A patient’s Insurance Plan can be edited by selecting their name on the Patient Lookup and clicking on GoTo on the menu bar. Select either Primary or Secondary Insurance Plan. This can also be done from their Patient Information screen. The patient’s Insurance Plan can be also be edited from their Transaction screen.
The UCR% column is used when a percentage of the doctor’s fees must also be calculated and added to the patient’s co-pay amount. The percentage amount that is entered under this column will be added to the patient portion on the Transaction screen.
Note: The UCR% column will not appear in the insurance plan window unless you have selected Capitation Plan in the Employer Information screen in the Plan Type field.
After you mark the plan as a “Capitation Plan”, you will do the following in the insurance plan window:
- Enter the patient’s co-pay amount under the P.Fee column
- Enter 0.00 under the P.Cov% column.
- Enter 0.00 under the P.Max column.
- Enter the percentage of the doctor’s fee that need to be calculated under the UCR% column. MOGO will calculate the UCR% of the doctor’s usual fee and add that to the patient’s co-pay (which you listed under the P.Fee column). The total of these two amounts will be added to the patient portion on the Transaction screen.