Fee Schedule Setup
Unlimited fee schedules can be set up in EZ2000 Plus Dental. Typically you will set up fee schedules for each insurance company you are contracted with, and for your Usual Customary and Regular (UCR) fees. To enter or import procedure fees for a fee schedule, see Procedure Codes. To print fee schedules, see the Procedure Codes Report.
In the Main Menu, click Setup, Fee Schedules. Or click Fee Scheds on the Procedure Codes window.
Fee schedules already setup are listed.
Type: Filter the fee schedule list by Type.
Up/Down: Reorder fee schedules in the list. The sort order here determines the sort order in the View Fee Sched list on the Procedure Codes window.
Sort: Quickly sort the fee schedule list alphabetically by type. Normal types appear first, CoPay types appear second, and Allowed types appear last.
Add: Add a new fee schedule.
Clean Up Allowed: This button is only visible to users with the Admin Permission. Delete Allowed fee schedules that are not being used, or are attached to hidden insurance plans. Sometimes useful if you used the Blue Book feature.
Check Ins Plan Fee Schedules Tool: Make sure that insurance plans have the correct fee schedule attached. See Check Ins Plan
Fee Schedules.
Double click an existing schedule to edit, or click Add.
Description: Enter the identifying name of the fee schedule.
Type: Select the type of fee schedule. See Insurance Plan Types for an explanation of how to use Copay and Allowed.
- Normal: Used for in-network fee schedules. These are options in the Fee Schedule dropdown on the Edit Insurance Plan window.
- Copay: Used for patient copays per procedure. These are options in the Patient Co-pay Amounts dropdown on the Edit Insurance Plan window. If selected, this fee schedule will override the patient portion of an insurance estimate. A co-pay fee schedule can have just a few fees on it, with the rest blank. Blank amounts will not affect ordinary insurance estimates. But if the co-pay fee schedule has any amount, including zero, it will override ordinary insurance estimates.
- Allowed: Used for out-of-network fee schedules. These are options in the Carrier Allowed Amounts dropdown on the Edit Insurance Plan window. An allowed fee is the fee allowed by the insurance company. When computing estimates, all percentages are based on this allowed amount instead of on the procedure fee. Blank amounts are ignored and will not change the estimates. But allowed amounts of zero will result in an estimate of zero. Allowed fee schedule entry can be automated using the Blue Book feature.
Hidden: Check this box to hide this fee schedule so it can not be selected.
Fee Schedules for Patients
Fee schedules for a patient are determined using the following criteria in this order:
- By Insurance Plan Fee Schedule
If the patient has insurance, this fee schedule takes precedence over other fee schedules. When there is more than one insurance plan, the plan listed first in the Family module is used (order = 1 on the Edit Insurance Plan window). If the procedure code is a medical code, but the patient doesn't have medical insurance listed first, then all insurance plans are ignored. Similarly, if the procedure code is a dental code, but the patient doesn't have dental insurance listed first, then all insurance plans are ignored. - By Patient Fee Schedule
If a fee schedule is set in the Edit Patient Information window, this fee schedule is used. This is rarely used. - By Provider
Every patient has a provider, and every Provider should have a fee schedule. So if no other fee schedule is set for the patient or for the patient's insurance, then the provider fee schedule is used. - Rarely, such as after a conversion, a fee schedule is not set for the patient's provider. In this case, to prevent malfunction, the top-most fee schedule listed in the Fee Schedules list (which is not hidden) is used.
