help determining what plan type is best for certain scenarios see: Insurance Flow Chart.

• PPO Insurance Plan: For use with in-network plans pays at a percentage. Can track write-offs.
• PPO Fixed Benefit Insurance Plan: For use with in-network plans where insurance pays at fixed amount. Tracks write-offs.
• Category Percentage Insurance Plan: Generally for out-of-network plans. Can be used with or without fee schedules or Blue Book. Does not track write-offs.
• HMO / DMO Insurance Plan with Co-pays (e.g., Texas plans): Track write-offs.
• Medicaid or Flat Co-Pay Insurance Plan: 100% coverage (no percentages, maximums or deductibles). Does not track write-offs.
• Capitation ( HMO / DMO ) Insurance Plan: Office receives a flat fee every month. Patients may pay a flat fee for some procedures and no fee for others.

Also see:

• Discount Plans
• Other Benefits