Originally published 5/31/2018. Updated 9/19/2024
Have you got burning questions about the Open Dental Treatment Plan Module? Well, this post is here for you! Read on to find the answers to some of our most frequently-asked questions.
What’s the best way to prioritize and present treatment in Open Dental?
First, chart procedures as treatment planned from the Chart Module. Once that’s done, head over to the Treatment Plan module. You can highlight treatment and select a priority from the “Set Priority” list. Procedures with the same priority are grouped together and subtotaled.
Priorities are entirely customizable, so you can use different descriptions and even color-code them. Just go to Setup, Definitions and select “Treat’ Plan Priorities” .
TECH TIP: Did you know that you can prioritize treatment from the Chart Module? It’s true! When you’re treatment planning from the Chart, choose a “Priority” in the dropdown from the Enter Treatment tab, then choose the procedure. The priority is automatically assigned. If you forgot to select a priority before treatment planning, you can also, check the “Treatment Plans” box to view Treatment Plans from the Chart Module and prioritize from here.
You can present treatment a number of different ways, but the first thing you’ll want to do is create a Saved Treatment Plan (highlight procedures and click Save TP). Once you’ve done that, you can use the Sign TP button to present the treatment on the computer screen and let the patient electronically sign or use the Print TP to print a physical copy of the treatment plan. For eClipboard users, use the eClipboard button to send the treatment plan to a mobile device for the patient to review and sign. For ODTouch users, go to the Tx Plans screen in the app to present treatment.
The patient accepted the treatment 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.
The estimates don’t look right in the treatment plan, how can I troubleshoot this?
There are a few things you can check into if estimates aren’t looking correct. Read on to learn about different ways to troubleshoot this issue. You can view the Claim Procedure details to figure out how estimates are being calculated.
Update Fees
If fees (Fee, Allowed Amt, etc.) look incorrect, it’s likely that fee schedules have been changed since procedures were treatment planned. These aren’t updated automatically (in case you want to honor old fees), so you’ll want to do this. Fees can be updated for a single patient by clicking the Update Fees button in the Treatment Plan Module.
TECH TIP: Made fee schedule changes and want to update the fees for all your patients? You can use Fee Tools. Check out the Fees Update page in our manual for more details.
Review Substitutions/Downgrades
The next thing to look into is if procedures codes are being downgraded (or substituted). In the Treatment Plan, take a look at the “Sub” column. If there is an “X”, the procedure is being substituted. If you’re looking in the Claim Procedure window, you’ll see a “Substitution Code” listed. The “Allowed Amt” listed is what is used to calculated the insurance estimate. The write-off is calculated using the allowed amount for the original procedure, so the patient is responsible for the difference between the substituted allowed amount and the original allowed amount.
If the patient has an insurance plan that doesn’t downgrade, go to the insurance plan, Other Ins Info tab, and check “Don’t Substitute Codes”. Substitutions can be set up on the insurance level or a global level. See Downgrades in our manual for more details.
Check the Insurance Plan and Setup
To ensure that Open Dental is correctly calculating insurance estimates, you’ll want to make sure the patient’s Insurance Plan is set up correctly. If you are in-network and expecting Open Dental to calculate write-offs, but aren’t seeing any, check that the “Plan Type” is set to PPO Percentage. If fees displayed aren’t accurate, check the Fee Schedules attached to the plan. If you’re not sure how to set up an insurance plan, check out our Decision-Making Flow Chart.
From the Claim Procedure window, you can see the percentage coverage being used to calculate benefits. You’ll also see any limitations (age, frequency, etc.) listed in the Estimate Note. If any of this looks incorrect, review the Insurance Benefits for the plan and make any corrections as needed. These changes are reflected in the estimates immediately.
Update Fee Schedules
Last but not least, make sure that you’ve got the most up-to-date fees entered into your fee schedules. These are what Open Dental uses to calculate estimates, so if these aren’t correct, your estimates won’t be either. Check out Fees Increase and Procedure Codes for tips on updating fees.
How can I customize how my treatment plan looks?
The treatment plan is a Sheet that can be customized. Check out our manual for how to customize this sheet or view our Sheets Webinars on YouTube.
Preauthorizations
Preauthorizations (preauths) can be created and managed from the Treatment Plan Module. Read on for some FAQs about preauthorizations.
How do I create a Preauthorization?
From the Treatment Plan Module, select procedures from an Active or Inactive treatment plan and click the PreAuthorization button to create a new preauth. Creating and sending these is very similar to claims. View the Preauthorization page in the manual for more details.
Where would I find preauthorizations that haven’t been sent?
Any preauthorizations you’ve created but not sent can be seen both in the patient’s Treatment Plan Module and in the Insurance Claims window (Manage Module, Send Claims). 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)?
You can find preauths that have been sent but haven’t been received in the Outstanding Insurance Claims report. Just set the “Preauth Options” so preauths will be included in the list. If a preauth isn’t showing up in the list, try changing the “Days Old” or “Date Range” filter.
If you have other questions on the Treatment Plan Module, reach out to our helpful and friendly Support Team.
Information in this post reflects features available in Open Dental Version 24.1. For the most up-to-date information, please visit our manual.