How Do I Set Up an Insurance Capitation Plan?
Summary:
With a capitation plan an insurance company, an employer and a dental practice agree that for a specific fee, the dental practice will provide professional dental care for all employees of a particular company. A yearly flat fee is paid to the dental office regardless of the number of patients seen or services rendered.
For example, the employees at the Widget Co. Ltd. have accepted a Blue Cross dental plan that covers 100 percent of all dental services for as long as the account holder is employed by Widget. Blue Cross then negotiates with Fairway Dental Clinic to provide full dental services to the employees of Widget for a yearly fee of $100,000. In order to benefit from this insurance plan, employees of Widget must go to Fairway Dental Clinic for dental services.
Steps:
1. Make sure you have assignment setup for System, Plan and Patient. See the Insurance Assignment article in the Knowledge Base.
2. Click File > Update > Insurance > Plans.
3. Click Edit Plan and either select and edit an existing plan, or click Add Plan to add a new one.
4. Click the Plan Type down-arrow and select "C" to indicate this is a Capitation type plan.
5. When the office enters assigned billing they will see:
- The service and the fee in the Treatment tab.
- The service description and the fee in the Financial tab. Directly under the service they will see 'CapWriteOff' with a negative entry for the same.
Product (s): ABELDent
Category: Insurance
Classification: Public
Date Created: 04 September 2015
Created by: Brian Neale