Insurance

FAQs Answered: Treatment Plan Module

treatment plan


Using the Treatment Plan module in Open Dental

This post answers common questions on the Treatment Plan module in Open Dental.

Learn how to troubleshoot common issues with treatment plans, better organize and present treatment planned care to boost treatment plan acceptance, and manage preauthorizations.

TECH TIP: Did you know you can create and view treatment plans in the chart module? Check the “Treatment Plans” box (right above the Procedures section).

 

Treatment Plan FAQs

I know that presenting essential care first boosts treatment plan acceptance. What’s the best way to do this in Open Dental?

Once you’ve charted the treatment, you can select and prioritize the procedures. Items with the same priority will group together, and be subtotaled. Color-code your priorities to identify them even more easily. Go to Setup, Definitions, Treat’ Plan Priorities to set colors.
TECH TIP: Prioritizing treatment makes creating planned appointments a breeze! Read more about using planned appointments here.

How do I present multiple treatment options?

Chart all the options, then take turns making each option the top priority before saving that option (to reflect deductibles and annual maximums correctly for each option).
Present each saved option to the patient (all charted procedures still stay in the active treatment plan).
TECH TIP: If presenting treatment that will be completed in the next coverage year, change the “Estimates as of:” date (under the Save TP button) to reflect more accurate estimates.

Once the patient has selected a specific option, delete the procedures that weren’t selected, leaving only the selected options in the active treatment plan, which can then be put on a planned or scheduled appointment.

TECH TIP: Want to have Open Dental automatically save a PDF of the digitally signed treatment plan in images?
1) Go to Setup, Definitions, Image Categories, open the category (folder) you want to save Treatment Plans into, and check the box for “Treatment Plans” under usage.
2) Go to Setup, Treat’ Plan. Check the box for “Save Signed Treatment Plans to PDF”
Open Dental will now automatically create a PDF of any digitally signed treatment plans, and save it to your designated image category (folder).

The patient declined treatment that was presented. Now what?

Select the procedures that were declined, and save them out as a saved treatment plan. Name this plan “Declined, MM/DD/YYYY” – this will keep a record that treatment was presented, but declined. Once this saved treatment plan has been created, go into the Chart module and delete the procedures the patient declined. This will help clean up the chart and active treatment plan.

The patient accepted treatment that I have on a saved treatment plan. Can I schedule it now?

A saved treatment plan is like a snapshot in time, but the charted treatment should still be in the active treatment plan. Create the planned or scheduled appointment, and attach the treatment planned procedures. If the procedures were deleted after the treatment plan was saved, simply re-chart them (you can change the treatment planned date to reflect when they were originally charted/saved), then attach them to the appointment.

My patient has a discount plan – why is the treatment plan showing insurance estimate columns?

If the patient used to have insurance, but now has a discount plan, you may need to change treatment plan type. In versions 17.3 and greater, the treatment plan will update from Insurance plan type to Discount plan type automatically. If you are using version 17.2 or older, you will need to double-click to open the active treatment plan, and change the Plan Type from Insurance to Discount. Once the plan type is correct, the display will adjust accordingly.

Want to update and get all the latest features and enhancements? Read our post, Open Dental Software Updates.

The insurance estimates don’t look right in the treatment plan, how can I troubleshoot this?

  1. Click “update fees.” This will pull in any fee schedule changes that have occurred since the item was treatment planned (both UCR and insurance fees).
  2. Check to see if there is an “x” in the Sub column. If there is, insurance coverage is being downgraded (like from composite to amalgam). Open Dental is set to auto-downgrade codes unless the “Don’t Substitute Codes” option is checked in the patient’s insurance, Other Ins Info tab.
    Pull up the Procedure codes list, and open up the procedure code. The Ins. Subst Code will show what code it is downgrading to. Check to make sure the office fee and insurance fee schedule fee is correct. If the insurance fee schedule doesn’t have a fee for the downgrade procedure, it will pull the UCR fee instead.
    TECH TIP: Writeoffs are always calculated using the UCR and Insurance fee schedule fees for the originally charted procedure code.
  3. Check to make sure the attached insurance plan has the correct plan type. If the Fee in the treatment plan shows the insurance allowed amount, and no writeoffs are showing, plan type is likely set to Category Percentage. If you are in-network and using an insurance fee schedule to calculate writeoffs and insurance estimates, change the insurance plan type to PPO Percentage. Go back into the treatment plan – you should see the change reflected immediately.
  4. Check to make sure the insurance plan fee schedule has the most up-to-date fees. You can either:
    • Double-click to open the procedure (you can do this from the active treatment plan, then double-click to open the insurance estimate. The Insurance allowed amount will be displayed. If you know this is outdated, update the fee schedule OR
    • Go to Lists, Procedure Codes and pull up the insurance fee schedule, then check the allowed amount. Update the fee as needed.
      TECH TIP: To update active treatment planned fees for all patients, run the global update fees tool. If you just want to update the fees for this patient, go back into the patient’s treatment plan, and click the Update Fees button.
  5. Check to make sure your insurance category percentages and benefits are correct.
    TECH TIP: Insurance benefits are calculated after any deductible amounts have been applied. So on a procedure where the insurance covers 80% up to $200, if the patient has a $50 deductible remaining, they will take $200 – $50 = $150, then calculate the 80% on the $150, resulting in an insurance estimate of $120.

How can I customize how my treatment plan looks?

The treatment plan is a “sheet” that can be customized. For a how-to on this, you can:
treatment plan Watch the webinar, Sheets Customization.
Read more about Customizing Treatment Plans Using Sheets.

When I print my treatment plan, the tooth chart shows up as a black box – how do I fix this?

You’ll need to adjust your graphics settings.
Watch the webinar, Tooth Chart Graphics.
Read more about Graphic Settings.

If you want to remove the tooth chart from your treatment plan, follow the link above to edit the Treatment Plan Sheet.

 

Also In the Treatment Plan Module: Preauthorizations

How do I create a Preauthorization?

Get step-by-step instructions here on how to create and manage preauthorizations.

I received the preauth and entered the amounts but the insurance estimate in my treatment plan didn’t change – why is this happening?

When you receive the preauth, double-click to open the preauth, and be sure you’re clicking the “By Procedure” button, then entering the information you received from insurance. When entered this way, the estimates in the treatment plan will update to show the numbers you entered.

Where would I find preauthorizations not sent yet?

Any preauthorizations you’ve created but not sent can be seen both in the patient’s treatment plan module, and in the Manage Module – click the Send Claims button. Preauths will show 01/01/0001 as the date of service, and sort to the top under “Claims Waiting to Send.”

Is there a report that shows outstanding preauthorizations (preauthorizations I’ve sent but not received info back from insurance)?

Go to Reports, Standard, and in the Monthly section, open the Outstanding Insurance Claims report. Check the box at the top to “Include Preauths.” Click on the “Type” column to sort by that column – preauthorizations will show the word “Preauth” in this column. Adjust the Days Old (min) in the upper left as needed to see older or newer outstanding preauthorizations.

 

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