Plan checks on the estimate
Everything that changes the number is listed under the estimate, and every check, with its source, is one tap away.
Updated November 4, 2026
Under the estimate, each plan rule that changes the number has its own note, such as “The yearly maximum runs out with this treatment”. When nothing does, it says No plan rules change this estimate. See every plan check lists every check, passed or not, and where each came from:
| Source | Means |
|---|---|
| Benefits page | Read from the portal page |
| Claims history | Worked out from the history table on the page |
| Plan start date | Worked out from the plan start date, on this computer |
| Your price list | From your office's price list |
| Your network list | From whether you marked this insurer in or out of network |
| Typed by staff | Someone at the desk entered or changed it |
| Typical plan, not read | Nothing was found on the page, so a common value stands in. Check it. |
The ones to look at first
- Typical plan, not read. Coverage, the deductible or the yearly maximum wasn't on the page. Open the patient's benefits page and read it again.
- No contracted fee in your price list, so your own price is used. Press the pencil beside the line and add the insurer's fee. It saves to your price list.
- The plan's usual fee wasn't read. Out of network, the patient owes more than the estimate if the plan's fee is lower than yours. Type it if you have it.
- Open the claims history to check the limit. The frequency limit was found but the history wasn't. Open the history page and press Read this page again.
- The yearly maximum runs out with this treatment. Insurance stops paying partway through. Worth telling the patient.
Below the list, Stayed on this computer lists the patient details that never left the computer. See exactly what the estimate used shows the codes, fees and plan values behind the number.
To change any of these, see correcting a value.
Didn't find it? Write to us and a person answers within two business days. Please leave patient details out.