Managing PPO Write-offs in Open Dental

When a patient has PPO insurance, your office must account for the difference between your standard office fee and the insurance-allowed amount. If you do not handle your open dental PPO writeoffs setup correctly, your patient balances will be inflated, and your practice will struggle to reconcile actual collections against expected revenue.

Before You Start

Before you can accurately post write-offs, your insurance plans must be configured correctly. Ensure that the "Insurance Plan" is set to the correct "Fee Schedule" for that specific PPO carrier. If the fee schedule is not attached to the plan, Open Dental cannot automatically calculate the write-off amount when you enter the insurance payment. Additionally, verify that your "Adjustment Types" are set up in Setup > Definitions > Adjustments so you have a specific category for "Insurance Write-off" to track these amounts separately from other adjustments.

Step-by-Step Instructions

Follow these steps in the Account Module to ensure your write-offs are applied correctly when posting an insurance payment.

1. Open the Account Module: Select the patient from the "Select Patient" window.
2. Locate the Claim: Find the claim in the patient's account ledger. Double-click the claim to open the Edit Claim window.
3. Receive the Payment: Click the Receive Payment button. This opens the Enter Payment window.
4. Select Procedures: Click the By Procedure button. This allows you to allocate the payment and the write-off to specific line items.
5. Enter Payment and Write-off: For each procedure, enter the amount paid by the insurance in the "Ins Paid" column. In the "Write-off" column, enter the amount the insurance disallowed.
6. Verify Totals: Ensure the "Total Paid" and "Total Write-off" match your EOB or ERA.
7. Finalize: Click OK to save the payment. Open Dental will automatically create an adjustment for the write-off amount and attach it to the procedure, updating the patient's remaining balance immediately.

Common Mistakes

The most frequent error occurs when staff manually enter a global adjustment instead of using the By Procedure button. If you enter a lump-sum adjustment, it is not tied to a specific procedure, which makes it nearly impossible to audit your production versus collection later. Another common mistake is failing to verify the "Allowed Amount" in the insurance plan setup; if this is missing, the write-off column will remain zero, and the patient will be billed for the insurance's contractual discount.

Related Scenarios

If you need to handle secondary insurance, ensure you understand how to use the "Hold until Pri Received" status to prevent premature billing.

For claims that are partially paid or denied, you may need to use the "Supplemental" button to add additional payments or adjustments to a claim that has already been marked as "Received."

Track all your outstanding claims at a glance with DentalCanvas — a visual dashboard that shows your insurance aging, pending claims, and collection trends in real time.

This article is provided by opendentalsupport.com, an independent community resource. We are not affiliated with Open Dental Software, Inc.