Treatment Plans are used to construct a series of charges that don't impact the account's balance. You can use these to submit predeterminations and to print out a plan that you can provide to your patients.
This article is intended to build on the foundations of the Ledger, as many functions will be very similar to how the ordinary Ledger functions. For a review on these fundamental concepts, please refer to the Ledger Quick Start Guide.
- Configuring Preferences
- Creating Treatment Plans
- Treatments and Phases
- Managing Predeterminations
- Printing a Treatment Plan
- Moving Treatments to the Ledger
- Deleting a Treatment Plan
- Rebuilding a Treatment Plan
- Treatment Plan Reports
Before working with Treatment Plans for the first time, we advise that you review your Preferences. To access Preferences, navigate to the MacPractice Menu and select "Preferences".
There are two areas in Preferences that impact Treatment Plans. In the Ledger Section, you can find a Treatment Tab that contains Treatment Plan Preferences. There's also a Treatment Plan Section. Both Sections are located in the Preferences Window Sidebar.
Let's review the Preferences in each section.
- Print Appointment Information On Treatment Plan: This option will print off appointment information for a Treatment Plan Phase that has been scheduled by using the "Schedule" button by the phase.
- When a Procedure Fee Has Been Updated After The Procedure Was Added To A Treatment Plan: Occasionally you'll need to update your fee schedule, which can impact Treatment Plan Treatments. You can choose whether to Always Use the Fee Amount in Treatment Plan, or you can choose to use the Higher Amount. You can also choose to have MacPractice always ask you which you'd prefer to do on a case-by-case basis.
- Print Treatment Phase Subtotals on Treatment Plan: This option will print subtotals for each Treatment Plan phase on Treatment Plan printouts.
- Print Restorative Charting Graphic with Treatment Plan: This option will include a restorative charting graphic with the Treatment Plan.
In the Ledger section, you'll want to navigate to the Treatment tab to find Preferences relevant to Treatment Plans.
- Create a Treatment Plan when Adding a New Incident: With this enabled, a newly created Incident will automatically populate with a blank Treatment Plan. If you would rather control when you create a Treatment Plan, uncheck this Preference.
- Hide Treatment Plan nodes in the Incident Sidebar: This Preference will hide the Treatment Plan node when there's no Treatment Plans to review. You can still add Treatment Plans via the Incidents menu, which will show the hidden Treatment Plan node.
- Preserve the Treatment's Insurance Estimate when moving to Transactions: If you use Insurance Estimating, this option will preserve the Insurance Estimate data when moving a Treatment over to the Transactions node.
- Draw Treatment Background With Color: This option and color selector allow you to differentiate the appearance of the Treatment Plan node from the Transactions node in the Ledger. This is best to use if you keep accidentally adding items on the wrong node.
- Production Date When Moving a Treatment to Transactions: This option allows you to configure what date is used when moving Treatments over to the Transactions node. You can choose to either use the Current Date or to Keep The Procedure Date of the Treatment.
To create a Treatment Plan, you can use the Incident Drop Down Menu to select the "New Treatment Plan" option. Alternatively, you can press Shift-Command-T on your keyboard.
By default, every new Incident created in a Patient's ledger generates a blank Treatment Plan. If you want to adjust this behavior, you can navigate to the MacPractice Menu > Preferences > Ledger > Treatment Tab and uncheck the first checkbox "Create a Treatment Plan when adding a new incident".
Treatments and Phases
Treatments are the line-item charges that make up a Treatment Plan. They are handled almost identically to Charges in the Ledger.
Phases allow you to group together Treatments into a logical order. They are not required to add, but they can help with creating a logical structure to better explain a Treatment Plan to a patient, or to better track a patient's progression through a Treatment Plan.
Treatment Plans have a Status listed in the Ledger Sidebar by their name. There are four potential Statuses that a Treatment Plan can be in.
- Proposed: A Proposed Treatment Plan is freshly created, but not yet presented to a patient.
- Presented: A Presented Treatment Plan has been shown to a patient and is pending their acceptance or rejection.
- Accepted: An Accepted Treatment Plan has both been presented to a patient, and has been accepted by the patient.
- Rejected: A Rejected Treatment Plan has been presented to a patient, but the patient has disagreed with the Treatment Plan in its current state.
You can set a Treatment Plan's Status by clicking the drop down menu right by a Treatment Plan's Status, and then click on the desired Status.
Rejected Treatment Plans can be hidden from the Treatment Plan node by using the "Hide Rejected Treatment Plans" option in the Incidents Drop Down Menu.
Adding Treatments is identical to adding Charges to the Transactions Node of the Ledger. All fields are identical to the New Charge Window. You can select a charge code, tie diagnosis codes to charges, and any other functionality that is available in the New Charge Window.
If you need a refresher on the New Charge Window and the basic functions of the Ledger, please refer to our Ledger Quick Start Guide.
Phases are easily added by using the Treatments Drop Down Menu. This will simply add a new Phase to the Treatment Plan Table. You can name your Phases by selecting a phase by clicking on it, and then single-clicking on the Phase name in the "Code" column.
You can also copy and paste Treatment Plans by holding down the Option Key and clicking a Treatment Plan, then dragging to a blank space in the Treatment Plan node.
Scheduling a Treatment Plan Phase
You'll notice that to the left of each Phase in the Treatment Plan Table, there's a Schedule button. This button allows you to schedule an appointment for the indicated Phase.
When you click the Schedule button, you'll be taken to the Schedule with the currently selected patient, where you can then schedule out a block for the appointment. When you return to the Ledger and the Treatment Plan, you should see that the time for that appointment now resides by the procedure underneath the Phase.
By scheduling a Treatment Plan this way, you open up the ability to have the Treatment Plan details on the created Schedule Block. You can configure the display elements of a Schedule Block by navigating to the Schedule Ability. Once there, click the "Appointment Display" node in the sidebar.
In the Appointment Display view, you'll switch over to the Text tab. From there, you can determine what items appear in a Schedule Block.
Predeterminations are handled almost identically to creating Insurance Claims in the Ledger. They are submitted like insurance claims, and received predeterminations are applied to charges in the same way that insurance payments are applied to charges in the ledger. Predeterminations and received Predeterminations even use the same Claim Creation window and the Payment window.
To create a Predetermination, first select the Treatments to be included on the Predetermination. You can select multiple Treatments by Command-Clicking each Treatment, or by using Shift-Click to select all Treatments in a range. Once you have your Treatments selected, navigate to the Print Drop Down Menu and select "Print Predetermination." This will open up the Claim Creation Window.
We won't cover the Claim Creation Window here. The Claim Creation Window's contents are covered in our Ledger Quick Start Guide and our Interactive Claim Creation Window article. There are virtually no differences in how Predeterminations and Claims are handled in MacPractice.
Predeterminations that have been initially posted can be accessed by double clicking on the Predetermination line item. This will bring up the claim form (or claim information if using eClaims). You can easily print this and send this off or file it away for paper records as necessary.
Handling Received Predeterminations
Once you have received a Predetermination's results back, you can handle these just like an incoming Insurance Payment. In the Payments Drop Down Menu, you can find a "Predetermination Received" option. With the original Predetermination selected, clicking that option will open up the Payment Window.
Alternately, you can select the "Outstanding Claim" within the Payment Window if you didn't select a Predetermination ahead of time.
From here, you can enter in the "Payment" amount and apply the "Payment" to the appropriate Treatment. Applied payments from a received Predetermination do not impact Ledger data. This information is only used to print an accurate Treatment Plan.
Printing a Treatment Plan
Once you've assembled a Treatment Plan you're ready to present to a patient, you can easily print a Treatment Plan by navigating to the Print Menu and selecting "Print Treatment Plan."
This will bring up the print window, where you can either print a paper copy of the Treatment Plan. If a Predetermination has been applied to treatments, the printed Treatment Plan will reflect the applied Predeterminations. Otherwise, the Treatment Plan will simply reflect the Treatments and scheduled dates if you used the Schedule button on each Phase.
Moving Treatments To The Ledger
Instead of re-creating the same charges on the Ledger when you've acted on a Treatment Plan, you can simply move selected Treatments to the Ledger by clicking the "Treatments" drop down menu and selecting "Move To Transaction". If you'd rather post the Treatments into a new Incident, you can use the "Post as Transactions in New Incident" option, also in the "Treatments" drop down menu.
To delete a treatment plan, select it in the incident sidebar, then press the Delete key on your keyboard. You will be asked to confirm that you wish to delete the plan.
Only empty treatment plans can be deleted. If a treatment plan has transactions within it, an alert will appear informing you the plan cannot be deleted.
When a change is made to an insurance plan, or a procedure type in an existing Treatment Plan is changed, you will need to Rebuild the Treatment Plan.
When you need to rebuild, you will see a red icon that looks like this:
All you need to do is click the icon and the treatment plan will recalculate for you.
A window will pop up to let you know if the patient portion will increase, decrease, or remain unaffected. If the patient portion does change, it will tell you by how much.
You will also see a breakdown of the changes. The top window has a breakdown of each charge in the Treatment Plan. Below that you will see a window called Current Treatments, this is what the unaltered Treatment Plan looks like. The After Rebuilding window shows you what the Treatment Plan will look like after it is rebuilt.
Once you verify the changes, you can click the Rebuild button.
After the treatment plan is rebuilt, it automatically inserts a comment into the Treatment Plan, remarking the change that was made, who made the change, and when it was done. You also have the option of showing this on the statement.
The Treatment Plans Report, in the Marketing category of the Reports Ability, can be used to track down Treatment Plans by Procedure Dates, Appointment Dates, or by a particular Procedure code. You can also filter by the Treatment Plan Statuses.
The Unscheduled Treatment Plans Report, located in the Predetermination category of the Reports Ability, locates any Treatment Plans that do not have a linking Appointment.
You may also find the other Predeterminations Reports useful as well, such as the Outstanding Predetermination or Predetermination Received Reports.