Tuesday, August 29, 2017

Requiring a Pre-Authorization for Specific Procedures

Updated 4/22/2021

Occasionally, insurance companies require you to submit a pre-authorization for a procedure before the work is completed. Because these requirements vary from insurance company to insurance company, you can manipulate the coverage table for each insurance company in Dentrix and mark the procedures that require pre-authorizations.

How To:
  1. In the Office Manager, select Maintenance > Reference > Insurance Maintenance.
  2. Highlight the insurance plan you want to update, and click the Benefits/Cov button.
  3. From the left side of the screen, select Coverage Table.
  4. Select the procedure (or procedure category) that requires a pre-authorization.

  5. Check the Pre Auth checkbox. When that procedure is treatment planned for a patient, a notation is added to the Treatment Plan view of the Ledger and the Case Detail view of the Treatment Planner.
  6. Click Save to save the changes.

Additional Information

  • You should make it a habit to update the coverage table when insurance companies notify you of procedures that require pre-authorization. Then as procedures are treatment planned for patients, double-check the Treatment Planner view of the Ledger for which procedures need authorized before treatment.
  • In the Treatment Planner, click View > Procedure Information and make sure that the PreAuth option is checked. Then when you use the Treatment Planner Case Detail view, you will be able to see whether a pre-authorization is needed before you complete the procedure.
  • When viewing the Treatment Plan view in the Ledger, procedures needing pre-authorization display the following information in the Ins column to indicate what kind of pre-authorization is required:
    • 1** - Indicates primary insurance requires a pre-authorization on that procedure.
    • 2 - Indicates secondary insurance requires a pre-authorization on that procedure.
    • 1*2 - Indicates both primary and secondary insurance require a pre-authorization on the procedure.
    • NO - Indicates neither insurance requires a pre-authorization on the procedure.

Tuesday, August 22, 2017

Tips for Adding Insurance Plans in Dentrix

Updated 10/7/2019

It's important to set up insurance plans properly in Dentrix in order to give accurate insurance estimates, and make it easier for you to process insurance claims and work with insurance in Dentrix.

Maybe your office sees patients who have different insurance carriers and you are constantly entering these new carriers into the database, or maybe your staff rotates front desk responsibilities and you have new staff entering insurance information regularly. By having policies in place to make sure the way insurance carriers are added to Dentrix is done consistently, you increase the likelihood of having accurate estimates.

Use these three tips to update your policies about how insurance plans are entered in Dentrix:

  1. You should always search for the insurance company you want to add to your database to make sure it hasn’t already been entered in Dentrix. Having multiple instances of the same insurance company can cause problems, such as assigning the wrong insurance plan to patients, or when you update insurance information for one plan you don't update the other, leaving one of the plans outdated.
  2. A good way to prevent different spellings or abbreviations of the carrier name is to enter the information exactly as it is printed on the patient's benefit card.
  3. The Group Plan name is primarily used to help you distinguish this plan from other plans with the same carrier. If the carrier doesn’t furnish the group plan name, you can use this field to enter a plan name that will mean something within your office. By marking the Do Not Include Group Plan Name option in the Insurance Claims Options group box, the name you give the group plan will not be printed on claims.

To learn more, read Entering a New Insurance Plan in the Dentrix Help.

Tuesday, August 15, 2017

Attaching Continuing Care Types to Procedure Codes

Updated 10/7/2019

If you discover that patients' continuing care due dates aren't resetting automatically when a patient is seen for a continuing care appointment, it is often because procedure codes have not been set up properly with continuing care attached to them.

To fix this problem, you should review your procedure code setup to make certain that codes have been properly assigned to the desired continuing care types, and then attach procedure code(s) to the continuing care type you want the continuing care due date to automatically reset for.

For example, your office wants to attach the PERIO continuing care type to procedure codes D4341 and D4342 so patients are automatically set up on continuing care when they come in for scaling and root planing.

How To:
  1. From the Office Manager, click Maintenance > Practice Setup > Procedure Code Setup.
  2. Select a Procedure Code Category and individual procedure, and click Edit.
  3. Click the Auto Continuing Care search button.

  4. Select the continuing care type to which you want to assign this procedure code, and click the Select button.
  5. Click Save, answer Yes to the prompt, and click Close.

Additional Information
  • A procedure code may be assigned to only one continuing care type. However, you can assign multiple procedure codes to the same type.
  • When a continuing care type is attached to a procedure, Dentrix automates three processes for you:
    • When you select a continuing care procedure as an appointment reason, Dentrix automatically attaches that assigned continuing care type to the appointment.
    • When you post a continuing care procedure, Dentrix automatically resets the patient's continuing care due date according to the interval you defined.
    • If you haven't previously assigned a continuing care type to the patient, when you post a continuing care procedure, Dentrix will assign that type for you using the defaults you defined.

To learn more, read the Dentrix Help topic titled, Attaching Continuing Care Types.

Tuesday, August 8, 2017

Reactivating Archived Patients

Updated 10/7/2019

Sometimes patients who have been away for several years move back into the area and come back to your practice. If you archived these patients and they return to your practice, you can easily reactivate them in Dentrix. When you reactivate the patient, their address, procedures, insurance claims, payments, adjustments, medical alerts, prescriptions, patient questionnaires, and periodontal exams are all restored.

How To
  1. From the Family File, open the Select Patient dialog box and check Include Archived Patients.

  2. Select the archived patient you want to reactivate and click OK.
  3. In the Family File window, double-click the Patient Information block.
  4. Click OK to the message that appears. Dentrix will change the patient status to Patient.

Additional Tips
  • The Include Archived Patients checkbox option is only available when selecting a patient from the Family File.
  • When an archived patient is reactivated, view the Patient Notes to see information regarding their previous continuing care, employer, insurance, and referral settings (if any).
  • To see a list of all archived patients, generate the Archived Patient List. From the Office Manager, select Reports > Lists > Archived Patient List and enter filtering criteria to generate the list.

To learn more about how to archive a patient, see our previous tip post titled, Archiving Patient Records.

Tuesday, August 1, 2017

Purging Appointments and Events in Dentrix

Updated 10/7/2019

You create and complete patient appointments hundreds of times each day as part of your workflow. But what should you do with those completed appointments from the past that are no longer needed?

You should purge old appointments from Dentrix on a regular basis, keeping only the last 1-2 years of appointments. And as of Dentrix G6, you can also purge old events as well. When you purge old appointments and events, searching for patient appointments takes less time, because you will have cleared out old data you don’t need anymore.

To purge appointments and events:

  1. In the Appointment Book, from the File menu, click Purge Appointments/Events.
  2. Enter a date in the Cutoff Date field. Appointments and events before this date will be purged from Dentrix.

  3. Click OK. A warning message appears asking you to confirm that you want to purge appointments. Click OK to continue with the purge.

Additional Tips
  • Dentrix automatically creates an entry for each purged appointment in the patient’s Office Journal.
  • Purging appointments and events does not purge unscheduled appointments. If you want to purge unscheduled appointments, open the Unscheduled List, select Appt > Purge Appointments, enter a cutoff date, and click OK.
  • When you purge appointments/events manually from the Appointment Book, other users do not have to close out of Dentrix.
  • You can purge appointments by setting up the Task Scheduler to include this part of your monthly routine.