Benefit Plan Entry Screen - page 2
Page 2 of the Benefit Plan Entry screen contains items that pertain to insurance benefits. These items are specifically used by the program when in the Automatic Benefit Calculation mode. Even if you don't use automatic benefits, these fields can be utilized for your own reference. This information is usually obtained from the patient's benefit booklet provided by the carrier or employer.

Maximum
Enter the plan’s Maximum benefit. You will further indicate if the Maximum pertains to a Single Patient or an Entire Family.

Deductible
Enter the plan’s Deductible. Again you are asked to indicate if the Deductible pertains to a Single Patient or an Entire Family.

Renew Maximum, Renew Deductible
Maximums and Deductibles usually renew yearly and usually in January. This is called the Plan Year. At the beginning of each new plan year the patient has available his or her full Maximum and Deductible. During the year as treatment progresses, the Deductible is eliminated and the available Maximum begins to dwindle. When the "Plan Year month" rolls around again, the program restores the Maximum and Deductible to their original plan values and the process begins again. Setting the plan year is done separately for Maximum and Deductible since they are not always the same. The options are the months, January through December will an additional choice of Lifetime. Use Lifetime is the plan has a Lifetime Maximum and/or a Lifetime Deductible. In that case no renewing will take place.

Preventive Waived
Some insurances do not consider the Deductible when the posted procedure is categorized as Preventive. You use the Procedure Table Entry screen to setup your procedure file. On this screen you have to ability to designate procedures as Preventive, Basic, or Major. If the insurance waives the deductible for Preventive procedures, indicate that here by clicking on Yes.

Auto Benefit Ready
The Auto Benefit Ready item indicates if the Benefit Plan has been filled out sufficiently to properly calculate Automatic Benefits. For example, if you have a Deductible of $0.00, that may indicate that you actually have a zero Deductible, but it may also be the result of not knowing what the Deductible is. The only way for the program to know that you have entered all the information needed to make a proper calculation is by indicating Yes for the Auto Benefit Ready option. Automatic Benefits will not calculate if this choice is marked not marked Yes.