2.2.2 Planned Treatment Management

When treatment is required but the patient is not doing it that day, it is entered as planned. Planned treatment can then be managed through statuses and interactive reports to ensure that treatment is being completed in a timely manner.

Enter Planned Treatment and Requesting Estimates

Enter Planned Treatment on the Treatment Entry screen of the Transactions Module using the Claim Status: P (Planned)
When Entering major work that requires a lab, you will get a pop-up like the one below. If Yes is clicked, the lab line will be added, giving you a closer estimate for the total work to be done
Select Save after each treatment entry. Select Submit when finished entering the treatment for this claim.

The Treatment Flow dialogue box will appear at this point. You can print an estimate or submit the claim to EDI to get an estimate of coverage.

Note: Remember, any Planned treatment submission is treated as an Estimate Request from the Insurer. Need an estimate? Plan the treatment and send it. Need to know if something is eligible for coverage or if the patient’s hygiene frequency is reset? Plan it and submit to EDI.

Note: If the Pre-Authorization requires x-rays or any other attachment, make sure you have selected Yes under the Submit Claim field. This way, the system will print a claim form to send to the insurance company (with which you can include any required documentation) instead of submitting it electronically (EDI)
It is advised you submit pre-authorization to the Insurer and await their response. In this manner, you can assure that the Estimate you provide the patient is accurate and takes into account what the policy will actually cover.

If you want to see a summary of the planned treatment you have entered, go back to the Treatment tab and select the Planned/Incomplete sub tab.

Treatment Pre-Determination Approval

When an EOB for a planned Treatment is back from the Insurance Company, you can update the information in the Treatment screen.

At the Planned/Incomplete sub tab, highlight the line of the procedure you want to update the information for (one at a time) and right-click the line, then select the Edit Treats option

From the edit screen, the status can be changed to Approved or Declined. If the treatment is linked to a booked appointment, the status will automatically change to Booked. Splits and Fees can be adjusted here in the Splits button as well, based on the pre-authorization information.

If you wish to see the full claim split details, right click on the claim and select Ins Split Details.

Each line of treatment will show for the claim in a format similar to an insurance pre-determination form and can be individually highlighted and edited in order to accurately reflect what the insurance company will pay out.

Treatment Planning

The Treatment Planning area is a great place to regroup or isolate planned treatments for one patient in order to provide them with multiple estimates for different treatments without having to re-enter or delete any planned treatments in the process. Additional lines of treatment can easily be added to the estimates here too if unexpected changes to the course of treatment arise.

Select the Treatment Plan icon in the Transactions module.
Highlight the line(s) of treatment that you would like to seperate for the estimate
Note: Press the Ctrl key to select multiple lines.
Use the arrow button to move the treatment to the New Claim side
Select Save.
Once saved you can select Est. Letter to print an estimate

Estimate Letter

Besides printing an Estimate from the Treatment Planning screen, you can also print it from the Transactions module.

Highlight the claim you would like to print the estimate for under the Planned Treatment tab. Right-Click on claim line and from the menu, select the Print Estimate
The Estimate Letter dialogue box will open
Check the settings and select Ok to print.

Choose one of the Three Layout fromats (N/A, Option 1, Option 2) for printing or customize your own with mail merge by choosing Word as the Optional Format. This options is also available for Proposal Letters, Payment Receipts and Tax Receipts. A template for each area has been created and is available for use. This template can be adjusted or a new one can be created to match your office colors, fonts, and add office logos. There is also an option to save these to the Document Manager.

Note: Word must be linked to Power Practice to use this feature. A working knowledge of Word is needed if altering these documents.

The images below showcase N/A (Black font) format and Word (Blue font)