Which Insurance Setup Should You Use in Dentrix? Here’s My Take

Hi, I’m Dayna Johnson, your go-to Dentrix expert and dental workflow optimizer. If you’ve ever found yourself confused about how to set up insurance plans in Dentrix when you’re in network, you’re not alone. It’s one of the most common questions I get from dental teams across the country.

The truth is, there are two methods for setting up in-network insurance in Dentrix: the fee schedule method and the allowed amount method. Both can give you accurate estimates, but they function differently and can dramatically affect how your reports look, how your team handles adjustments, and even how patients perceive their treatment estimates.

Let’s break it down.

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Fee Schedule Method: Clean and Net

The fee schedule method links your contracted, in-network fees directly to the insurance plan, not to the patient. When you use this method, Dentrix posts your in-network fees to the ledger and the treatment plan, meaning your production numbers on reports, appointment books, and day sheets all reflect net production. That gives you a clean view of collectible dollars without the fluff of inflated numbers.

This method also eliminates PPO adjustments on your ledger. Since you’re already posting the contracted fee, there’s no need for write-offs after the insurance payment comes in. It simplifies your reporting and makes it easier to track performance.

However, your team must be well-trained in reading EOBs (Explanation of Benefits), because the insurance will still reference your full fee on claims, even though you’ve already posted the discounted one. You need to know not to apply the adjustment twice.

In my opinion, Medicaid plans are a perfect match for this method. Medicaid fees are typically very black and white, and using the fee schedule method ensures you don’t artificially inflate your production numbers. It gives you a realistic picture of your practice’s performance, especially if you’re heavily dependent on government plans.

Allowed Amount Method: Transparent and Flexible

With the allowed amount method, Dentrix posts full fees to the ledger, treatment plan, and appointment book, while still calculating insurance estimates using the in-network contracted amount. You’ll copy the contracted fees into the “allowed amount” fields in the insurance setup, rather than attaching a fee schedule.

This method keeps adjustments visible, which is a big plus for many practices. Why? Because patients see the insurance write-offs on their walkout statements. If you’re in a state that lets you bill full fees for non-covered services or when patients go over their annual maximum, this method makes a lot of sense. You’re already posting full fees, so there’s no messy backtracking later when an EOB tells you a service wasn’t covered.

But remember, using this method means you’ll be taking manual adjustments when EOBs come in, and that requires discipline and accuracy from your team.

My Honest Advice: Pick One and Stick With It

Here’s the deal. I don’t care which method you use. Seriously. Both will get you accurate estimates. What matters most is consistency. Choose one method that works best for your practice and stick with it 100 percent of the time.

Your reports will look different depending on the method you use. So before deciding, ask yourself: Do you want to see net production or full gross production? Do you want patients to see adjustments? Are you dealing with Medicaid or private PPOs?

Both methods require ongoing maintenance. That includes keeping fee schedules current, training your team to read EOBs accurately, and understanding how Dentrix interprets insurance data. But with the right setup and a bit of training, your office can run like a well-oiled machine.

And if your team needs help understanding the ins and outs of Dentrix insurance workflows, that’s exactly what I’m here for. Reach out via email or DM. My contact info is in the show notes. Let’s get your team aligned, your estimates accurate, and your practice running at high performance.