If you have been following along with our blog the past couple of days you’re now well versed on the changes coming with Metlife and Connection Dental. One piece of data you must have how much production you have tied to Metlife. If you need that question answered and don’t know what report to run here’s a quick cheat sheet on some of the more major dental softwares.
Remember, you want to know your gross production tied to each insurance company, NOT the insurance income reports. Insurance income reports only show what the insurance company paid you, not what you billed out and that will severely underestimate the impact when analyzing your numbers.
Remember that Tricare is not included in this potential move to Connection Dental so if you can identify how much of your production is tied to Tricare you’ll need to back that out.
Pull your reports based on the last 12 months to get a whole year’s worth of data.
SoftDent does not have production numbers available by insurance company. We’ve continued to request this feature from their software but so far have been told only that it may be available in future releases.
Run the “Utilization Report for Dental Insurance” with the past 12 months in the date range
This report is huge if you run the whole thing but you can specify the first and last Metlife’s listed in the range of insurance companies and then it will subtotal at the end so jump to the last page.
Run the “Insurance Company Productivity Report” and look at the column that is titled “YTD Amount Submitted” . You may have more than one Metlife category showing up so if you do, you’ll need to add all the Metlife’s together.
OD has a great query code to use. Take the code below, copy and paste it and just change the date range
/*claim count by insurance carrier for date range with sum of fees, estimates and paid amounts*/
SET @FromDate=’2011-01-01′ , @ToDate=’2011-12-31′;
SELECT ca.CarrierName, ca.Phone, COUNT(cl.ClaimNum) AS ‘#Claims’,
FORMAT(100*(COUNT(cl.ClaimNum)/(SELECT COUNT(claim.ClaimNum) FROM claim WHERE DateService BETWEEN @FromDate AND @ToDate)),2) AS ‘%Claims’,
SUM(cl.ClaimFee) AS ‘$ClaimFees’,
SUM(cl.InsPayEst) AS ‘$InsPayEst’,
SUM(cl.InsPayAmt) AS ‘$InsPaidAmt’
FROM claim cl
INNER JOIN insplan i ON i.PlanNum=cl.PlanNum
INNER JOIN carrier ca ON ca.CarrierNum=i.CarrierNum
cl.ClaimType<>’PreAuth’ AND (cl.ClaimStatus=’R’ OR cl.ClaimStatus=’S’) AND
(DateService BETWEEN @FromDate AND @ToDate)
GROUP BY ca.CarrierName
ORDER BY ca.CarrierName;