Deductibles

Sometimes the deductibles for specific Insurance Plan Categories differ from the general deductible. Below are some common scenarios and how to set them up in Benefit Information.

When the General Deductible does not apply to diagnostic or preventive care, enter 0.00 for both Diagnostic and Routine Preventive deductibles. This is the default.

When the General Deductible applies to diagnostic care but not preventive care, leave Diagnostic blank and enter 0.00 for Routine Preventive.

When the General Deductible applies to all care, leave all Deductibles (if different) fields blank

When the diagnostic deductible is different than the general deductible and preventive work has no deductible, enter the deductible for Diagnostic and 0.00 as the deductible for Routine Preventive.


Q: In what order are deductibles and annual max applied?

A: Deductibles and annual max are applied in the order that claims are created, not by procedure date.