Insurance Payment Does Not Include Lab Fee
Summary:
A Lab code (99111) falls within the insurance Adjunctive class range (90000 to 99999).
In order for lab fees to be paid, you must make sure that the Adjunctive Class in the Insurance Plan is set to M and the Pays column shows 100% (or whatever percentage is allowed by the plan).
If the Adjunctive class in the Insurance plan is NOT set to M, ABELDent will NOT calculate lab coverage in assignment offices and will NOT deduct lab from the insurance maximums and will not place the lab fee on the assigned balance.
More Information
Steps:
1. Click File > Update> Insurance > Plans.
2. Click Edit Plan.
3. Click on the plan in the list .
4. Go to Adjunctive in the Classes area and do the following:
a. In the Class column, type “M” for major.
b. In the Pays column, type the percentage payable.
5. Click Apply Now.
Product (s): ABELDent
Category: Insurance
Classification: Public
Date Created: 22 January 2016
Created by: Brian Neale