Editing the Plan

Your usual fees for service will be shown on the patient Transaction screen when you enter treatment. At the time you enter the insurance payment, an editing window will open so that you can edit amounts based on the Explanation of Benefits (EOB) from the insurance company. The adjustment amount will then be calculated by MOGO.

Your usual office fees will print on the insurance form.

The Approved/Accepted and Allowed/Plan Calculation amounts on the insurance plan window will then be updated for all patients with the same employer, insurance, and group number information at that time.

• Enter the insurance payment as usual on the Transaction screen.
• When the insurance payment distribution window opens, click on the line of treatment as usual.
• The Participating Plan with Adjustment screen will open. A description of each field will be shown on the screen as you move your cursor to the field.
• Based on the EOB, enter the Approved Fee/Accepted Fee, the Allowed/Plan Calculation Fee, the Coverage %, and the Plan Payment (the insurance payment amount). It is important to enter these amounts accurately since the discount amount is calculated based on this information. Tip: Point to each field and a Help screen will explain how information is calculated!
• Click OK. MOGO will ask if you want to save this information to the insurance plan. Click on Yes. The next time you enter this same service code, MOGO will automatically calculate the discount for you!
• MOGO will send a special adjustment code to the patient’s Transaction screen along with the adjustment amount. The adjustment code will contain the group number and insurance company name in the description.

The next time you enter the same code on the Transaction screen, the Estimated Insurance Writeoff code will automatically be added to the Transaction screen. This adjustment code will display the group number and insurance company name AFTER the insurance payment is linked.

Tip: You can right click on the treatment code on the Transaction or History screen to see the Distribution Detail window showing all linked payments and adjustments!

How can I open the Participating Plan with Adjustment screen?

The Participating Plan with Adjustment screen will open automatically when you enter an insurance payment. You can edit the Approved/Accepted Fee, the Allowed/Plan Calculation Fee, the Coverage %, and the Plan Payment fields.

In addition, if you edit the estimated insurance amount for a line of treatment on the Transaction screen, it will also open the Participating Plan with Adjustment screen.