How Andre Sets Up Primary and Dependent Employer/Coverage Plans in Eaglesoft
Question: A parent has one Employer/Coverage Plan and a completely different Employer/Coverage Plan for their children or spouse, but they are the Policy Holder for both. How do I set that up in Eaglesoft?
Answer: The kneejerk reaction is simply to create a duplicate of the Policy Holder. Make them a Policy Holder connected to kids and boom done. This creates “bad data” with number of Patients, number of Policy Holders in Eaglesoft IMO.
Here is how I would set it up:
The Parent really does have two Employers/Coverage Plans. The second just does not cover them, it only covers dependents. In this situation I create a Primary version of the Employer/Coverage Plan and a Dependent version of the Employer/Coverage Plan.
Remember after entering Primary. you have to Save ("OK") then go back in and add Secondary for it to "stick".
This picture shows the Patent’s set up. The orange box is the Primary Employer with benefits for the parent, and the green box is the “Dependent plan” that will then be connected to each dependent as their Primary plan.
Question: When I submit a claim for the parent, won't their primary wonder about them having secondary insurance on the claim?
Answer: Typically, with this Parent/Dependent plan, they are with the same insurance company. They will see the plans are the same and there is no Coordination of Benefits. Until you send a Primary Claim into the secondary for payment, which you are not going to do. You’re going to close any Parent’s secondary claim.
DISCLAIMER:
This is a resource guide and all decisions on each dental office setup should remain the sole decision of the dentist/owner of the practice. Eaglesoft is a registered trademark of Patterson Dental Company. All other software or products mentioned are the property of their respective owners. Although Andre Shirdan was an employee of Patterson Dental, he is not associated with Eaglesoft or Patterson Dental Company or endorsed by Patterson or any other Company Mentioned in this blog.
