View Benefit Plan screen – page 1 | page 2 | page 3 , View Video, 2 min. 15 sec.

Auto Benefit Ready
This is only significant if you are using the Automatic Benefit Calculation mode in Posting.  The item indicates if the benefit plan has been filled out sufficiently to properly calculate Automatic Benefits.

Payment Base
The Payment Base indicates whether an insurance plan is operating on a UCR percentage or a pre-set benefit schedule.  UCR stands for Usual, Customary, and Reasonable.  The insurance carrier will pay a set percentage for Preventive, Basic, and Major procedures based upon whatever your office fees are, as long as they are "reasonable" fees.  If a benefit schedule is used the carrier should supply you with a listing of benefits indicating what the benefit is per procedure code.  These benefits are usually listed in the form of a published benefit schedule.  In this case your office fee is not a consideration unless the benefit is larger than your fee.  In that case the benefit will be reduced to equal your fee.  This glorious anomaly does not happen very often.

UCR Rate Coverage
If the Payment Base is UCR then enter the appropriate percentages for Preventive, Basic, and Major procedures.  Some insurance carriers consider Single Crowns (free-standing, not part of a bridge) to be Basic procedures and others consider them as Major.  Indicate Basic or Major in the Single Crown field. In addition to Single Crowns, you may indicate if this insurance plan considers Perio, Endo, or Oral Surgery to be covered a Basic or Major percentages.

Schedule Of Benefits
If you select the Schedule of Benefits instead of UCR, you will bring up the Benefit Schedule Entry screen to enter the benefit schedule into the computer.

Benefit Plan Entry Screen - page 3
Page 3 of the Benefit Plan Entry screen primarily contains items that pertain to insurance eligibility.  These eligibility items are not required for either insurance printing or automatic benefit calculation.  They are simply for your own information to aid you in the day to day running of the dental office.  These are optional entries.

Policy Number
This is distinguished from the Group Number which is stored elsewhere. Some carriers may require some additional identifying number.  If so, you may enter it here.