You can post a procedure or a charge for a product to a patient's ledger.
Important: The recommended method for posting procedures is to attach procedures to an appointment and then complete or post those procedures from the progress notes of the clinical chart.
Note: Completed procedures appear in the clinical record and financial record. Posting or editing a completed procedure in either of these areas affects the other area.
To post a procedure
How to get there
Use the Patient Search box to access a patient's record.
Notes:
If the last patient record you accessed since you last logged on is the correct patient's record, you do not need to re-enter the patient's name in the Patient Search box.
You can include inactive patients in the search results by setting the Include inactive patients switch to On.
Do one of the following:
On the Patient menu, under Financial, click (or tap) Ledger.
The patient's Ledger page opens.
On a patient's Ledger page, click (or tap) Procedure.
The Enter Procedure dialogue box appears.
Enter the procedure details, such as the rendering provider, procedure code, and amount.
Set up the following options:
Date - The date of service. Leave the current date entered, or click (or tap) in the box to select a different date. However, you cannot backdate a procedure to a date that would cause it to become locked based on your organisation's transaction lock setting.
Status - A completed, treatment-planned, or existing procedure.
Procedure - The procedure performed or product sold. Click (or tap) in the box, begin typing the code or description of a procedure, continue typing as needed to narrow the results list, and then select the procedure to post.
When you are searching for a procedure, procedures appear in the results list not only according to your search criteria but according to the selected filter.
Select one of the following procedure filters as needed:
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NHS procedures - If the patient is an NHS patient, NHS procedures is selected by default. Selecting this option (if another option is already selected) changes the Assign to selection to NHS and the Amount to 0.00, and if the Procedure box contains a procedure that is not an NHS procedure, removes the procedure from the Procedure box.
Note: Only procedures that have an NHS Clinical Data Set Default specified are allowed. If you select a procedure that is not allowed, Dentrix Ascend ignores your selection and does not insert that procedure into the Procedure box.
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Third-Party procedures - If the patient is not an NHS patient but has an active third party attached to his or her record, and if the selected Provider is contracted with the patient's third party, Third-Party procedures is selected by default. Selecting this option (if another option is already selected) changes the Assign to selection to Third Party, may change the Amount, and if the Procedure box contains a procedure that is not allowed by the patient's third party, removes the procedure from the Procedure box.
Note: Only the third party's allowed procedures are available.
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Location procedures - If the patient is not an NHS patient and is not covered by a third party that the provider is contracted with, Location procedures is selected by default. Selecting this option (if another option is already selected) changes the Assign to selection to Private, may change the Amount, and if the Procedure box contains a procedure that is not allowed at the current location, removes the procedure from the Procedure box.
Note: Only the location's allowed procedures are available.
Note: NHS procedures is available only if the patient is an NHS patient. Third-Party procedures is available only if the patient has an active third party attached to his or her record, and if the selected Provider is contracted with the patient's third party. Location procedures is available for any patient.
Important: If you post a multi-code that includes some procedures that are not allowed by the NHS, the location, or the patient's third party, those procedures will not be posted.
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Assign to - Select whether this procedure is to be billed as Private, NHS, or Third Party. Changing the assignment may change the Amount, may remove the procedure in the Procedure box, and according to the Assign to option that you have selected, changes the selection in the procedure filter list (which is next to the Procedure box) to NHS procedures, Third-Party procedures, or Location procedures.
Note: Private is available for any patient. NHS is available only if the patient is an NHS patient. Third Party is available only if the patient has an active third party attached to his or her record and if the selected Provider is contracted with the patient's third party. However, none of the Assign to options are available until you select a Procedure.
Amount - The charge for the selected procedure. The amount appears automatically, but you can change it as needed if your user account has the appropriate security right enabled and the procedure is not assigned to NHS. By default, this amount is determined by the following method:
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If the selected Assign to option is NHS, the amount is always 0.00 and cannot be changed.
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If the patient has third-party coverage, there is a fee schedule attached to that third-party plan, and the selected provider is contracted with that third party, the amount comes from the selected procedure on the contracted fee schedule. However, if the selected procedure does not exist on that fee schedule, the amount comes from the selected procedure on the selected provider's fee schedule. However, if the selected procedure does not exist on that fee schedule, or the selected provider does not have a fee schedule, the amount comes from the selected procedure on the procedure code list.
If the patient has third-party coverage, but either a fee schedule is not attached to that third-party plan, or the selected provider is not contracted with that third party, the amount comes from the selected procedure on the selected provider's fee schedule. However, if the selected procedure does not exist on that fee schedule, or the selected provider does not have a fee schedule, the amount comes from the selected procedure on the procedure code list.
If the patient does not have third-party coverage and does not have a discount plan, the amount comes from the selected procedure on the selected provider's fee schedule. However, if the selected procedure does not exist on that fee schedule, or the selected provider does not have a fee schedule, the amount comes from the selected procedure on the procedure code list.
If the patient does not have third-party coverage but has a discount plan, the amount comes from the selected procedure on the selected provider's fee schedule. However, if the selected procedure does not exist on that fee schedule, or the selected provider does not have a fee schedule, the amount comes from the selected procedure on the procedure code list. Also, a credit adjustment will be entered automatically in the Ledger for the difference between the charged amount and the amount for the selected procedure on the patient's discount fee schedule if the selected procedure exists on that fee schedule and if the amounts are different.
Note: If you need to change the amount, but the security rights for your user account do not allow you to change procedure amounts, after receiving approval from someone who does have the appropriate security right, have that authorized user, click (or tap) the padlock icon next to the Amount box, enter his or her credentials, and then click (or tap) Unlock to temporarily unlock the amount. The Amount box will remain editable until you click (or tap) Save.
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GST Amount - If the procedure is subject to GST, the amount appears for your reference.
Note: When you finish posting the procedure, to indicate that the procedure has a GST amount associated with it, a GST icon appears next to the description of the procedure on the patient's ledger.
Teeth, Surfaces, and so forth - If applicable for the selected procedure, specify the supporting treatment information, such as a Tooth number and Surfaces.
The maximum length allowed for the note is 255 characters.
Start/Completion Dates - The date the procedure was started, and the date it will be completed. To enter dates, you must first select the Require Start/Completion Dates check box.
Third-Party Estimate Overrides - An amount that differs from the estimated amount the third party will pay for primary coverage and/or secondary coverage. To enter an amount, you must first select the corresponding check box. The sum of both estimates cannot exceed the amount being charged for the procedure. If the amounts are locked, to change an amount, you (or someone with adequate rights) must first unlock the overrides.
Diagnosis - On this tab, you can link conditions to the procedure.
Note: Conditions (diagnoses) can be associated automatically with a procedure when charting a quick exam. Chart one or more conditions; and then, with the same tooth (or teeth) selected, treatment plan a procedure to treat those conditions.
Update procedure code/amount to the recommended value above? - Do any of the following:
If the selected Procedure is not valid for the specified tooth number and/or treatment areas (such as surfaces), the recommended procedure code appears next to the box. To use the recommended procedure, either click (or tap) the recommendation to insert that value into the Procedure box, or select the Update procedure code/amount to the recommended value above? check box to use the recommended value automatically when you save the procedure. To not use the recommended procedure, clear the Update procedure code/amount to the recommended value above? check box.
If there are recommendations for both the Procedure and the Amount, but you want to use only one of those recommendations, click (or tap) the recommendation that you want to use, and then clear the Update procedure code/amount to the recommended value above? check box before saving the procedure.
Click (or tap) Save.
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