A response from the insurance company includes a pre-authorization number, the total amount of benefits, and the amount that the insurance company pays for each submitted procedure.
To enter the pre-determined benefits:
Open the patient’s clipboard.
Click Tx plan. The Treatment Plan Pick List window is displayed.
Click Edit plan. The Treatment Plan window is displayed.
Select the procedure, and click Enter Approval. The Approved Treatment window is displayed.
Type the total amount approved for the treatment plan in the Predetermination amount field, and press Tab. The cursor moves to the Preauthorization # field.
If the insurance company has included a preauthorization #, type the number. If there is no preauthorization #, leave the field blank.
For each procedure, enter the preauthorization date, approval status, and the approved amount. The total of the individual approved amounts must equal the preauthorization amount at the top of the window.
When finished, click OK, update the blue book to update blue book entries, or click OK, don't update the blue book to close the window.
Click Close to close the treatment plan.
Entering Acceptance of a Treatment Plan