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welcome to the adding insurance webinar this is an introduction to adding an insurance plan and open dental this training will let users see how to add insurance plans to existing patients at the end of this training you should be able to add an existing insurance plan to a patient create a new insurance plan and add insurance benefits to an insurance plan so in the open dental for patient Gordon Jones we're going to add an insurance plan to Tennessee we will do that by first making sure selected in the family module and then clicking the add insurance button will first be asked if the patient is the subscriber in this case we will be saying yes if we were to say no then we'll be prompted to select another patient from the family or from your patient list as the subscriber this time we're just going to say yes so we'll be creating a new plan first thing to do when you add an insurance plan is to click on this pick from a list button this will allow you to choose an insurance plan that is already entered into your database that way you can avoid making unnecessary duplications of insurance plans so we'll put the paperless button in this window we can search for an existing insurance plan I filtering by employer remember carrier good name or plan number in this case I'm just going to search by carrier for a midlife plan though see we have two MetLife plans currently in our system we'll go ahead and choose this one I like and click OK and you'll notice that all of that insurance plan information automatically populates and attaches to Gordon Joe Jones from here all we need to do is enter a subscriber ID number right under Gordon's name on the right side and in Gordon we're not the subscriber on this plan we'd also be asked to select a relationship to this subscriber in this case he is the subscriber so we'll just leave it at itself and we'll click OK and now he has this MetLife plan and we'll be calculating insurance benefits on any treatment plan that was yours we're gonna move on to red farming and we're going to add an insurance plan brand new insurance plan to him so again in his family module we'll be clicking the add insurance button and yes these are subscribers so again we're going to create a new plan so again we will be searching through our pick criminalist just to make sure we don't have any duplicates so currently we don't have any other Delta carriers listed in our system so this is a good indicator that we can start from scratch and not have any duplications so in order to do that we can enter employer information and we can start populating carrier address phone number and electronic IP so probably a filter insurance ad phone number and a billing address we can search through a list of pre-populated electronic hey your IDs for electronic things and it will be selecting our Delta Dental organ in this case we have the option to tell open dental whether or not we want to send this insurance these insurance claims electronically to this carrier this will vary by carrier we can send electronically we can not send electronically or we can just limit only primary claims to go electronically we'll just leave Addis and all planes electronically we can enter a group name this is not a required field and open dental and is a great way to list insurance plans with maybe one more than one benefit tier so we could call this warehouse or maybe gold plant you could have another one for silver which maybe has either a lower and you'll mess no more different benefits so it's a great way to keep differences within the same group group number separate and we enter a group number this field here other subscribers will keep track of all other subscribers that are attached to this plan currently there are none because we're just setting this up from scratch now next you have plan type information this is where you'll need to know how your insurance plan works we have several options we have options for in-network out-of-network medicaid or flat copay some capitation we also have an option for fixed PPO fix benefit plans we're gonna leave this one as a PPO indicating that we are in network and we're going to be attaching at Delta Dental all that Amell fee schedule is our contracted fee schedule for more information on the differences between how these plans function you can view our insurance plan types whether there is an option further below to add different types of fee schedules as well so we have a field to add a patient copay fee schedule would add that if patient is expected to pay a particular portion for each procedure and/or visit and there's also the carrier on loud amounts this would typically be used for an out-of-network insurance plan below that we have planned notes any notes entered into this field would be carried over to each subscriber that signs up with this plan something like a missing choose class so it is not subscribers specific it is planned specific we also have a field or subscriber notes that would limit the notes within that field to show on the subscriber and any relevant any other family members that would also be attached to this subscriber we do have two buttons here on the very bottom one is a create new plan if needed and the other is change plan for all subscribers if you were to come in and change any billing information for this such as a group name maybe you finally found somebody who has a silver option for the warehouser plan with the group number of 895 6 to 3 you can create a new plan if needed that way it would not affect other subscribers on the attached to the gold plan or you can just change it for everybody that's attached that would be specific to having any billing information changed here on the right side excuse me left side and if an information we move up here on the left you can double click into the benefit information grid and it will bring up the simplified view here in this window we can enter plan details such as individual maximum general deductible even family deductible those fields unfunctional we do have two boxes for limitations on fluoride and sealants through age whatever you enter here this would be specific to ages through that age not up to so of flora were covered up to age 15 and floor and dental you would enter as Florida through age 14 all the way through same thing with still is that number may be the same or different again that would depend on your insurance plan frequencies we have the ability to set frequency limitations on these types of procedures and we have four options on how to read that you would replace that little hashtag sign in the center here with whatever number you put in the blank field so who were to put a one four by twinks it would read every one year they can have right wing's once a year or it could read every number of months so every six months or we have the option to enter two total in the last twelve months so it would be a revolving twelve months the same options exist for your panel there's a little bit more standard every five years and exams two per benefit year if you click the more button you'll see that we have similar type frequency limitations for a variety of other treatments that we do in the dental office there is a section for a separate orthodontic lifetime maximum covered at a percentage through age ninety nine months name's Elijah and benefit we also have the option to add deductibles to preventive services as needed by default open dental is assuming there's no deductible for diagnostic and routine procedures the ductal would apply starting with x-rays and fillings and online we can change our benefit coverage level quickly you'll notice we have several fields one for each category and then we have the quick percentage we make a change in the quick percentage it will quickly change it for all the fields within that section or we need it to be a little bit specific we can just make as needed changes by category the waiting periods and the restorative and no aperio everything below the diagnostic section is functional and it would be looking at the insurance plans effective date so we can say maybe there's a 12 month waiting period on in a restorative work and maybe at 12 month waiting period for any crown and bridge we do have the option in the other benefits window to add exceptions exclusions or overrides as needed we have more information on how to use and how to set up other benefits on our website and the notes section at the bottom would be the same as the subscriber notes so any notes that you enter here would be specific to the subscriber or family member so when I say okay to that you'll notice it shows in the subscriber knows moving up you can sign up for an electronic benefit requesting the service you would do that simply by clicking request after you have the service and it can launch an interface that you can import some benefits from your insurance carrier through your Clearinghouse it does require some human interaction to make sure that you are importing correct benefits and not contradictory information the benefits verify button we can indicate that we have called to verify patients insurance and if it's an eligibility we can mark that now that does work with the verification list in your appointment module effective dates so this would be mostly informational unless you want it to use or to use it to calculate waiting periods within your benefit information so let's say this is a new plan for red and we'll just leave the back the the to date open-ended because it doesn't have an end date he's just going to continue to use this plan again we would enter subscriber ID and now moving up into the green area on the right side we do have the ability to add adjustments to insurance benefits this would be indicated for patients that maybe came from a different office mid-year or maybe had some treatment done that a specialists office such as repairs extractions and so on anything that wasn't done in your office but used insurance benefit you would want to indicate that here so that our insurance estimates can continue to be accurate so we'll click the Add button let's just say he zetas $200 at a different office somewhere earlier this year and also met his that no deductible that information would only be active for the current benefit year it will remain as informational that will not affect benefit information after 20 months Cyndi's on the calendar year plan we also have the history button this can track frequency limitations for these limited procedures so on that note let's say he was at a different office this year maybe he already had bite wings we'll call that sometime in April so now our bite Wings will be allowed once every six months not what I said that was every six months he would be allowed to have a bitewing if we make this sooner let's say he was just in not that long ago we would have a note when we treatment plan might means that it does not meet this frequency limitation if there are multiple insurance plans on the account you can have many you can change their order in which they appear here so currently we only have one insurance plan on the account so the order would be one but if we needed to make this secondary we could just type a two in and it would make this plan the secondary plan and again we have relationship to subscriber here on the left side you'll notice we also have other tabs here within the insurance plan including this other insurance info within this plan we have the option to not substitute codes by default open Dental will substitute any posterior composites - around them you can also set up custom codes per plan just by clicking on the substitution codes and adding one maybe your crowns they're all porcelain crowns downgrade to lab pfm clown on rollers sang the millers specifically that would be for this insurance plan only so you do have the option to set up separate boundaries if you check the box then open dental will not calculate the downgrade and the restorative percentage will be calculated based off of standard codes posterior composites specifically PPO substitutions still calculating write-offs if you have a PPO and percentage insurance plan and you're downgrading your posterior composites you ain't still wish to show your write-offs based off of here at standard fee schedules you have the option also to check the box to have the claim so you see our fee regardless of what would build the patient we can mark this insurance plan as hidden if this patient were to use this plan anymore we can just mark it as hidden and fill it with no one else would be naphtha and either we can indicate which insurance claim form this plan would be using if we were to print a claim we have several coordination of benefit rules to keep an eye on for your secondary insurance plans we have more information on how each formation event that rule works on our formation of benefits web manual page do we have this exclusion for you rule this rule dictates how this insurance plan will treat procedures that are not covered by insurance we can set a practice default to be one of these two rules we can do nothing which means if the procedure is excluded or not covered it will still take a write-off if we use the UCR fee role then if the procedure is excluded or not covered open dental mold not take the right off and show the full used RV we also have an ortho tab which is specific for setting up how ortho claims behave you can view more information on how those options work and our ortho claims liver and then finally we have the drop button here at the top when a patient has well just button say okay to this one for now so we've saved infrared this is new insurance plan at some point in the future he may no longer be on this plan and has a different insurance maybe he has switched jobs we would click the drop button in most instances that's the recommended way to remove an insurance plan from a patient if we click the delete and no other subscribers are attached it would delete the entire plan from your system if other patients are attached other subscribers are attached and you click delete it will just remove this from the family for more information on how these insurance plan types affect your treatment plans you can view preview our corresponding webinars on a network insurance setup and networking shredding setup and copay insurance setup thank you