Insurance and what the patient owes · 3 of 7

Which carriers you are in network with

A short checklist in settings that changes every estimate. Here is why it asks about Delta Dental of California rather than about Delta, and what happens to the ones you skip.

Whether you are in network with a carrier is the single biggest fork in how a procedure gets priced, and it is not something Mesio can work out on its own. In network, the carrier pays a percentage of a rate that is in your contract. Out of network, there is no contract and the allowed amount has to be estimated. Same patient, same crown, very different number.

So there is a checklist in Settings → Insurance, and it is worth ten minutes.

Why it asks about entities, not brands

The checklist does not ask whether you take Delta. It asks about Delta Dental of California, and Delta Dental of Michigan, and Delta Dental of Pennsylvania, separately.

That is not pedantry. Those are different companies with different contracts, and a practice is routinely in network with one and out of network with another. Rolling them together would mean pricing half of them wrong.

One question per carrier, not one per plan

The other direction matters too. Your practice system probably lists the same carrier several times over, once per plan it sells. You are in network with the company, not with each plan separately, so the checklist asks once.

Mesio holds those together, which is what lets the answer you give here reach everything that depends on it: how a procedure is priced, and what that carrier has actually paid you. When a carrier is recorded inconsistently, those pieces never meet, and a perfectly good answer in settings sits unread while quotes quietly fall back.

What happens to the ones you skip

This is the part worth knowing, because the failure is quiet.

A carrier you have not answered for is treated as unknown, and an unknown carrier is priced the in-network way. That is the safer default for a practice that is mostly in network, but if you are actually out of network with that carrier the estimate will come out too low, and too low is the direction that produces surprise bills.

Mesio does label those quotes as unknown rather than passing them off as settled. But the label is only useful if someone reads it, and the checklist removes the question entirely.

You do not have to do it all at once

The list is ordered by how much of your actual book each carrier represents, so the first few entries are worth more than the rest of the list combined. Answer those and the long tail can wait.