Exercise 1—Set up a treatment plan.
At 2:00 today, George Hormel has an appointment. Dr. Klein wants to recommend a treatment consisting of two crowns of a particular type. The ADA code for this procedure is 2750; the abbreviation for the same procedure is CRPHN, crown porcelain with high noble metal. The teeth that are affected are numbers 19 and 30. The treatment requires two visits.
To set up the treatment plan for Mr. Hormel:
Right-click on Mr. Hormel’s appointment. A shortcut menu is displayed.
Select Clipboard for Hormel, George, and Mr. Hormel’s clipboard is displayed.
Click Tx plan on the right side of the clipboard. The Treatment Plan Pick List window is displayed. There are no plans listed yet.
Click Create new plan. A blank Treatment Plan is created with the cursor in the Visit # field.
In the Description of plan field, type Crowns #19 and #30, and then click in the Visit # field.
Press Tab to accept the default, which is Visit #1. The cursor moves to the Prod column.
Press Tab to accept the default doctor, JEK. The cursor moves to the Description column.
To add the procedures that make up the treatment plan, enter the ADA code or the corresponding abbreviation. To see a list of ADA codes, press Tab, select the code, and click OK.
In this exercise, enter 2750 19 in the Description column—2750 is the ADA code; 19 is the tooth number.
Press Tab to move to the Fee column, and the standard fee for this procedure is displayed.
Press Tab to accept the standard fee.
To enter the second procedure, type 2 in the Visit # field, and press Tab twice to move to the Description column.
Type the abbreviation crphn 30 in the Description column, and press Tab.
Press Tab to accept the standard fee.
Click Close, click Close again, and then click OK.
Exercise 2—Print the treatment plan created for George Hormel.
To print the treatment plan:
Open George Hormel's clipboard.
Click Tx plan. The Treatment Plan Pick List window is displayed with Crowns #19 and #30 Treatment Plan highlighted.
Click Edit plan, and the Treatment Plan window is displayed.
Click Print patient proposal in the upper-right corner of the window. The Estimating for Proposal window is displayed.
Select one of the options, and click OK. The Report Destination window is displayed.
For a hard copy, click Print to Printer, and click OK.
To print a treatment plan to mail, click Yes. To print a treatment plan to give to a patient, click No.
Click Close.
Exercise 3—Indicate that George Hormel has accepted his treatment plan.
To indicate the patient’s acceptance of a treatment plan:
Open the patient’s clipboard.
Click Tx plan on the right side of the clipboard. The Treatment Plan Pick List window is displayed.
Select the treatment plan, and click Accept plan at the bottom of the window. The Status with Patient column changes from Proposed to Accepted.
Click Close. The clipboard is displayed again.
Click OK to close the clipboard.
Exercise 4—Mr. Hormel wants to know what part of the cost of his treatment is covered by insurance.
To pre-determine Mr. Hormel’s insurance benefits:
Open George Hormel's clipboard.
Click Tx plan on the right side of the clipboard. The Treatment Plan Pick List window is displayed.
Click Edit plan. The Treatment Plan window is displayed.
Highlight the first procedure, and click Request Pre-D at the bottom of the window. The Status column on the window changes to Waiting to submit Pre-D.
Highlight the second procedure, and click Request Pre-D. Its status changes.
Click Submit ins Pre-D in the upper-right corner of the window. The Submit for Predetermination window is displayed. The Submit Primary option is selected by default.
Select Print form on paper now.
Click OK. The Insurance Submittal Information form is displayed.
Review the form, and click OK. The Treatment Plan window is displayed again, and the Status column has changed to Pre-D submitted and includes the date on which it was submitted.
Click Close.
Exercise 5—Enter a pre-determination of benefits into the system.
A few weeks later, you receive a response from the insurance company. Your estimate of benefits was $650 ($325 for each procedure), but the insurance only pays $630 ($315 for each procedure). The pre-authorization number is #012345.
To enter the pre-determined benefits:
Open George Hormel's clipboard.
Click Tx plan on the right side of the clipboard. The Treatment Plan Pick List window is displayed.
Click Edit plan. The Treatment Plan window is displayed.
Highlight the first procedure, and click Enter Approval. The Enter Insurance Approval window is displayed with the cursor in the Predetermination amount field.
Type the approved amount—630—and press Tab.
In the Preauthorization number field, type 012345, and press Tab. The cursor moves to the Preauth date field for the first procedure.
Press Tab to accept the default date. Press Tab twice to move to the Approved amt field.
Enter the preauthorized amount—315—and press Tab to move to the second procedure.
Press Tab to accept today’s date. Press Tab twice to move to the Approved amt field.
Enter 315 in the Approved amt field, and click OK, don’t update blue book. The Treatment Plan window is displayed again with the Status column changed.
Click Close. The Treatment Plan Pick List window is displayed.
Click Close. The Clipboard window is displayed.
Click OK to close the clipboard.
Entering Acceptance of a Treatment Plan
Approvals of Pre-Determinations
Creating Treatment Plan Messages