Troubleshooting Procedure Fees and Insurance Estimates

Many elements contribute to the calculation of procedure fees and insurance estimates. If treatment plan or procedure estimates are inaccurate, below are some troubleshooting hints.

Fee Schedules

Fee schedule can be set in several places and certain settings override others. See Fee Schedule Logic for an explanation of how a patient's fee schedule is determined.

If you recently updated a fee schedule, you may need to update fees.


Below are items to check.

Claims already paid will affect insurance remaining. See Insurance Remaining Calculations for more details about how remaining insurance amounts are calculated.

To see an example of the math behind downgrades, see PPO Insurance Calculations.