Viewing the details of an estimated guarantor portion for a treatment plan

When you are previewing a patient's treatment plan, you can view details of the estimated guarantor portion for the treatment-planned procedures. For each charge listed in the view, you can see the charged amount, the remaining insurance portion, the applied credit adjustments and payments, and the remaining balance.

Viewing the details of an estimated guarantor portion for a treatment plan

1. While previewing a patient's treatment plan case, clicktap the amount next to Estimated guarantor portion.

   

   The Guarantor Portion page displays.

   

2. On the Summary View tab, review the columns in the Tx Case section for each treatment-planned procedure listed.

   • Charge Description - The description of the charge and the date of service.

   • Patient Name - The patient whom the charge corresponds to.

   • Charge Amount - The charged amount. This charge is based on the provider's fee schedule. If there is no fee schedule attached to the provider, it is based on the location's fee schedule.

   • Insurance Portion Remaining - The estimated insurance portion.

   • Credit Adjustment Amount - This is always zero (0.00) for a treatment-planned procedure.

   • Payments Made - This is always blank for a treatment-planned procedure.

   • Guarantor Portion - The estimated guarantor portion.

3. If necessary, clicktap the Detailed View tab and review the columns in the Tx Case section for each treatment-planned procedure listed.

   Note: You may have to scrollswipe horizontally to see every column.

   • Charge Description - The description of the charge and the date of service.

   • Patient Name - The patient whom the charge corresponds to.

   • Charge Amount - The charged amount. This charge is based on the provider's fee schedule. If there is no fee schedule attached to the provider, it is based on the location's fee schedule.

   • Primary Allowable Amount - The contracted amount according to the primary insurance plan's fee schedule.

   • Primary Coverage, % - The percent covered according to the primary insurance plan's coverage table. If the percent is a link, you can clicktap it to view the applicable coverage exception.

     

   • Primary Deductibles Remaining - The unmet portion of the primary insurance plan's deductible that is to be paid by the patient.

   • Primary Insurance Portion Remaining - The estimated primary insurance portion. If the amount is a link, you can clicktap it to view the remaining primary plan benefits prior to the primary insurance carrier paying for the charge but after what is expected to be paid by the primary insurance carrier for any outstanding charges listed before this charge.

     

   • Secondary Allowable Amount - The contracted amount according to the secondary insurance plan's fee schedule.

   • Secondary Coverage, % - The percent covered according to the secondary insurance plan's coverage table. If the percent is a link, you can clicktap it to view the applicable coverage exception.

     

   • Secondary Copayment, $ - The copay according to the secondary insurance plan's coverage table. If the amount is a link, you can clicktap it to view the applicable coverage exception.

     

   • Secondary Deductibles Remaining - The unmet portion of the secondary insurance plan's deductible that is to be paid by the patient.

   • Secondary Insurance Portion Remaining - The estimated secondary insurance portion. If the amount is a link, you can clicktap it to view the remaining secondary plan benefits prior to the secondary insurance carrier paying for the charge but after what is expected to be paid by the secondary insurance carrier for any outstanding charges listed before this charge.

     

   • Credit Adjustment Amount - This is always zero (0.00) for a treatment-planned procedure.

   • Payments Made - This is always blank for a treatment-planned procedure.

   • Guarantor Portion - The estimated guarantor portion.

4. (Optional) From either tab, you can expand the Ledger Items (Guarantor Account) section and view the same information for completed procedures in the Ledger with the following differences.

   • Credit Adjustment Amount - The total amount of any applied credit adjustment(s).

   • Payments Made - The total amount of any applied payment(s) (insurance and patient).

   

   Notes:

   • The Ledger Items (Guarantor Account) section only displays charge(s) with a remaining balance (insurance and/or patient).

   • The charge(s) for completed procedure(s) are for the selected patient, the patient's guarantor (if different), and other patient(s) who have the same guarantor. The charge(s) for treatment-planned procedure(s) is only for the selected patient.

   • The Guarantor portion for this Tx Case amount only applies to the selected patient. The other totals at the bottom apply to the patient, the patient's guarantor (if different), and other patient(s) who have the same guarantor.

   • The insurance portions, credit adjustments, and payments display as negative numbers to clarify how they affect the guarantor portion of the charge.

5. To return to the preview of the treatment plan case, clicktap Back to Tx Case Preview.