Suggestion:

INS: Additional DMO type plan features - see comments

Great Expressions: GE-42A Enable 'DMO' plans to have fee schedules, where the fee schedule will be code based and with the ability to: (1) Apply a patient co-pay as a % of UCF, or as a fixed dollar amount, (2) Designate a supplemental amount (insurance fixed dollar amount) and (3) Designate an "Insurance Guarantee" amount (not the same as chair-hour guarantee), which will be used to generate insurance claims under the formula = Insurance Guarantee - Patient co-pay. E.g. A procedure w/ UCF $800, patient co-pay of 20% ($160), and an Insuraance Guarantee of $250 results in patient charge of $160 and an insurance charge of $90 ($250-$160). Using the same example with the change to a co-pay of 40%, the result would be $320 charge to the patient and $0 to the insurance.

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