Category Percentage Insurance Plan
Set up an out-of-network Insurance Plan Type when you are NOT contractually obligated to reduce your fees. This is a traditional percentage insurance plan.
In this setup, estimates and procedure fees will be based on the provider's fee schedule.
On the Insurance Plan, set the following:
Even if you are not contractually obliged to follow out-of-network fees, you can get more accurate insurance estimates by using them.
Benefits: Percentages will be based on the out-of-network fee schedule. If the published fee schedule shows exact amounts that will be paid, set category percentages to 100%.
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 amounts your office charges above the published fees. If desired, you can update out-of-network fees as you enter claims and payments.