If a patient wants to know what part of the cost is covered by insurance, you can create a pre-determination.
To pre-determine insurance 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 for which you want a pre-determination, and click Request Pre-D. The Status column on the window changes to Waiting to submit Pre-D.
Repeat step 4 for each procedure to be included on the pre-determination until each one is listed as Waiting to submit Pre-D in the Status column.
Click Submit ins Pre-D. The Submit for Predetermination window is displayed.
Select to print the form on paper or submit it electronically. If the patient has secondary insurance, you can submit the secondary predetermination now or wait until the primary approval is received.
Click OK. The Insurance Submittal Information form is displayed.
Review the form, and when you are satisfied, click OK.
If you selected to print the form on paper, the form prints. If you selected to submit the form electronically, it is submitted in the next batch of electronic claims.
Click Close to close the treatment plan, click Close to close the treatment plan pick list, and click OK to close the clipboard.
Entering Acceptance of a Treatment Plan
Approvals of Pre-Determinations