Category Percentage Insurance Plan
Set up an out-of-network Insurance Plan Type when the office is not contractually obligated to reduce its fees. This is a traditional percentage insurance plan.
Blue Book is a a tool that uses allowed fees entered on received claims to update estimates for future procedures. See Insurance Blue Book Setup.
When Blue Book is enabled, Manual Blue Book is the only Carrier Allowed Amount fee schedule available. Manual Blue Book fees may or may not be selected based on the hierarchy set up in Insurance Blue Book Setup.
Even if the office is not contractually obliged to follow out-of-network fees, offices can enter the fees in order to get more accurate insurance estimates..
All fees on procedures will show the provider's fees, but the out-of-network fee schedule will be used for estimates. Percentages will be based on the out-of-network fee schedule. The patient is still responsible for any difference between the office fee and the published insurance fee. If desired, the office can update out-of-network fees as users enter claims and payments.
In this setup, estimates and procedure fees will be based on the provider's fee schedule.
On the Insurance Plan, set the following:
This method will generally provide the least accurate insurance estimates. Insurance estimates will be based on a percentage of the provider's fee schedule .