Preliminary Definitions
Insurance Fee: This is the fee from the Fee Guide listed in the insurance plan
Percentage: This is the coverage percentage defined in the Coverage Table in the insurance plan
Deductible: This is the deductible defined in the Insurance plan
FEE: This can be either the Secondary Insurance Fee, OR the total for the procedure on the invoice/tx plan. The smaller of these two numbers will be used
Primary Insurance Estimates:
(Insurance Fee - Deductible) * Percentage
Secondary Insurance Estimates:
(FEE - Primary Insurance Estimate - Secondary Deductible) * Secondary Percentage
Other Considerations
Other fields in the insurance plan like the Payment Table, or Plan Details can prevent a calculation from happening, or over ride a calculation with a preset number.
It is also a good idea to look at the remaining maximums and deductibles in the insurance drop down in the sidekick to ensure that we are using a correct deductible amount and that the patient is not out of benefits.
Insurance estimates in billing will not be deducted from the remaining maximum in the insurance drop down in the sidekick. However any estimates in charting will only calculate up to the remaining maximum minus the estimates in billing.
Maximum in insurance available in charting = Remaining maximum - Insurance estimates in billing
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