Setting up Templates for Treatment Plan and Care Plan
Adding a Template
If you are changing the Unites per Visit under the Therapeutic Exercises, you will receive a box that asks if you want to make this change in the Care Plan template as well.
Care Plan
If a Product or Service is not showing on the drop down, check that the PCP box is checked in the Product and Services setup.
Setting up Product & Services for Cash and DMPO (Discount Medical Plan Organization)
Under Utilities - System Set Up - General - Products and Services - Fee Schedule
Under Utilities - System Set up - General - Products and Services
- DMPO - Setup for DMPO Name, %, and Per Visit Cap
- PCP - Check mark if you want it to show on the Primary Care Plan
- Chusa/Apex Fee - The DMPO price you are charging the patient
- Disc% - Check if this Service or Product is using the DMPO Discount Percentage
- Exc. Cap - Check mark if the Service or Product is Exempt from the DMPO Cap
Setup both Products and Services with the correct DMPO Fee and check marks in the PCP, Disc %, and Exc. Cap columns for the Care Calculator and Plan to calculate correctly!
Patient Setup up for Care Calculator for Insurance Patient
Under the Patient Menu - Edit Information - Insurance tab - Coverage Tab, you will find where to put the patients insurance coverage details.
The Copy from Insurance Bible allows you to pull in from the patients insurance template to mark the yes and no bubbles which you can then customize on the patient level.
You find the Insurance Bible under Billing - Carriers - search for your carrier - and click the Insurance Bible.
Whatever is filled in on this screen can be pulled into the patient by clicking the copy from Insurance Bible.
Next to the Insurance Bible tab is the EOB Settings tab. You come here to enter the Allowed, Paid, Adj and/or Percentage for CPT codes that are covered with the carrier.
Care Plan inside of the Doctor screen
Care Plan will pull over the Frequency, Chiropractic Technique, Modalities and Exercises from the Treatment Plan to form a Plan for the patients services for this treatment.
Modalities will pull in the CPT codes from template, when you see a orange circle you will need to fill in the Body Regions and Goals. Exercises will pull in the goals from the template, when you see a orange circle you will need to fill in the Exercises and Minutes.
- Load From Template - Choose the Save Template you would like to use
- Save as Template - Save a new Template off of the fields in the Treatment Plan
- Care Plan - Will pull codes from Treatment Plan without using a saved Template
Creating the Care Calculator
Cash View VS Insurance
1. Visits - The Total Visits comes directly from the Care Plan chosen. You can click on Total Visits and look at the frequency.
2. Services - Shows all the Services that comes directly from the Care Plan chosen.
3. Products - Products are separated out from the Services.
4. Total Patient Responsibility - Shows the total that the patient is responsible for using the standard Cash fees.
5. Will show your DMPO name - Shows the total the patient is responsible for using your DMPO.
6. Show Detail - Breaks down what Services and Products will be given to the patient each visit.
You can break down the Visit Total by clicking the + next to the Visit No.
Excluded from DMPO shows in RED
Included in DMPO shows in BLACK
When the details are expanded, and you hover over Product, Description, Deductible sections, you will see important tool tips like above shows.
- Charge = Unit Price per visit
- Allowed = Allowed amount for that charge in the EOB settings
- Deductible = Deductible amount under the Insurance Coverage
- Running Ded. = This is the amount the patient has left to pay out of pocket before insurance will pay
- Co-pay = Dollar amount Patient is responsible for
- Co-Ins = Percentage Patient is responsible for
- Pri. Pmt = EOB Allowed Amount
- Tax = If tax is attached to Cash fee schedule it will add them If tax is attached to a cash fee schedule it will add them
- Pt Resp = Charge + Tax
- Apex = APEX Price per visit
- Tax = If tax is attached to APEX fee schedule it will add them
- Total = APEX + Tax
1. Save - Any changes made have to be saved as this does not save automatically from this screen.
2. Refresh Pricing - Any price changes made to the Cash or DMPO fee schedule would be refreshed using this button.
3. View Care Plan - This screen will allow you to make changes to the Care Plan by changing the frequency, adding or removing items, changing units or when and where services or products are given in the Detail Tab.
4. Fin. Resp.
Clinic Fees = Standard Fee
5. GFE - Good Faith Estimate
