Home User Manual Discussion Forum Search

Same Plans with Different Coverage Levels 

Insurance Plans that provide different coverage levels by patient can be handled with patient overrides.

Examples:

  • Incentive plans: First year of coverage: 70%. For each year after, coverage increases by 10%.
  • Adults or subscribers covered at a different level than children or dependents.

Setup

  1. Enter the insurance plan for the subscriber with the subscriber's benefit information.
  2. Add the insurance plan to other family members (non-subscribers).
  3. For family members that have a different coverage level, add an Other Benefit.
    a. On the Edit Insurance Plan window, double click Benefit Information.
    b. Click Add under Other Benefits.

c. Check Patient Override.
d. Select the category affected.
e. Enter the percentage covered for this year.
d. Select a Coverage Level of Individual.
e. Click OK.

In the benefit grid this benefit row will have an X in the Pat column to indicate it applies to this patient only. In this example, restorative procedures for this patient are only covered at 50%.


 

Open Dental Software 1-503-363-5432