Editing Insurance Plan Exceptions

Nearly every insurance plan has some restrictions and limitations. Some procedures will have downgraded coverages, and others will have limitations on the patients’ age and/or the number of times a procedure can be covered when performed repeatedly. The Exceptions Table is a great place to document and track these types of rules and exceptions, for both in-network and out-of-network insurance plans.

Watch the following video to learn how to edit insurance plan exceptions. (Duration 2:19)

Additional Tips

• • If you need to find exception rules quickly, enter the codes (or words) in the Search Bar (at the top of the screen) that you want to search for.
  • With a blank exceptions table open, you can apply a template of well-known exceptions to it. To load the template in the Exceptions tab, click the Insert Exceptions Template button. From here, you can edit any exceptions as needed.
  • Clicking the Undo button removes ALL changes made to the exceptions table since it was last saved. And once selected, it cannot be undone.
  • When some procedures within a selected procedure code range have different rules or exceptions, use the Split option to make two additional copies of the selected line. Then, fill in the blanks to subdivide the range of codes and customize or make any needed modifications to each range. To learn more about this function, read Splitting Exceptions in the Exceptions Table in Dentrix Help.
  • If you find a range of codes with an identical rule that you want to use with another range of codes, you can save entry time by selecting that range and then choose Copy. The row will be duplicated. Then, update the procedure code range on the duplicated line. To learn more about this function, read Copying Exceptions in the Exceptions Table in Dentrix Help.
  • To learn more about editing insurance plan exceptions, read the following topics in Dentrix Help:
    • Creating Exceptions Tables
    • Adding Exceptions to the Exceptions Table
    • Editing Exceptions in the Exceptions Table
    • Deleting Exceptions in the Exceptions Table

Check Your Knowledge

If you have access to Dentrix, check your knowledge with this exercise.

• • 1. Switch to the Dentrix demo database.
       (Skip this step if you are using the Dentrix Learning Edition software.)
    2. Open the Office Manager and select the Guardian, U.S. Government plan.
    3. Add the exceptions template to the plan.
    4. Add, edit, split, copy, or delete the plan as you see fit.
    5. Save your changes and return to the Office Manager.
    6. Open the Exceptions Table for the Guardian, USPS plan, and copy the exceptions table from Guardian, U.S Government to the USPS plan.
    7. Save and return to the Office Manager.