In this tips & tricks post, we’ll discuss the Exclusion Fee Rule for in-network plans that do not cover certain treatment categories or specific procedures, how to use Display Fields to customize your Treatment Plan and patient information in the Chart Module, and how to transfer patient records to another practice.
The Exclusion Fee Rule helps you deal with in-network plans that do not cover certain procedures or procedure categories.
You may be dealing with in-network insurance plans that have procedure codes or categories that are excluded from their coverage (Federal Blue Cross, FEP, FEP Blue are some names we’ve heard in our support calls). For these types of plans, you would set the plan up as a PPO plan type, and the Exclusion Fee Rule in the Edit Insurance Plan window will take the exclusions you set up into account. It will exclude them from the usual insurance coverage, will not calculate write-offs, and instead, push the entire charge to the patient.
In order to set this up properly, take these steps:
1. Set your module preferences for the Exclusion Fee Rule in Setup> Family/Insurance> Family Preferences.
2. In the patient’s insurance plan, select the Other Ins Info tab and select your Exclusion Fee Rule setting. As a reminder, this is only for use with PPO plan types.
Select an option for how procedures not covered by insurance are billed.
- Practice Default: Uses Exclusion Fee Rule as set in your Family Module Preferences (in the step above).
- Do Nothing: Exclusions will be billed normally based on the insurance plan fee schedule.
- Use UCR Fee: Exclusions will be billed at the full UCR fee rather than the negotiated rate.
3. In the patient’s Family Module, double-click to open the insurance Benefit Information, Click +Add, and create an Exclusion for either the category that isn’t covered or for each of the procedures that aren’t covered. In this example, we’re showing the Crowns Category is excluded from coverage.
4. Once the exclusions are entered, you’ll want to click Update Fees in the patient’s treatment plan. You will notice that write-offs are not calculated, and the entire balance has been pushed to the patient.
Customize display fields in the Treatment Plan Module for easier use by you and your patients.
NOTE: The fields we’re discussing here are actually displayed in the Treatment Plan Module, Procedures list, on saved and printed Treatment Plans, and in the TreatPlanMain grid. But for today, we’re focused on how they look in your treatment plan module (and this is the area most often discussed in our support calls).
To see the default display fields, go to Setup> Display Fields > Treatment Plan Module.
Maybe you’d like to display different fields, re-name some so your patients understand them better, or re-order the fields to suit your practice. This can be done quickly and easily. Here are some of the changes we decided to make to our display fields. When you change a description, you will want to also change the column width number to allow sufficient room for your new description (especially if it’s longer!)
Note that we’ve decided to remove Done, add DateTP, re-ordered a few fields, and changed some descriptions (shown in the New Descript column).
Now that we’ve made these changes, our Treatment Plan Module view looks like this:
Customize display fields in the Chart Module’s Patient Information section so you can see what you need right at the top.
In the same way, you can customize the fields that display (and the order in which they are shown) the Chart Module by going to Setup> Display Fields> Chart Patient Information. By default, the following fields display.
More than likely, you’d really like to see medical information at the top. We’ve moved the highlighted fields to be re-ordered at the top.
Bonus Tech Tip:
You can also customize your Chart Layout! Here’s a quick video to show you how. You can also set a default chart layout per clinic in Sheet Def Defaults.
Create a patient record you can print or send if your patient moves to another practice.
The quickest and easiest way to export your patient’s records is to print their progress notes.
- In the Chart Module, right-click and select Print Progress Notes
- If you just want to print treatment notes for a date or date range:
- In the Chart Module, click on the Show tab.
- Click on the ellipsis next to All Dates.
- In the Progress Notes Date Range Filter window, enter the date range of the progress notes you want to print, and click OK.
- Once the progress notes window has been filtered to the date range you entered, right-click and select Print Progress Notes… (like shown above).
If you have a secure method for sending PHI, you can print it to PDF and send that to the patient’s new practice.
Tech Tip: If you don’t want your fees to show, create a “view” that does not include the fees. What shows in the Progress Notes area is what will print. For more on how to create chart views, see our manual.
Have a question or need to troubleshoot an issue? We are here for you! There are several ways to reach our support team: