Submitting an Ortho Case

When you submit a claim for an ortho insurance case, you can simultaneously set up an ortho budget plan. Before using this feature, you must set up the budget plan defaults. See Setting Patient Budget Plan Defaults for more information.

To submit an ortho case:

From the Patient Transactions window, click ADD. The Transactions window is displayed in ADD mode.
Select a transaction that includes an orthodontic procedure code and click OK and Close. The Patient Transactions window is displayed.
Click Submit Insurance. The Claim window is displayed.
Type the number of months that remain in the treatment process and click OK. The insurance is submitted, and the Patient Transactions window is displayed. A message is displayed.
Click Yes. The Patient Budget Plan window is displayed.

The estimated amount for the insurance company's first payment is displayed in the Periodic Pymt field. This amount is calculated by dividing the expected payment amount by the number of treatment months and multiplying the sum by the submission frequency.

Example:Example:If the expected insurance payment is $200, the months of treatment is 6, and the payment frequency is 3.

The estimated periodic payment would be $100 ($200 divided by 6 = $33.333; 3 x $33.333 = $99.999, or $100).

Select Edit Budget Plan from the Options section of the Express bar or Options menu. The Patient Budget Plan window is displayed in EDIT mode.
Select the patient budget plan effective date from the Start Date drop-down list. The first budget plan charge will be posted on the date. The next charge will be posted one month after the start date.
Type the patient portion of the budget plan (the amount to be billed over time) in the Cash Price field. If the patient is uninsured, type the full amount of the procedure in the field.
If the patient makes a down payment, type the down payment amount in the Cash Down field. The cash price minus any cash down payment is displayed in the Total on Plan field.
When you enter a down payment in this window, you must also post it to the Patient Transactions window. If you forget, the program reminds you when you exit the window.

Click OK.
To print patient ortho budget plan coupons, select Coupons from the Options section of the Express bar or Options menu. A message that asks you to confirm your request is displayed. Click Yes. The Output Options window is displayed. Select the appropriate option and click OK.
To specify a budget plan coupon format, see Selecting Budget Plan Coupon Formats.

To print a statement specifying the loan details for the patient’s signature, select Truth in Lending Form from the Options section of the Express bar or Options menu. A message that asks you to confirm your request is displayed. Click Yes. The Output Options window is displayed. Select the appropriate option and click OK.
To post the cash down payment amount to the Patient Transactions window, select Post Adjustment from the Options section of the Express bar or Options menu. A credit adjustment code selected in the General System Settings window for patient budget plans is posted to the Patient Transactions window, and the plan balance is decreased by the financed amount.
Click Close.