Best Practice for capturing additional Benefits Information

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opensource
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Joined: Fri Jun 22, 2007 8:11 pm
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Best Practice for capturing additional Benefits Information

Post by opensource » Fri Apr 17, 2009 9:17 am

Hello Dr. Jordan / Team,

My office staff tells me that they need to capture the following additional information for each of the subscriber/patient from the insurance carriers/providers based on the Patient Plan. They have created a 'Quick Notes' and insert the quick notes in the Insurance Plan information window for each subscriber ?. I was hoping that there was a better and more intuitive way to capture this information..is there a way to do it in a better way in open-dental ?...Maybe through the Forms feature or any other way..any Best Practices that folks can share ?

Insurance Benefits Additional Information
--------------------------------------------------
Cleaning
Guidelines : - Can the cleaning be done anytime or it has to be done with a gap of 6 consecutive months?

Perio maintenance
- Covered by Insurance : Yes or No ?
- Fequency : If covered, What is the frequency: - Is it twice or four times a year ?
- Guidelines : Is it in addition to prophy or is it either prophy or perio maintenance?

Fluoride
- Covered by Insurance - Yes or No ?
- Frequency - If covered, What is the frequency ? - Is it once or twice a year ?

Sealants
Coverage Age Limit - Up to what age are sealant allowed
- For 1st Molar :
- For 2nd molar :
Coverage Percentage - What Percentage is it covered at ?
Frequency - Is it every 2 year or 3 years ?

Fillings
Coverage - Posterior composite : - Are posterior composites covered or they are downgraded to amalgam?

Crowns
Replacement Guidelines - Is a crown replaceable every 5 years or more?

Nightguard
Covered by Insurance - Is there any coverage for nightguard - Yes or No ?
Coverage Percentage - What Percentage is it covered at ?

Family History
---------------------
Subscriber Name : - Replace with Name
last FMX-
last SRP-
last:Prophy-
any claims pending-

Spouse Name: - If applicable Replace with Name or else delete section
last FMX-
last SRP-
last:Prophy-
any claims pending-

Child Name: If applicable Replace with Name or else delete section
last:Prophy-
sealants -
any claims pending-

Child Name: If applicable Replace with Name or else delete section
last:Prophy-
sealants -
any claims pending-


Othodontic Coverage - Age Limit
---------------------------------------------------
- Subscriber & Spouse -
- Non Student Chidren -
- Full Time Students Children :

Tooth Replacement
--------------------------------
Prior extractions- Are prior extractions covered - Yes or No ?

Waiting Period
-----------------------
Is there a Waiting Period - Yes or No ?
Waiting Time - Is it six months or one year ?
Applicable Category : Is it Basic, Major or Both ?

As always, thanks for the quick response and you guidance...

Cheers,

OpenSource

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jordansparks
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Location: Salem, Oregon
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Re: Best Practice for capturing additional Benefits Information

Post by jordansparks » Fri Apr 17, 2009 12:27 pm

We will create a sheet someday specifically for this purpose. I imagine it will be somewhat integrated with electronic elegibility. For now, I think the fastest and best approch is to create a paper form. Then fill, scan, shred.
Jordan Sparks, DMD
http://www.opendental.com

opensource
Posts: 97
Joined: Fri Jun 22, 2007 8:11 pm
Contact:

Re: Best Practice for capturing additional Benefits Information

Post by opensource » Fri Apr 17, 2009 3:40 pm

Hello Dr. Jordan,

I did try to play around with the CarrierLabel Template in Sheets but dont think it works to the specifications that I need it to but looks like we are both thinking along the same lines.

We will continue with the QuickNotes part for now..within the Benefits information..atleast that way, it is pretty easy to look up..since it shows up in the Benefits information as well as on the Summary Screen in the Patient Information module.

Thanks for your quick response...as always.

Cheers,

OpenSource

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