Handling patient visits

This workflow document provides instructions for the tasks that are done from the time an existing patient calls to schedule an appointment until his or her visit is complete.

1. Scheduling

Scheduling appointments for existing patients

You can schedule an appointment for an existing patient.

To schedule an appointment for an existing patient

  1. On the Schedule menu, click (or tap) Calendar.

    The Calendar page opens.

  2. On the Calendar page, navigate to a day or week.

  3. Do one of the following:

    • Click (or tap) an open time slot.

    • On the Actions menu, click (or tap) Create Appointment.

    The Appointment Information panel opens.

  4. Do one of the following:

    • If you are currently accessing the record of the patient for whom you are scheduling the appointment (the patient's name appears in the Patient Search box), click (or tap) the Create Appointment for [patient name] link.

    • Click (or tap) in the Search existing patient/household field. Start typing a patient's first name, last name, chart number, or phone number (at least the first four digits). Continue typing as needed to narrow the search results list. Click (or tap) a patient name.

      Note: You can include inactive patients in the search results by setting the Include inactive patients switch to On.

    The options for the patient's appointment become available.

  5. Select the procedures that are to be performed, and set up the other options as needed.

    Set up the following options:

    • Status - By default, all new appointments have Unconfirmed selected, but you can select a different status if necessary. The corresponding status icon appears on the appointment (for example, Unconfirmed is a question mark ).

    • ASAP - Select this check box if the patient wants to be contacted if an earlier date and/or time becomes available. With this option selected, the patient will show on the ASAP List. With this option selected, the patient will show on the ASAP List, and an ASAP icon appears on the appointment.

    • Needs Follow-up - Select this check box if any of the procedures for this appointment require you to follow up with the patient after his or her visit. The patient will show up on the Patient Follow-up list after his or her appointment.

    • Premedicate - Select this check box if the patient prefers to be medicated before any of the procedures are performed or if any of the procedures require premedication.

    • Procedure(s) - Click (or tap) in the box, begin typing procedure code, multi-code, or description, continue typing as needed to narrow the results, and then select the appropriate procedure from the results list. To select other procedures, repeat this process.

      If you select a procedure that is associated with a recare type, that recare type is attached to this patient's appointment. If the same recare type is already attached to another one of this patient's appointments, and that appointment's status was not set to Complete, when you save the appointment information, a message appears and asks you to confirm that you want to remove the recare type from the other appointment and attach it to this appointment; click (or tap) Attach to this Appointment. On the Appointment Information panel, a recare procedure that is attached to an appointment has a green stripe.

      Tip: To remove a procedure from the appointment, click the corresponding Remove button .

    • Add Tx Planner - Click (or tap) this link to select one or more visits with treatment-planned procedures that you want to attach to the appointment, and then click (or tap) Update appointment.

      If the same treatment plan case's visit is already attached to another one of this patient's appointments, when you save the appointment information, a message appears and asks you to confirm that you want to remove the visit from the other appointment and attach it to this appointment; click (or tap) Attach to this Appointment. On the Appointment Information panel, a treatment plan case's visit that is attached to an appointment has a red stripe.

      Note: When you position your mouse pointer over a treatment-planned procedure, either the details of all the procedures in the corresponding case appear (if it is assigned to a case) or the details of only this procedure appear (if it is not assigned to a case).

    • Other - Enter a reason, other than that of the selected procedures, for the appointment.

    • Operatory - Select an operatory from the list. If you selected a time slot in step 3 while viewing by operatory, an operatory is already selected, but you can select a different one. Alternatively, to quickly change the operatory, click (or tap) and hold and then click (or tap) an open time slot in a different operatory.

    • Appointment Provider - Select an appointment provider from the list. If you selected a time slot in step 3 while viewing the schedule by provider, a provider is already selected, but you can select a different one. Alternatively, if you are viewing the schedule by provider, to quickly change the provider, click (or tap) and hold and then click (or tap) the column of a different provider. Only providers who have access to the current location are available. The exception to this is when a provider is associated with the appointment and no longer has access to the current location; that provider is available in the list unless you select a different provider and then save the change.

    • Other Provider - Select a secondary provider, such as a hygienist, for the appointment from the list. A colored box (determined by the provider color assigned to this provider) appears on the appointment. Only providers who have access to the current location are available. The exception to this is when a provider is associated with the appointment and no longer has access to the current location; that provider is available in the list unless you select a different provider and then save the change.

    • Date - The date being viewed on the schedule is already selected by default, but you can change it. Click (or tap) in the box to select a different date. Alternatively, if you are viewing the schedule by week, to quickly change the date, click (or tap) and hold and then click (or tap) an open time slot on a different date.

    • Time - Click (or tap) in the box, and then enter a time. If you selected a time slot in step 3, the time is already entered, but you can change it. Alternatively, to quickly change the time, click (or tap) and hold and then click (or tap) a different open time slot.

      Tip: You can enter a time using various formats. For example, you can type 08:30, 8:30a, or 8:30 AM; 8a or 8am; 13:30, 1:30p, or 1:30 PM; or 1p or 1pm.

    • Length - The length of the appointment is determined by the selected procedures or the specified time range, but you can change the length as needed. The end time of the appointment changes accordingly.

    • Note - Enter a note regarding the appointment. To insert the current date where the text cursor is positioned in the box, click (or tap) Insert Date. If there is an appointment note, a note icon appears on the appointment.

    • Contact Info - On the Contact Info tab, you can view or update the patient's contact information, contact preferences, and automated reminders preference (this option is available only if the patient is the primary contact for himself or herself or anyone else and has a supported mobile phone number). Any changes that you save from the appointment will be reflected in the patient's record.

      The patient's primary contact also appears.

      Tips:

      • To change the primary contact person for the patient, click (or tap) Edit . In the search box, begin typing the contact's name, continue typing as needed to narrow the results, and then select the appropriate name from the list of matching results. Or, to make the patient whose appointment you are viewing the primary contact, click (or tap) Switch to "Self" at the bottom of the results list.

      • To assign the primary phone number of the patient's primary contact (if different from the patient) as the primary phone number of the patient on the appointment, click the Copy Up button . To assign the patient's primary phone number as the primary phone number of the patient's primary contact (if different from the patient), click the Copy Down button .

    • Related Appts - On the Related Appts tab, you can view the appointment information for other members of the patient's household who have appointments scheduled on the same day as this appointment. For your reference, the number of related appointments, if any, appears next to the name of the tab.

    • Medical Alerts - On the Medical Alerts tab, you can view the medical alerts that are attached to the patient's record. You can also add medical alerts to the patient's record as needed.

  6. Click (or tap) Save.

2. Patient check-in

Handling the patient's arrival

  1. The routing panel is available at all times while you are logged in to Dentrix Ascend. To open or close the panel, click (or tap) anywhere on the thin, vertical bar on the left side of your browser window.

  2. When a patient arrives at the office, the receptionist clicks (or taps) the Here status button for that patient on the routing panel.

    The appointment's status changes to Here, and the patient now appears on the routing panel under Here.

Updating patient information

For established patients of record, you can edit patient information. Also, for new patients with appointments scheduled, he or she has a patient record with some basic information entered, but you can enter additional information to complete the record.

To update a patient's information

  1. 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.

  2. Do one of the following:

    • On the Patient Information ribbon, click (or tap) the Edit Patient Information button . If the ribbon is not visible, click (or tap) the arrow button below the Patient Search box .

    • On the Patient menu, under General, click (or tap) Patient Information.

    The patient's Patient Information page opens.

  3. On the Patient Information page, update a patient's information as needed.

    The following tabs are available:

    • Basic Info

      Basic Info tab

      1. Set up the following options:

        • Name - Enter the patient's first and last name and middle initial.

        • Preferred Name - The name the patient prefers you use when addressing him or her. The preferred name can also be used on correspondence from your office.

        • Title - Enter a prefix for the patient's name, such as Dr., Mr., Ms., or Mrs.

        • Suffix - Enter a suffix for the patient's name, such as Jr., Sr., or III, if applicable.

        • Gender - Select the patient's gender.

        • Birthdate - Enter the date of the patient's birth.

        • Status - Select Active, Non-Patient, Inactive, or Duplicate as the patient's status. Changing the patient's status to Duplicate or from Duplicate to another status requires the security right to manage duplicate patients.

        • Chart # - Enter a unique chart number (up to 10 characters in length; letters, numbers, periods, and dashes are allowed) for the patient. Alternatively, to have a chart number automatically generated for the patient, after you have entered the patient's first and last name, click (or tap) the Update button .

        • First Visit - This is the date of the patient's first visit. This date is for reference only and cannot be edited. This date is updated automatically when you post a completed procedure for a new patient.

        • Last Visit - This is the date of the patient's most recent past appointment. This date is for reference only and cannot be edited. This date is updated automatically when you post a completed procedure for a patient.

        • Primary Provider - Select the preferred or primary provider for this patient. Only providers who have access to the patient's preferred location are available. The exception to this is when a provider is associated with the patient and no longer has access to the current location; that provider is available in the list unless you select a different provider and then save the change.

        • Discount Plan - Select a fee schedule to use for treatment-planned procedures and charges that are billed to this patient if the patient does not have insurance coverage. The difference between the provider's fee for a given procedure (or if there is no provider fee, the default fee) and the discount fee appears as a credit adjustment on the ledger. However, if the patient has insurance coverage, the selected discount fee schedule is ignored.

          Note: You can also assign a sliding fee schedule to determine the discount.

        • Address - Enter the street address, city, state, and ZIP Code of the patient's residence. All correspondence will be sent to this address unless the patient is not the guarantor; in which case, bills, account statements, and other financial documents will be sent to the address listed for the patient's guarantor. By default, the address of the patient's primary contact, if that is someone other than the patient whose record you are adding, is entered.

          Tip: To copy the address of another household member to this patient's record, click (or tap) in the Address, City, State, or ZIP Code box, and then click (or tap) the Copy button of a household member. Only the address of the primary contact and other household members (if different) are available.

        • Phone number - Select a phone type (Home, Mobile, Work, or Other), and enter the correct Number and Ext (if applicable) for the patient.

          Important:

          • Sending automated text messages to mobile phone numbers is subject to the FCC's Telephone Consumer Protection Act (TCPA). That law and our terms and conditions require you to obtain consent from your patients before sending them any text messages through the Dentrix Ascend reminder system. Federal law dictates the form of prior express consent you must obtain. Prior written consent is optimal for all text messages, and may be required by law depending on the content of your text messages.

            The following is an example of consent language you may consider adapting for your practice.

            As a service to our patients, we provide courtesy appointment and recare reminder messages, and other important messages, such office closures, by using text messages. We also may send text messages notifying you of promotions our practice may offer from time to time. By providing your cell phone number, you consent to receiving text messages reminders and notifications at this number. You may opt out of receiving text messages by texting STOP to 45827 at any time.

          • If you do not have a patient's prior consent, turn off reminders for the patient by selecting Home as the patient's phone number type instead of Mobile.

          To add another phone number for the patient, click (or tap) Add Phone.

          Tips:

          • To copy the phone number of another household member to this patient's record, click (or tap) in one of the phone number boxes, and then click (or tap) the Copy button of a household member. Only the first (primary) phone number of the primary contact and other household members (if different) are available.

          • To change the priority of the patient's phone numbers, click (or tap) the Move Up button of the phone number that you want to move up in the list. To remove a phone number from the patient's record, click (or tap) the Remove button of that phone number. These buttons are not available for the first (primary) phone number.

          • If you enter a mobile phone number for the patient and then click (or tap) Save, below that phone number, the text Automated Text Reminders appears along with a status message (Yes or Carrier not Supported) to indicate that the number you entered has been verified as either a supported or unsupported mobile phone number.

          • If the patient already has a mobile phone number entered, the status message next to the Automated Text Reminders text for that number can be, in addition to Yes or Carrier not Supported, No if the patient is the primary contact for himself or herself or for anyone else and has been opted out of receiving automated text message reminders (any other patients who have this patient as their primary contact have also been opted out).

          • The patient's text message reminder status also appears in the upper-right corner and on the Contact Info tab of the Appointment Information panel that appears when you click (or tap) any of that patient's appointments on the schedule.

          • Once a supported mobile phone number is entered, and the patient's record is saved, the patient is automatically opted in to receiving automated text message reminders. Any other patients who have this patient as their primary contact or who have the same mobile number as this patient entered in their patient records are also automatically opted in. However, if the patient has someone else as his or her primary contact, the patient will receive text messages only if the patient's primary contact has a supported mobile phone number and that person is opted in.

          • If you do not have patient consent, or a patient informs you that he or she no longer wants to receive text messages, turn off reminders for the patient by selecting Home as the patient's phone number type instead of Mobile. Patients who have consented may also opt-out by texting STOP to 45827 from their mobile phones. Any other patients who have this patient as their primary contact or who have the same mobile number as this patient entered in their patient records are also opted out.

        • Email - Enter the patient's email address. The email address must be unique across your entire organization (for all patients in all locations).

          Note: If the patient has someone else as his or her primary contact, the email address of the primary contact will be used for this patient, but you can enter a different, unique email address for this patient if necessary.

      2. Click (or tap) Save.

    • Related Patients

      Related Patients tab

      • Primary Contact - To change the primary contact person for the patient, click (or tap) Edit . In the search box, begin typing the contact's name, continue typing as needed to narrow the results, and then select the appropriate name from the list of matching results. Or, to make the patient whose record you are viewing the primary contact, click (or tap) Switch to "Self" at the bottom of the results list.

        Note: If the primary contact is someone other than this patient (not "Self"), the name and Preferred Contact Method of the patient's primary contact appear on the Patient Information ribbon.

      • Add New Member - To add patient records, at one time, for others members of the same household as the current patient, click (or tap) Add New Member.

        Note: A household is a group of patients who have the same primary contact person. The complete list of household members is available when you are viewing the patient record of any member of a given household.

      • Secondary Contact - To add a secondary contact person for the patient, click (or tap) Add Secondary Contact. In the Select Patient box, begin typing the contact's name, continue typing as needed to narrow the results, and then select the appropriate name from the list of matching results.

      • Primary Guarantor - To change the primary person who is financially responsible for the account, click Edit . In the search box, begin typing the guarantor's name, continue typing as needed to narrow the results, and then select the appropriate name from the list of matching results. Or, to make the patient whose record you are viewing the primary guarantor, click (or tap) Switch to "Self" at the bottom of the results list.

        Note: If the current patient is the guarantor, that patient and all patients for whom that patient is the guarantor appear in the list. If the current patient is not the guarantor, only the guarantor and the patient appear in the list.

      • Secondary Guarantor - To add a secondary person who is financially responsible for the account, click (or tap) Add Secondary Guarantor. In the Select Patient box, begin typing the secondary guarantor's name, continue typing as needed to narrow the results, and then select the appropriate name from the list of matching results.

    • Medical Alerts

      Medical Alerts tab

      Click (or tap) Add Medical Alert to attach medical alerts to the patient's record.

    • Patient Forms

      Patient Forms tab

      • To request forms from the patient, click (or tap) Request Forms.

      • To view completed forms, expand the section of a form type that has completed forms, and then click (or tap) a form.

      • To change the due date of a form, click (or tap) the corresponding Edit icon .

    • Preferences

      Preferences tab

      1. Set up the following options:

        • Preferred Contact Method - Select whether the patient prefers to be contacted by phone, text message, or email message. For Call me, you must enter a phone number in the box that appears if a phone number is not already entered for the patient (if it is not already, this phone number will be made the first listed phone number for the patient). For Text me, you must enter a mobile phone number in the box that appears if a mobile phone number is not already entered for the patient (if it is not already, this mobile phone number will be made the first listed phone number for the patient). For Email me, you must enter an Email address in the box that appears if an email address is not already entered for the patient. These options are available only if the patient is his or her own primary contact. Currently, this information is for reference only.

          Notes:

          • If someone else is this patient's primary contact, the preferred contact options are not available because the patient's preferred contact method is that of the primary contact, but you can click the name of the primary contact person shown to go to his or her patient record to view or change the preferred contact method for that patient.

          • The selected preferred contact method appears on the Patient Information ribbon, which is available when you are viewing the patient's record.

          • If someone else is this patient's primary contact, the name and preferred contact method of the patient's primary contact appear on the Patient Information ribbon. Similarly, if this patient is the primary contact for someone else, this patient's name and preferred contact method will appear on the other patient's Patient Information ribbon.

          • The preferred contact method is not associated with and, therefore, does not determine whether the patient will receive automated reminders as text messages or as email messages.

        • Automated Reminders - Select Yes or No to indicate that the patient (any other patients who have this patient as their primary contact) will or will not receive automated text message reminders for appointments and recare. These options are available only if a supported mobile phone number has been entered (on the Basic Info tab) for the patient and the patient is the primary contact for himself or herself or anyone else.

          Notes:

          • Automated text message reminders for this patient (and any other patients who have this patient as their primary contact) will be sent to the mobile phone number displayed. If the patient has more than one mobile phone number, the first one listed (on the Basic Info tab) for the patient will be used for the automated text message reminders.

          • If No is already selected, the date that the patient was last opted out appears for your reference next to the No option. Either someone in your office opted the patient out, or the patient texted STOP to 45827 from his or her mobile phone. Any other patients who have this patient as their primary contact or who have the same mobile number as this patient entered in their patient records have also been opted out.

          • If Yes is already selected, and then you select No and click (or tap) Save, the patient is opted out, and the current date appears next to the No option as the opt-out date. Also, a text message, stating that the patient has been opted out, is sent to the patient's mobile phone. Any other patients who have this patient as their primary contact or who have the same mobile number as this patient entered in their patient records are also opted out. The primary contact can resume receiving text messages for the entire household by texting RESUME to 45827.

        • Preferred Language - Select the patient's preferred language. English is the default. If the preference is a language other than English, the selected language appears on the Patient Information ribbon, which is available when you are viewing the patient's record. Currently, this information is for reference only.

        • Preferred Location - Select the office that the patient prefers to receive treatment at. A matching patient will appear in the results list of a patient search box throughout Dentrix Ascend if that patient's preferred location is in a location to which your user account has access unless you use the advanced search functionality. Other than for patient searches, currently the preferred location is for reference only.

        • Preferred Appointment Day/Time - Select the check boxes that correspond to the days of the week and/or times that the patient prefers to have his or her appointments. The days that are available correspond to the working days set up on your practice's schedule. The selected preferred appointment days and times appear when you are scheduling an appointment for the patient, so you can offer those times to the patient. Currently, this information is for reference only.

      2. Click (or tap) Save.

    • Referrals

      Referrals tab

      Do one of the following:

      • In the Referred By search box, enter all or part of the name of the referral source (patient, professional, marketing, or other) that referred this patient to your practice, and then click (or tap) the appropriate source's name in the list of matching results that appears.

      • To remove an existing referral source from the patient's record, click (or tap) the Remove button next to the referral's name.

    • Notes

      Notes tab

      Do one of the following:

      • To attach a note to the patient's record, click (or tap) Add Note.

      • To edit a patient's note, click (or tap) a note's Edit button .

      • To delete a patient's note, click (or tap) a note's Delete button .

Adding patient notes

You can attach multiple notes to a patient's record. The notes that were created or last modified on the same date are grouped together. Also, you can set up a note to appear as a notification (as a pop-up in the lower-right corner) when you access certain areas of Dentrix Ascend.

To add a patient note

  1. On the Notes tab of a patient's Patient Information page, click (or tap) Add Note.

    The Add Notes dialog box appears.

  2. By default, the Date of the note is today's date, but you can change it if necessary.

  3. In the Patient specific note field, type any important information regarding the patient, such as a conversation you have had with the patient (in person or electronically). This note will appear in the Patient Notes box of the patient's Overview page. The note can be up to 5000 characters long.

    Note: To insert the current date where the text cursor is located, click (or tap) Insert Date.

  4. To make the note into a notification that will appear when someone accesses specified areas of Dentrix Ascend, under Notification Pages, do one of the following:

    • To add the notification to all available areas, select the Add all pages check box.

    • To add the notification to only certain areas, select the desired check boxes. To select all pages within a category (General, Insurance, Financial, Clinical, or Schedule), select the check box of the desired category. To select an individual page within a category, expand the category, and then select the check box of the desired page.

    Note: To remove the notification from all pages in a category, clear the check box of the category. To remove the notification from an individual page within a category, expand the category, and then clear the check box of the page.

  5. Click (or tap) Save.

Adding medical alerts to patients

You can enter a patient's medical alerts (conditions and diseases) as needed. If a patient has a medical alert, a medical alert icon appears on his or her appointments.

To add a medical alert to a patient

  1. On the Medical Alerts tab of a patient's Patient Information page, click (or tap) Add Medical Alert.

    The Add Medical Alert dialog box appears.

  2. Do one of the following:

    • To search for a medical alert, in the Medical Alert search box, begin typing a condition or disease. Continue typing as needed to narrow the results in the list. Then, select the desired alert. The default options for the medical alert are selected automatically, but you can change any of those options as needed.

    • For an alert that is specific or unique to this patient, type any custom text in the Medical Alert search box (for example, "Do not discuss politics with Bob"), and then select Patient Specific Alerts from the list.

  3. Change the Permanent condition and/or Alert Importance options as needed.

    Do any of the following as needed:

    • If you anticipate that this medical alert will be permanent, select the Permanent condition check box. If you anticipate that this medical alert will no longer apply some time in the future, clear the check box. If you are unsure how long the medical alert will be in effect, you can select or clear the check box. You can change this option at a later time if necessary.

      Tips:

      • In the future, if you mark a medical alert as not being permanent, you can set it as expired.

      • Also, regardless of its permanency setting, you can remove a medical alert from a patient's record as needed in the future.

    • Specify the Alert Importance:

      • High - A message that describes the patient's condition or disease will appear each time you access the patient's information, and the Medical Alert icon will appear where applicable.

      • Low - A message will not appear when you access the patient's information, but the Medical Alert icon will appear where applicable.

  4. Click (or tap) Save.

Attaching recare to patients (if attached to appointment but not to patient)

You can attach recare to a patient's record as needed.

Note: Manually attaching recare is not necessary. When you post a completed procedure that is associated with a recare type (such as when you are completing an appointment), Dentrix Ascend automatically attaches the corresponding recare to the patient's record, if it is not already attached, using the default settings for that recare type.

To attach recare to a patient

  1. While viewing a patient's record, on the Patient menu, under General, click (or tap) Recare.

    The Recare page opens.

  2. On a patient's Recare page, click (or tap) Add New Recare.

    The options for attaching recare become available.

  3. Select the Type of recare that you want to attach to the patient.

  4. Change the default Interval for the selected recare type if necessary. Enter a number, and select Weeks, Months, or Years to specify how often a patient with this recare type attached to his or her record should be seen for this type of recare. The Due Date is entered automatically.

  5. Click (or tap) Save.

Updating a patient's recare

You can change the interval and/or due date of a recare that is attached to a patient's record as needed.

To update a patient's recare

  1. On a patient's Recare page, select a recare type.

    Note: Primary recare types are bold for quick identification.

    The options for attaching recare become available.

  2. Do any of the following:

    • Next to Interval, enter a number, and select Weeks, Months, or Years to specify how often a patient with this recare type attached to his or her record should be seen for this type of recare. The Due Date is updated automatically.

      With the workflow compliance feature for your location turned off, each time you complete an appointment with this recare type attached, the due date for the patient's next recare appointment (of this recare type) advances by the specified interval, and a message appears and asks if you want to schedule the next recare appointment.

    • Click (or tap) in the Due Date box, and then select a different date. Changing the due date does not change the Interval automatically.

    Note: Next to Appointment, if there is a link that reads, "Unscheduled," you can click (or tap) the link to go the due date of the patient's recare in the schedule.

  3. Click (or tap) Save.

Updating insurance information for patients

You can update the insurance information attached to a patient's record as needed.

To update a patient's insurance

  1. While viewing a patient's record, on the Patient menu, under Insurance, click (or tap) Insurance Information.

    The patient's Insurance Information page opens.

  2. On a patient's Insurance Information page, select an insurance plan.

    The options for editing insurance information become available.

  3. Update the information as needed, such as the subscriber ID, relation to the subscriber, coverage order, and coverage period.

    Set up the following options:

    • Subscriber and Plan - The subscriber and insurance associated with that subscriber. To change the subscriber and plan, click (or tap) in the Subscriber box, search for and select a different provider, and then select a plan. To change only the plan, select a different plan for the selected subscriber. To show or hide the plan selection list, click (or tap) the Show button or the Hide button .

    • Subscriber ID # - The ID used to identify the subscriber of the insurance plan on claims that are submitted to the corresponding carrier. The subscriber ID might not be the same as the subscriber's Social Security number. Changing the ID will affect the subscriber and all patients covered under that subscriber.

    • Release of Information - The subscriber authorizes the release of information to the practice. With this check box selected, "Signature on File" appears in box 36 on insurance claims. With this check box clear, box 36 is blank.

    • Assignment of Benefits - The subscriber authorizes payments from the carrier to go directly to the provider. With this check box selected, "Signature on File" appears in box 37 on insurance claims, and the carrier will send payments to your practice. With this check box clear, box 37 is blank, and the carrier will send payments to the subscriber.

    • Relation to Subscriber - For a subscriber, since he or she is the current patient, Self is selected automatically and cannot be changed. For a non-subscriber, select Spouse, Child, or Other.

    • Coverage Type - The coverage order of the plan (such as Primary or Secondary). The number of items that are available on the list depends on the number of plans that have already been set up for this patient. If there are no plans, only Primary is an option; if there is one plan, Primary and Secondary are options; if there are two plans, Primary, Secondary, and Tertiary are options; and so on.

    • Coverage Period - In the Coverage Start and Coverage End boxes, enter the date that coverage started and, if known, the date that the coverage will end for the subscriber and all patients who are insured under the selected plan. For a non-subscriber, you can specify an end date that is before or the same as that of the subscriber.

    • Eligibility - If known, select the patient's eligibility status: Unable to Verify, Eligible, or Ineligible. Then, enter today's date (or the date that eligibility was actually checked) in the Verification Date box.

      Note: Changing the eligibility status here affects the patient's eligibility status for his or her appointments on the Insurance Eligibility page and vice versa.

    • Note - Any notes regarding the insurance plan.

Editing the coverage table of a patient's insurance plan

You can edit the coverage table that is attached to a patient's insurance plan. Along with deductibles and benefits, a coverage table allows for accurate insurance estimates.

Important: Changing an insurance plan's coverage table affects all patients covered by that insurance plan.

To edit a coverage table

  1. While viewing an insurance plan that is attached to a patient's record, click (or tap) Coverage Table.

    The Coverage Table dialog box appears.

  2. Select a procedure code range.

    The options for editing the range become available.

  3. Change the Deductible Type and/or Coverage %.

  4. Click (or tap) Save.

Updating a patient's deductibles and benefits

You can update the required and met deductibles and maximum and used benefits for the current and previous years of a patient's insurance plan. Along with coverage tables, updating deductibles and benefits allows for accurate insurance estimates.

To update a patient's deductibles and benefits

  1. While viewing an insurance plan that is attached to a patient's record, click (or tap) Benefits.

    The Deductibles and Benefits dialog box appears.

  2. As needed, for the Current Year and/or Previous Year, enter or change any Met amounts for Deductibles and/or Used amounts for Benefits.

    Note: Updating any Required deductible or Maximum benefit amount updates the deductibles and benefits for all patients who have this insurance plan attached to their records.

  3. Click (or tap) Save.

  4. Click (or tap) Save.

Getting the patient to the back office

  1. When the patient is all checked in, the receptionist clicks (or taps) the Ready status button.

    The appointment's status changes to Ready. The hygienist in the back office, at his or her computer, sees the notification of the status change, and the patient now appears on the routing panel under Ready.

  2. After escorting the patient to an operatory chair, the hygienist clicks (or taps) the Chair status button.

    The appointment's status changes to Chair, and the appointment now appears on the routing panel under Chair.

  3. The hygienist clicks (or taps) the notification.

    The corresponding patient becomes available (if not already visible) on the routing panel.

  4. On the routing panel, the hygienist clicks (or taps) the name of the patient who is currently in the chair.

    The hygienist has the clinical chart of the previous patient open, so the clinical chart of the patient in the chair appears.

3. Clinical

Charting a quick exam

You can quickly chart a patient's conditions, existing treatment, and treatment needs during a full evaluative examination.

Note: Access to the quick exam features is controlled by the same security rights as those for dental charting and managing patient procedures.

To chart a quick exam

  1. On the Quick Exam tab of a patient's clinical record, in the Provider list at the top, select the provider who you want to associate with conditions, existing work, and treatment-planned procedures posted during the quick exam. Only providers who have access to the current location are available.

    Note: At any time during the quick exam, you can change the provider as needed before posting a condition or procedure.

  2. Select one or more teeth.

  3. Do any of the following as needed:

    • Change the dentition.

      • Click (or tap) either the Permanent Dentition or Primary Dentition button in the Conditions column header. The button that is available depends on the current dentition of the selected tooth.

        Note: To change the dentition of all the teeth to primary or permanent, click (or tap) Clear Selected to deselect all teeth before attempting to change the dentition.

    • Chart a condition.

      Click (or tap) a condition in the Conditions list. The posted condition is now pinned to the top of the list (and is visible while the current tooth is still selected). Also, the tooth now has a green box to indicate that a condition is associated with that tooth.

      Tip: To search for a condition that is not a favorite or to filter the list, click (or tap) the column's Search button , and then begin typing part of a SNODENT code, SNOMED CT code, or description in the field that appears.

      Notes:

      • If you are posting a condition that requires a surface to be selected, in the pop-up box that appears when you click (or tap) the condition, select the appropriate surfaces, and then close the pop-up box.

      • If clinical decision support (CDS) is turned on and procedure codes have been associated with a condition, after you select that condition, the potential treatment appears at the top of the Treatment Plan list, so you can quickly treatment plan a procedure relevant to the diagnosis.

        Note: If there is a procedure in the Potential Treatment (Clinical Decision Support) area of the Treatment Plan list that you want to use to treat the selected condition, and if the potential treatment requires treatment areas (such as tooth numbers and surfaces) that the condition does not, you can specify those treatment areas when you treatment plan the procedure, just like any of the other procedures in the Treatment Plan list.

      • To delete a posted condition, click (or tap) the corresponding Unpin button , and then click (or tap) Delete.

    • Chart existing work.

      Click (or tap) a procedure in the Existing Work list. The posted procedure is now pinned to the top of the list (and is visible while the current tooth is still selected). Also, the tooth now has a blue box to indicate that an existing procedure is associated with that tooth.

      Tip: To search for a procedure that is not a favorite or to filter the list, click (or tap) the column's Search button , and then begin typing part of a procedure code or description in the field that appears.

      Notes:

      • The procedures that are available depend on if a tooth is selected. Also, only procedures that have been marked as favorites appear in the list.

      • If you are posting a procedure that requires a surface to be selected, in the pop-up box that appears when you click (or tap) the procedure, select the appropriate surfaces, and then close the pop-up box.

      • To delete a posted procedure, click (or tap) the corresponding Unpin button , and then click (or tap) Delete.

    • Treatment plan a procedure.

      Click (or tap) a procedure in the Treatment Plan list. The posted procedure is now pinned to the top of the list (and is visible while the current tooth is still selected). Also, the tooth now has a red box to indicate that a treatment-planned procedure is associated with that tooth.

      Tip: To search for a procedure that is not a favorite or to filter the list, click (or tap) the column's Search button , and then begin typing part of a procedure code or description in the field that appears.

      Notes:

      • The procedures that are available depend on if a tooth is selected. Also, only procedures that have been marked as favorites appear in the list.

      • If you are posting a procedure that requires a surface to be selected, in the pop-up box that appears when you click (or tap) the procedure, select the appropriate surfaces, and then close the pop-up box.

      • To delete a posted procedure, click (or tap) the corresponding Unpin button , and then click (or tap) Delete.

      Notes:

      • If you chart a tooth-specific condition (with one or more teeth, but not a whole quadrant or arch, selected) and then treatment plan a procedure for a quadrant or an arch, Dentrix Ascend will automatically assign the correct treatment area for the posted procedure.

      • If you chart a mouth-specific condition (with no teeth selected) and then attempt to treatment plan a procedure for a tooth, a quadrant, or an arch, a message appears and asks you to select the correct teeth and then try to post the procedure again.

      • If you chart conditions and then, with the same tooth (or teeth) selected, treatment plan procedures to treat those conditions, the conditions (diagnoses) are automatically associated with those procedures. When you complete the procedures, Dentrix Ascend prompts you to choose which, if any, of the associated conditions you want to mark as Treated. Also, when you create a claim or pre-authorization for the procedures, the corresponding ICD-10 codes are automatically attached to the claim or pre-authorization.

  4. Create a clinical note as needed.

    Notes:

    • When you create a clinical note with a tooth selected, that tooth will be associated with the clinical note by default. To create a clinical note that is not tooth specific, click (or tap) Clear Selected to deselect all teeth before attempting to add the clinical note.

    • After you create the clinical note and close the Add Clinical Note dialog box, you are returned to the quick exam.

  5. Repeat steps 2 - 4 as needed for each tooth.

Tips:

Charting dentition

You can change the graphical tooth chart to show a patient's dentition: primary, permanent, or mixed.

To chart a patient's dentition

  1. On the Chart tab of a patient's clinical record, select the teeth whose dentition you want to change in the graphical tooth chart, or leave no teeth selected to change the dentition for the whole mouth (this is the same as selecting all the teeth).

  2. Click (or tap) the Permanent Dentition or Primary Dentition button .

    All the selected teeth now show in the graphical chart according to the specified dentition. For example, changing the dentition to permanent changes tooth F to 9, or changing the dentition to primary changes tooth 15 to *.

Charting conditions

You can chart dental conditions present at the time of charting in a patient's clinical chart.

Note: A condition charted in the clinical chart appears only on the graphical tooth chart and in the progress notes, not in the financial ledger.

To chart a condition

  1. On the Chart tab of a patient's clinical record, select one or more teeth.

  2. Click (or tap) Add Condition to select the appropriate condition, surfaces (if applicable), and provider in the Add Condition dialog box.

    In the Add Condition dialog box, do the following:

    1. Make sure the correct provider is selected for this charting session. Only providers who have access to the current location are available.

    2. Click (or tap) a condition.

      Note: The conditions that appear in the list depend on which teeth or if no teeth are selected. For example, if no teeth are selected (the treatment area is the mouth), a missing tooth condition will not appear in the list of conditions because it can apply only to one or more teeth, but malocclusion options can appear because they apply to the whole mouth.

    3. If applicable, in the Select Surfaces dialog box that appears, select the surfaces on each tooth for the selected condition, and then click (or tap) Done.

      Tips:

      • To navigate between teeth, click (or tap) a Th. Alternatively, click (or tap) Back and Next.

      • To not enter surfaces for the selected tooth, set Exclude tooth to On.

      • To apply a common combination of surfaces, under Surface combinations, click (or tap) the appropriate button.

Charting existing treatment

You can chart existing treatment in a patient's clinical chart.

To chart existing treatment

  1. On the Chart tab of a patient's clinical record, select one or more teeth.

  2. Click (or tap) Add Procedure to select the appropriate procedure, surfaces (if applicable), and provider from the Add Procedure dialog box.

    In the Add Procedure dialog box, do the following:

    1. Click (or tap) Existing (for past services performed at another practice)

    2. Make sure the correct provider is selected for this charting session. Only providers who have access to the current location are available.

    3. Search for a procedure using one of the following methods:

      • Click (or tap) in the Search box, and begin typing part of the ADA description (for example, "ama" for Amalgam 1 Surface) or code (for example, "21" for D2140). The procedures that match the criteria entered appear in the list. Continue typing as needed to narrow the results.

      • While viewing the procedure list by the Top procedures (the most common procedure types for the selected tooth, arch, or quadrant or for the full mouth), locate a procedure.

      • While viewing the procedure list by the View by categories option (the procedures for the selected tooth, arch, or quadrant or for the full mouth are grouped by category), click (or tap) a category to view the corresponding procedures.

      Note: Procedures appear in the procedure list according to which teeth or if any teeth are selected. For example, if no teeth are selected (the treatment area is the mouth) and you perform a search for "amalgam," no procedures will appear in the list; similarly, if no teeth are selected, an amalgam, procedure will not appear in the list of top procedures or within a category (if you are viewing procedures by categories).

    4. Click (or tap) a procedure.

    5. If applicable, in the Select Surfaces dialog box that appears, select the surfaces on each tooth for the selected procedure, and then click (or tap) Done.

      Tips:

      • To navigate between teeth, click (or tap) a Th. Alternatively, click (or tap) Back and Next.

      • To not enter surfaces for the selected tooth, set Exclude tooth to On.

      • To set Class 5 to On, at least one of the appropriate Surfaces must be selected: mesial, distal, lingual, or facial/buccal.

      • To apply a common combination of surfaces, under Surface combinations, click (or tap) the appropriate button.

    6. You can edit the procedure as needed (such as to enter a supernumerary tooth number or to attach diagnosis codes).

    Note: The charge that is used for a charted or scheduled procedure comes from either the provider's fee schedule or, if not applicable, the preferred fee schedule of the location where the procedure was charted or scheduled.

Entering perio exams

You can enter a perio exam in a patient's record.

To enter a perio exam

  1. On the Perio tab of a patient's clinical record, click (or tap) New Perio Exam.

    The New Perio Exam dialog box appears.

  2. Select the desired options, such as the arch and tooth sequence and the teeth to be skipped.

    Set up the following options:

    • Date - Verify that the date is correct. If necessary, you can change it.

    • Provider - Verify that the correct provider is associated with the exam. If necessary, select a different provider. Only providers who have access to the current location are available.

    • Tooth navigation script - Select whether you want enter primarily pocket depths, primarily gingival margins, or the pocket depth and then the gingival margin at each measurement site. A selection frame will appear next to the applicable measure (PD or GM) during the exam by default, but you can toggle between pocket depth and gingival margin as needed.

      Tip: If you are not using the script that allows you to enter pocket depths and gingival margins at each measurement site, to enter pocket depths first and then gingival margins, select Pocket Depth as the script, start the exam, enter pocket depths, save the exam, restart (or edit) the exam, select Gingival Margin as the script, enter gingival margins, and then save the exam. Or, you can enter gingival margins first and then pocket depths by making the script selections in the opposite order than just explained.

    • Script - Select the method that you will use to move around the patient's mouth to take perio measurements.

    • Skip conditions - Specify if any teeth will not get examined. Teeth with any of the selected conditions will be skipped automatically. A tooth is considered to have one of those conditions if an applicable charting symbol is associated with an existing or a completed procedure that was posted for that tooth,

    • Enter Bld and Sup [#] teeth after measurement sites - Enter the number of teeth that you must measure before you can start entering bleeding and suppuration (for example, if you enter four, you must enter measurements for Distal, Center, and Mesial on the Facial side of teeth 1-4) unless you click (or tap) a different area of the exam than where the script starts. Zero indicates that you can start entering bleeding and suppuration immediately upon starting the exam. Also, as you follow the script to continue charting, the selection frame for BOP and Sup trails behind the current position by the specified number of teeth (as with our example of four, if the current position is tooth 10, the selection frame for BOP and Sup is on tooth 6).

  3. Click (or tap) Start Exam.

    The options for entering a perio exam become available.

  4. By default, if the patient has a previous perio exam entered, the measurements (pocket depth, gingival margin, clinical attachment level, furcation grade, bone loss, and mobility) from that exam appear in gray. To switch between showing and hiding the previous exam's measurements, turn the Show prev. exam values switch On and Off.

  5. For each tooth, enter the probing depth and then the gingival margin (if applicable for the tooth navigation script being used) at each site. As you type the probing depth and then the gingival margin (if applicable for the tooth navigation script being used), the exam advances to each site and tooth automatically. You can also enter other periodontal measurements, such as bleeding and suppuration.

    Enter any of the following measurements for the central, distal, and mesial sites on the facial and lingual sides of each tooth (the order depends on the script selected in step 2):

    • PD - If you are using the tooth navigation script for entering pocket depths or the one for entering pocket depths and gingival margins, type the probing depths (0 to 19). If you are using the tooth navigation script for entering gingival margins, enter pocket depths in the M, B (or F or L), and/or D boxes.

      Note: For measurements that are four or greater, a red box appears around the number on the chart.

    • GM - If you are using the tooth navigation script for entering gingival margins, type the gingival margins (-19 to 19). If you are using the tooth navigation script for entering pocket depths and gingival margins, type the gingival margin after typing the pocket depth at each site. If you are using the tooth navigation script for entering pocket depths, enter gingival margins in the M, B (or F or L), and/or D boxes.

    • BOP - If bleeding is present for any sites, click (or tap) the M, B (or F or L), and/or D circles. To quickly add bleeding to multiple sites at once, click (or tap) the shortcut button or press the B key. Clicking (or tapping) the shortcut button or pressing the B key changes the applied bleeding and toggles between the bleeding options for that button: the empty circle removes the bleeding from M, B (or F or L), and D, if any; the two half circles adds bleeding to M and D; the filled circle with an A adds bleeding to M, B (or F or L), and D.

    • SUP - If suppuration is present for any sites, click (or tap) the M, B (or F or L), and/or D circles. To quickly add suppuration to multiple sites at once, click (or tap) the shortcut button or press the S key. Clicking (or tapping) the shortcut button or pressing the S key changes the applied suppuration and toggles between the suppuration options for that button: the empty circle removes the suppuration from M, B (or F or L), and D, if any; the two half circles adds suppuration to M and D; the filled circle with an A adds suppuration to M, B (or F or L), and D.

    • Furc - Select furcation grades (F0 to F4). Furcation is not applicable to all tooth sites, so some sites do not have this option available.

    • Bloss - Select amounts of bone loss (None to Severe).

    • Mob - Select levels of mobility (None to Class III).

    Tips:

    • For pocket depths, gingival margins, and the other measurements, you can click (or tap) the left and right arrow buttons to rewind and advance the script for the exam. Click (or tap) an area on the graph to go directly to that part of the script for the exam. You can use the left and right arrow keys to move the selection frame for PD or GM left and right between the M, B (or F or L), and D sites. You can use the up and down arrow keys to move the selection frame for PD or GM up and down. With a site selected for PD or GM, to remove the value that you have entered, press the Delete key. After using the keyboard keys to stray from the script, to get back on script, click (or tap) the left or right arrow button.

    • You can enter bleeding and suppuration separately from the script for the exam. Click (or tap) the left and right arrow buttons to go backward and forward sequentially between areas in the mouth.

      To enter bleeding and suppuration for an entire sextant at once, click (or tap) Mark Bleeding and Suppuration. By default, the tab of the sextant that corresponds to the tooth that is currently selected, but you can enter bleeding and suppuration on any tab as needed. In a sextant, you can quickly specify bleeding and suppuration for all sites, for the same site on all teeth on the buccal or lingual sides, or on a tooth by tooth basis. When you are finished entering bleeding and suppuration, click (or tap) Save.

    • You can use the number buttons or keyboard keys to enter probing depths and gingival margins.

    • You can zoom in and out at any time during the exam either by holding down the Ctrl key and scrolling or by moving the Zoom slider between Full, Quad, and Tooth. The Full option is available only if the resolution of your computer's (or device's) display is high enough.

    • To switch between hiding and showing the perio exam controls for entering data, click (or tap) the Hide and Show button .

    • To switch to a different tooth navigation script, select the desired script from the Tooth navigation script list.

    • To view an explanation of all the abbreviations and symbols that are used for perio exams and the available keyboard shortcuts, click (or tap) the Legend button .

  6. When you have finished the exam, click (or tap) Finish Exam.

    If the patient has a previous exam, the Finish Perio Exam dialog box appears. If not, ignore the next step.

  7. Do one of the following:

    • To save the current exam with measurements (if they exist) from the previous exam where you have not entered new measurements, click (or tap) Save Exam with the Previous Values.

    • To save the current exam without any of the measurements from the previous exam, click (or tap) Save Only New Values.

Charting treatment performed (if not scheduled for today)

You can chart completed treatment in a patient's clinical chart.

Note: A completed procedure charted in the clinical chart appears in the clinical record and financial ledger; however, a treatment-planned procedure or existing condition does not appear in the financial ledger.

To chart treatment

  1. On the Chart tab of a patient's clinical record, select one or more teeth.

  2. Click (or tap) Add Procedure to select the appropriate procedure, surfaces (if applicable), and provider from the Add Procedure dialog box.

    In the Add Procedure dialog box, do the following:

    1. Click (or tap) Completed (for today's services).

    2. Make sure the correct provider is selected for this charting session. Only providers who have access to the current location are available.

    3. Search for a procedure using one of the following methods:

      • Click (or tap) in the Procedure Search box, and begin typing part of the ADA description (for example, "ama" for Amalgam 1 Surface) or code (for example, "21" for D2140). The procedures that match the criteria entered appear in the list. Continue typing as needed to narrow the results.

      • While viewing the procedure list by the Top procedures (the most common procedure types for the selected tooth, arch, or quadrant or for the full mouth), locate a procedure.

      • While viewing the procedure list by the View by categories option (the procedures for the selected tooth, arch, or quadrant or for the full mouth are grouped by category), click (or tap) a category to view the corresponding procedures.

      Note: Procedures appear in the procedure list according to which teeth or if any teeth are selected. For example, if no teeth are selected (the treatment area is the mouth) and you perform a search for "amalgam," no procedures will appear in the list; similarly, if no teeth are selected, an amalgam, procedure will not appear in the list of top procedures or within a category (if you are viewing procedures by categories).

    4. Click (or tap) a procedure.

    5. If applicable, in the Select Surfaces dialog box that appears, select the surfaces on each tooth for the selected procedure, and then click (or tap) Done.

      Tips:

      • To navigate between teeth, click (or tap) a Th. Alternatively, click (or tap) Back and Next.

      • To not enter surfaces for the selected tooth, set Exclude tooth to On.

      • To set Class 5 to On, at least one of the appropriate Surfaces must be selected: mesial, distal, lingual, or facial/buccal.

      • To apply a common combination of surfaces, under Surface combinations, click (or tap) the appropriate button.

    6. You can edit the procedure as needed (such as to enter a supernumerary tooth number or to attach diagnosis codes).

    Note: The charge that is used for a charted or scheduled procedure comes from either the provider's fee schedule or, if not applicable, the preferred fee schedule of the location where the procedure was charted or scheduled.

Charting recommended treatment

You can chart planned treatment in a patient's clinical chart.

Note: A completed procedure charted in the clinical chart appears in the clinical record and financial ledger; however, a treatment-planned procedure or existing condition does not appear in the financial ledger.

To chart recommended treatment

  1. On the Chart tab of a patient's clinical record, select one or more teeth.

  2. Click (or tap) Add Procedure to select the appropriate procedure, surfaces (if applicable), and provider from the Add Procedure dialog box.

    In the Add Procedure dialog box, do the following:

    1. Click (or tap) Tx Plan (for potential future services).

    2. Make sure the correct provider is selected for this charting session. Only providers who have access to the current location are available.

    3. Search for a procedure using one of the following methods:

      • Click (or tap) in the Procedure Search box, and begin typing part of the ADA description (for example, "ama" for Amalgam 1 Surface) or code (for example, "21" for D2140). The procedures that match the criteria entered appear in the list. Continue typing as needed to narrow the results.

      • While viewing the procedure list by the Top procedures (the most common procedure types for the selected tooth, arch, or quadrant or for the full mouth), locate a procedure.

      • While viewing the procedure list by the View by categories option (the procedures for the selected tooth, arch, or quadrant or for the full mouth are grouped by category), click (or tap) a category to view the corresponding procedures.

      Note: Procedures appear in the procedure list according to which teeth or if any teeth are selected. For example, if no teeth are selected (the treatment area is the mouth) and you perform a search for "amalgam," no procedures will appear in the list; similarly, if no teeth are selected, an amalgam, procedure will not appear in the list of top procedures or within a category (if you are viewing procedures by categories).

    4. Click (or tap) a procedure.

    5. If applicable, in the Select Surfaces dialog box that appears, select the surfaces on each tooth for the selected procedure, and then click (or tap) Done.

      Tips:

      • To navigate between teeth, click (or tap) a Th. Alternatively, click (or tap) Back and Next.

      • To not enter surfaces for the selected tooth, set Exclude tooth to On.

      • To set Class 5 to On, at least one of the appropriate Surfaces must be selected: mesial, distal, lingual, or facial/buccal.

      • To apply a common combination of surfaces, under Surface combinations, click (or tap) the appropriate button.

    6. You can edit the procedure as needed (such as to enter a supernumerary tooth number or to attach diagnosis codes).

    Note: The charge that is used for a charted or scheduled procedure comes from either the provider's fee schedule or, if not applicable, the preferred fee schedule of the location where the procedure was charted or scheduled.

Entering clinical notes

You can enter clinical notes into a patient's record.

Note: You can also enter and sign clinical notes from the Clinical Note Tasks page.

To enter a clinical note

  1. To assign tooth numbers to the clinical note that you are going to create, on the Chart or Quick Exam tab of a patient's clinical record, select one or more teeth. To not assign tooth numbers to the clinical note, skip this step. You can assign tooth numbers and change the assigned tooth numbers as needed later on.

  2. On the Chart, Progress Notes, Quick Exam, Perio, or Tx Planner tab of a patient's clinical record, click (or tap) Add Clinical Note; or if the patient has an existing clinical note, on the Clinical Notes button menu, click (or tap) Add Clinical Note.

    The Add Clinical Note dialog box appears.

    Note: For your reference, any of the patient's completed and treatment-planned procedures for the selected date appear on the Procedures tab.

  3. Set up the following options:

    • Th - By default, if you have selected teeth on the patient's Chart page, those tooth numbers are automatically assigned to this clinical note. Do one of the following if needed:

      • If no tooth numbers are assigned to the clinical note, to assign tooth numbers, click (or tap) the Assign teeth link, select the applicable teeth, and then click (or tap) X.

      • If tooth numbers are assigned to the clinical note, to modify the assigned tooth numbers, click (or tap) the link for those tooth numbers (such as 2-4). Select or deselect teeth, and then click (or tap) X.

    • Provider - The provider to associate with this note. Only providers who have access to the current location are available.

    • Date - The date of the note. Leave the current date selected, or click (or tap) the box to select a different date.

    • Additional Provider - A secondary provider (such as a hygienist) to associate with this note. To associate an additional provider with the note, select that provider; otherwise, leave [None] selected. Only providers who have access to the current location are available.

    • Note - The text of the note. Enter the note text, and/or insert notes from templates.

  4. If the note is complete, and if you are the selected provider or have permission from the provider, you can sign the note. To sign the note, select the Sign as [provider name] check box, and then enter the selected provider's or, if you are the provider, your Password. However, if the note needs to be finished later, or if the provider has to review the note, the note can be signed later.

    Note: The Sign as [provider name] check box is available only if a digital signature for the selected provider has been set up. Also, the Password box is available only if the Sign as [provider name] check box is selected.

  5. Click (or tap) Save.

Entering clinical notes (using templates)

Using the clinical note templates for the current location, you can quickly enter clinical notes into a patient's record.

To enter a clinical note from a template

  1. To assign tooth numbers to the clinical note that you are going to create, on the Chart or Quick Exam tab of a patient's clinical record, select one or more teeth. To not assign tooth numbers to the clinical note, skip this step. You can assign tooth numbers and change the assigned tooth numbers as needed later on.

  2. On the Chart, Progress Notes, Quick Exam, Perio, or Tx Planner tab of a patient's clinical record, click (or tap) Add Clinical Note; or if the patient has an existing clinical note, on the Clinical Notes button menu, click (or tap) Add Clinical Note.

    The Add Clinical Note dialog box appears.

  3. On the Templates tab, select a template.

    Note: A location's clinical note templates are available when entering clinical notes only from that location. However, if a user makes a clinical note template a favorite, it will be available for that user from any location.

  4. If there are any quick-picks associated with the selected template, respond to all prompts that may appear, clicking (or tapping) Next between each prompt.

    Note: If you need to save your progress and close the clinical note before you are finished responding to all the prompts that are associated with the selected template, click (or tap) Save Progress. The clinical note becomes marked as In Progress. Later, you can resume entering the clinical note from the following areas of Dentrix Ascend:

    The Clinical Notes button menu. The note that is in progress is indicated by "[In Progress]."

    The Progress Notes tab. The note that is in progress is indicated by a red dot on the note symbol.

    The Clinical Note Tasks box. The count in the In Progress column accounts for the note that is in progress.

    On the last prompt, the Next button changes to a Done button.

  5. Click (or tap) Done.

    The finished note appears in the Note field.

  6. Edit and/or add to the note text, and change the other options, such as the provider, as needed.

    Set up the following options:

    • Th - By default, if you have selected teeth on the patient's Chart page, those tooth numbers are automatically assigned to this clinical note. Do one of the following if needed:

      • If no tooth numbers are assigned to the clinical note, to assign tooth numbers, click (or tap) the Assign teeth link, select the applicable teeth, and then click (or tap) X.

      • If tooth numbers are assigned to the clinical note, to modify the assigned tooth numbers, click (or tap) the link for those tooth numbers (such as 2-4). Select or deselect teeth, and then click (or tap) X.

    • Provider - The provider to associate with this note. Only providers who have access to the current location are available.

    • Date - The date of the note. Leave the current date selected, or click (or tap) the box to select a different date.

    • Additional Provider - A secondary provider (such as a hygienist) to associate with this note. To associate an additional provider with the note, select that provider; otherwise, leave [None] selected. Only providers who have access to the current location are available.

    • Note - The text of the note. Edit the note text, and/or insert notes from templates (where the text cursor is located).

  7. If the note is complete, and if you are the selected provider or have permission from the provider, you can sign the note. To sign the note, select the Sign as [provider name] check box, and then enter the selected provider's or, if you are the provider, your Password. However, if the note needs to be finished later, or if the provider has to review the note, the note can be signed later.

    Note: The Sign as [provider name] check box is available only if a digital signature for the selected provider has been set up. Also, the Password box is available only if the Sign as [provider name] check box is selected.

  8. Click (or tap) Save.

Creating treatment plans

Using the procedures that have been treatment-planned in the clinical chart or ledger, you can create a custom treatment plan for a patient.

To create a treatment plan

  1. On the Tx Planner tab of a patient's clinical record, under Active, make sure Unassigned is selected.

    The procedures that have not been assigned to a specific case appear.

  2. Create a new case for procedures and/or add procedures to an existing case as needed.

    Do any of the following:

    • To create a new case that contains a specific procedure, drag that procedure (using the handle ) to the box on the left.

    • To add a procedure to an existing case, drag that procedure (using the handle ) to a case under Active on the left.

    • To add multiple procedures to an existing case at once or a new case, select the check boxes of the procedures you want to add to a case, and then, from the Move To button menu, click the name of the desired case or New Case.

  3. To rename the newly created or existing case, with the case selected under Active, click (or tap) the corresponding Edit button to open the Rename dialog box, type the New case name, and then click (or tap) Rename.

    With the case still selected, the recommended treatment for that case appears on the right.

  4. Create a new visit for procedures, add procedures to an existing visit, and/or adjust the order of procedures in a visit as needed.

    Do the following:

    1. Select the check boxes of the procedures that you want to move.

    2. Do any of the following:

      • To create a new visit, drag a procedure (using the handle ) to the box below the visits.

      • To add a procedure to an existing visit, drag that procedure (using the handle ) to the desired visit.

      • To create a new visit or add a procedure to an existing visit, from the Move To button menu, select the applicable option (New Case; or Visits > [case name]).

    3. To adjust the order of procedures in a visit, drag a procedure (using the handle ) to a location above or below another procedure in that visit.

  5. Specify the Expiration date of the case. You can choose a specific date or insert the last day of the current year. To show the expiration date when presenting the case, on the printed copy of the case, and on a consent form, select the Show on form check box.

  6. Enter a Note regarding the case. The note can be up to 250 characters long. To show the note when presenting the case, on the printed copy of the case, and on a consent form, select the Show on form check box.

  7. To change the duration of any visit, select a different time length from the corresponding Duration list.

  8. By default, a new case has a "New" status initially, but you can select a different Status as needed.

    Select one of the following options:

    • New - If this is a newly created case that you have not presented to the patient yet.

    • Presented - If you have presented the case to the patient.

    • Accepted - If the patient accepts the entire case.

    • Rejected - If the patient rejects any part of the case.

Note: The fees on treatment plans come from either the preferred fee schedule of the location where the procedures are treatment planned or, if there is not a fee schedule for the location, the treatment-planned provider's fee schedule. The fees do not take into account an insurance plan's fee schedule and coverage table or a patient's estimated portion.

Posting procedures (scheduled for today and treatment planned)

You can post a treatment-planned procedure as complete in a patient's clinical chart. Also, from the patient's clinical chart, you can post a procedure that is attached to an appointment scheduled for today.

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 complete treatment

Use any of the following methods:

Scheduling the next recare appointment

To schedule a patient's next recare appointment

  1. To schedule the next recare appointment, in the Chair section of the routing panel, expand the Schedule Recare task, and then click (or tap) the Unscheduled link next to the correct recare type.

    The Appointment Information panel opens.

  2. Set up the options for the appointment as needed.

    Set up the following options:

    • Status - By default, all new appointments have Unconfirmed selected, but you can select a different status if necessary. The corresponding status icon appears on the appointment (for example, Unconfirmed is a question mark ).

    • ASAP - Select this check box if the patient wants to be contacted if an earlier date and/or time becomes available. With this option selected, the patient will show on the ASAP List. With this option selected, the patient will show on the ASAP List, and an ASAP icon appears on the appointment.

    • Needs Follow-up - Select this check box if any of the procedures for this appointment require you to follow up with the patient after his or her visit. The patient will show up on the Patient Follow-up list after his or her appointment.

    • Premedicate - Select this check box if the patient prefers to be medicated before any of the procedures are performed or if any of the procedures require premedication.

    • Procedure(s) - On the Appointment Information panel, a recare procedure that is attached to an appointment has a green stripe.

    • Other - Enter a reason, other than that of the selected procedures, for the appointment.

    • Operatory - Select an operatory from the list. Alternatively, to quickly change the operatory, click (or tap) and hold and then click (or tap) an open time slot in a different operatory.

    • Appointment Provider - Select an appointment provider from the list (only providers who have access to the current location are available). Alternatively, if you are viewing the schedule by provider, to quickly change the provider, click (or tap) and hold and then click (or tap) the column of a different provider. Only providers who have access to the current location are available. The exception to this is when a provider is associated with the appointment and no longer has access to the current location; that provider is available in the list unless you select a different provider and then save the change.

    • Other Provider - Select a secondary provider, such as a hygienist, for the appointment from the list. A colored box (determined by the provider color assigned to this provider) appears on the appointment. Only providers who have access to the current location are available. The exception to this is when a provider is associated with the appointment and no longer has access to the current location; that provider is available in the list unless you select a different provider and then save the change.

    • Date - The date being viewed on the schedule is already selected by default, but you can change it. Click (or tap) in the box to select a different date. Alternatively, if you are viewing the schedule by week, to quickly change the date, click (or tap) and hold and then click (or tap) an open time slot on a different date.

    • Time - Click (or tap) in the box, and then enter a time. Alternatively, to quickly change the time, click (or tap) and hold and then click (or tap) a different open time slot.

      Tip: You can enter a time using various formats. For example, you can type 08:30, 8:30a, or 8:30 AM; 8a or 8am; 13:30, 1:30p, or 1:30 PM; or 1p or 1pm.

    • Length - The length of the appointment is determined by the selected procedures or the specified time range, but you can change the length as needed. The end time of the appointment changes accordingly.

    • Note - Enter a note regarding the appointment. To insert the current date where the text cursor is positioned in the field, click (or tap) Insert Date. If there is an appointment note, a note icon appears on the appointment.

  3. Click (or tap) Save.

Getting the patient to the front office

  1. After work is completed on the patient, the hygienist opens the routing panel (if it is not already open) and then clicks (or taps) the Checkout status button. The patient starts walking to the front desk to check out.

    The appointment's status changes to Checkout. The receptionist at the front desk, at his or her computer, sees the notification of the status change, and the appointment appears on the routing panel under Checkout.

  2. The receptionist clicks (or taps) the notification.

    The corresponding patient becomes available (if not already visible) on the routing panel.

4. Patient checkout

Presenting treatment plan estimates

After treatment-planned procedures have been added to a case, you can present the treatment plan to the patient.

To present a treatment plan

  1. 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.

  2. Do one of the following:

    • On the Patient menu, under General, click (or tap) Overview. The patient's Overview page opens. The Treatment Plan box displays the patient's treatment plans. Click (or tap) a treatment plan. Skip step 1.

    • On the Patient menu, under Clinical, click (or tap) Treatment Planner.

    The patient's clinical record opens with the Tx Planner tab selected.

  3. On the Tx Planner tab of a patient's clinical record, under Active, select a case.

    The recommended treatment for the selected case appears.

  4. Click (or tap) Preview.

    The treatment plan appears.

  5. By default, a presented case has a "Presented" status, but you can select a different Status as needed.

    Select one of the following options:

    • New - This is a newly created case that you have not presented to the patient yet.

    • Presented - This is a case that you have presented to the patient.

    • Accepted - The entire case has been accepted by the patient.

    • Rejected - Any part of the case has been rejected by the patient.

  6. If there is a blue insurance plan icon next to the name of any of the patient's insurance plans, there is a note for that insurance plan. To view the note as a tooltip (only if you are using a mouse), position the pointer over the icon; otherwise, click (or tap) the icon.

  7. To view the details of the treatment plan's estimated guarantor portion, click (or tap) the amount next to Estimated guarantor portion.

  8. To print a copy of the treatment plan for the patient to take, click (or tap) Print.

  9. To return to the Treatment Planner page, click (or tap) Back to Treatment Planner.

Scheduling appointments from treatment plans

You can quickly schedule appointments for the procedures in a patient's treatment plan.

To schedule a treatment plan

  1. Select the check boxes of all the procedures in the visit that you want to schedule an appointment for, or select the check box at the top of that visit to select all the corresponding procedures.

  2. Click (or tap) Create Appointment. This button is available only if all the procedures in a visit are selected.

    The Appointment Information panel opens.

  3. Set up the options for the appointment as needed.

    Set up the following options:

    • Status - By default, all new appointments have Unconfirmed selected, but you can select a different status if necessary. The corresponding status icon appears on the appointment (for example, Unconfirmed is a question mark ).

    • ASAP - Select this check box if the patient wants to be contacted if an earlier date and/or time becomes available. With this option selected, the patient will show on the ASAP List. With this option selected, the patient will show on the ASAP List, and an ASAP icon appears on the appointment.

    • Needs Follow-up - Select this check box if any of the procedures for this appointment require you to follow up with the patient after his or her visit. The patient will show up on the Patient Follow-up list after his or her appointment.

    • Premedicate - Select this check box if the patient prefers to be medicated before any of the procedures are performed or if any of the procedures require premedication.

    • Procedure(s) - On the Appointment Information panel, a treatment plan case's visit that is attached to an appointment has a red stripe.

    • Operatory - Select an operatory from the list. Alternatively, to quickly change the operatory, click (or tap) and hold and then click (or tap) an open time slot in a different operatory.

    • Appointment Provider - Select an appointment provider from the list (only providers who have access to the current location are available). Alternatively, if you are viewing the schedule by provider, to quickly change the provider, click (or tap) and hold and then click (or tap) the column of a different provider. Only providers who have access to the current location are available. The exception to this is when a provider is associated with the appointment and no longer has access to the current location; that provider is available in the list unless you select a different provider and then save the change.

    • Other Provider - Select a secondary provider, such as a hygienist, for the appointment from the list. A colored box (determined by the provider color assigned to this provider) appears on the appointment. Only providers who have access to the current location are available. The exception to this is when a provider is associated with the appointment and no longer has access to the current location; that provider is available in the list unless you select a different provider and then save the change.

    • Date - The date being viewed on the schedule is already selected by default, but you can change it. Click (or tap) in the box to select a different date. Alternatively, if you are viewing the schedule by week, to quickly change the date, click (or tap) and hold and then click (or tap) an open time slot on a different date.

    • Time - Click (or tap) in the box, and then enter a time. Alternatively, to quickly change the time, click (or tap) and hold and then click (or tap) a different open time slot.

      Tip: You can enter a time using various formats. For example, you can type 08:30, 8:30a, or 8:30 AM; 8a or 8am; 13:30, 1:30p, or 1:30 PM; or 1p or 1pm.

    • Length - The length of the appointment is determined by the selected procedures or the specified time range, but you can change the length as needed. The end time of the appointment changes accordingly.

    • Note - Enter a note regarding the appointment. To insert the current date where the text cursor is positioned in the field, click (or tap) Insert Date. If there is an appointment note, a note icon appears on the appointment.

  4. Click (or tap) Save.

Posting procedures (those not charted)

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

  1. While viewing a patient's record, on the Patient menu, under Financial, click (or tap) Ledger.

    The patient's Ledger page opens.

  2. On a patient's Ledger page, click (or tap) Procedure.

    The Enter Procedure dialog box appears.

  3. Enter the procedure details, such as the rendering provider, ADA 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 organization's transaction lock setting.

    • Provider - The provider who performed the procedures (rendering provider). Only providers who have access to the current location are available.

    • 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.

    • Bill to insurance - Whether the selected procedure should be billed to insurance. If the switch is On, the procedure can appear on a claim. If the switch is Off, the procedure cannot be added to a claim and will not be included in estimated insurance portion calculations. The default state of this switch is determined by the setup of the procedure code. Use caution when turning on this option for an alias procedure code or a non-standard code because some carriers may reject this procedure on a claim or may reject the entire claim due to the presence of an unrecognized procedure code. However, being able to bill a non-standard code, such as a rate code, to an insurance carrier is helpful for Federally Qualified Health Centers (FQHCs) when a rate code is needed for a wrap claim.

    • 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. By default, this amount is determined by the following method:

      • If the patient has insurance coverage, there is a fee schedule attached to that insurance plan, and the selected provider is contracted with that carrier, 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 insurance coverage, but either a fee schedule is not attached to that insurance plan, or the selected provider is not contracted with that carrier, 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 insurance 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 insurance 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.

    • Teeth, Surfaces, and so forth - If applicable for the selected procedure, specify the supporting treatment information, such as a Tooth number and Surfaces.

      Note: To change the tooth number to a supernumerary tooth number, do the following: for a permanent tooth, add 50 (for example, 16 + 50 = 66); for a primary tooth, add a letter "s" (for example, CS).

    • Note - Any notes regarding the procedure. 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.

    • Insurance Estimate Overrides - An amount that differs from the estimated amount insurance 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.

    • Orthodontic Treatment - If the procedure is for orthodontic treatment, select the Orthodontic Treatment check box. Then, enter the date that the orthodontic device was placed (in the Placement box) and the number of months that remain until the treatment is complete (in the Month Remaining box). These options are available only if an orthodontic procedure is selected.

      Note: When you create a claim for the procedure, the total number of months will be calculated (based on the placement date and remaining months) and entered on the claim automatically.

    • 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 ADA 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 the Amount entered is different than the fee for the selected procedure in the patient's discount fee schedule (if applicable) or the provider's fee schedule (or if not applicable, the default fee for the procedure code), the recommended amount appears next to the box. To use the recommended amount, either click (or tap) the recommendation to insert that value into the Amount 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 amount, 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.

  4. Click (or tap) Save.

Checking out patients

You can enter a payment, generate a walkout statement, and create claims at the same time for a patient when that patient is ready to check out after a visit.

To check out a patient

  1. Do one of the following:

    • Click (or tap) the Patient Walkout button for a patient in the Checkout section of the routing panel.

    • On a patient's Ledger page, click (or tap) Patient Walkout.

    The Patient Walkout dialog box appears.

  2. Perform the necessary tasks on the following tabs for checking the patient out after his or her visit:

    • Create Claims

      Create Claims tab

      1. Select the check boxes of any completed procedures posted to the patient's ledger that are not attached to claims.

      2. For the selected procedures, the associated diagnoses appear. You can have up to four ICD-10 codes per claim. If you have more than four, either remove ICD-10 codes from the claim (by clicking, or tapping, on the corresponding codes), or split the procedures between separate claims (clear the check boxes of the procedures that you do not want on this claim, so you can create one or more additional claims for those procedures).

        Note: Removing ICD-10 codes from a claim does not affect the corresponding procedures. All diagnoses remain attached to their corresponding procedures as currently posted in the patient's ledger and progress notes.

        If there are two, three, or four ICD-10 codes, select the one that you want to be the primary diagnosis.

      3. Click (or tap) Create Claims.

        Procedures are grouped by Service Date, so you can create separate claims for each unique date of service.

    • Send Claims

      Send Claims tab

      1. Select the check boxes of the claims that you want to send.

      2. Click (or tap) Send Selected Claims.

    • Payment

      Payment tab

      1. Type the Amount of the payment.

      2. Select a payment Type.

        The other payment options become available.

      3. Set up the payment details as needed.

      4. Click (or tap) Save Payment.

      5. Repeat steps a - d for any other payments that you need to post.

    • Statement

      Statement tab

      1. Set up the following walkout statement options as needed:

        • Statement View

          • Guarantor View - Select this option to include transactions for the current patient, all patients who have the same guarantor as the current patient, and the guarantor (if not the current patient).

          • Patient View - Select this option to include transactions for the current patient. This option is not available if the patient is the guarantor for only himself or herself (the Guarantor View option will be used).

        • Statement Message - Type a message that you want to have appear at the bottom of the walkout. This message will be saved for the current patient (and appear on this patient's individual statements and walkouts from now on) when you click (or tap) Print Walkout Statement. In addition to this patient-specific message, a general message may also appear below at the bottom of the walkout (if a default message exists for batch statements).

          Note: Only the first 450 characters of the statement message can be transmitted with an electronic statement.

        • Include credit card payment options - Select this check box to have credit card payment options appear on the walkout.

        • Include due date as - Select this check box to have the specified date entered as the due date on the walkout.

          Note: You can choose a date that is 1 to 180 days in the future. However, industry consultants recommend that the due date be 30 days, which is the default.

      2. To record a summary of the statement in the patient's connections history and save a copy of the statement in the patient's Document Manager, set the Add to Patient Connection switch to Yes. To not record the statement as a patient connection or save a copy of the statement, set the switch to No.

        Notes:

        • With this switch set to Yes, the patient's "last billed date" is updated, which affects which statements get generated if you generate a batch of statements in the future using the Only generate statement if not billed since option.

        • With this switch set to Yes, if the Guarantor View option is selected, a patient connection is added to, a copy of the statement is copied to, and the "last billed date" is updated for not only the current patient but the patient's guarantor (if not the same) and all patients who have that guarantor.

      3. To send an electronic statement (e-statement) to the patient, set the Send eStatement switch to Yes. To not send an e-statement, set the switch to No.

      4. Do one of the following:

        • Print a statement for the patient.

          • If the Send eStatement switch is set to No, click (or tap) Print.

          • If the Send eStatement switch is set to Yes, from the Print button menu, select Print.

        • Send an electronic statement (e-statement) to the patient. Whether the Send eStatement switch is set to Yes or No, from the Print button menu, select Send eStatement only.

        • Print a statement for the patient and send an electronic statement (e-statement) to the patient. With the Send eStatement switch set to Yes, click (or tap) Print.

        If you clicked (or tapped) Print, a .pdf version of the walkout appears.

Note: A balance forward amount will appear on the walkout for the account's balance up to today's date.

Completing the appointment

Completing appointments is a good way to make sure that all the necessary tasks have been done for that appointment, such as posting procedures, scheduling the next recare appointment, gathering contact information, and collecting a payment. On the calendar, you can see at a glance which appointments have been completed because those appointment tiles will be a gray color.

Also, to help you complete all the necessary appointment tasks, you can turn on the workflow compliance feature for any location.

To complete an appointment

  1. Do one of the following:

    • On the routing panel, click (or tap) the Complete status button.

      Note: Changing the status of an appointment for a new patient to "Complete" causes the status of the patient to change from New to Active.

    • On the Calendar page, click (or tap) an appointment. On the Appointment Information panel, change the appointment's Status to Complete, and then click (or tap) Save.

    If any of the appointment's procedures have not been posted (either from the routing panel or from the progress notes), the Post Procedures Complete dialog box appears. Otherwise, skip to step 6.

  2. Post the recare procedures and any other procedures as needed by clicking (or tapping) the corresponding Post buttons.

  3. Complete treatment-planned procedures as needed by clicking (or tapping) the corresponding Complete buttons. You can mark any associated conditions as Treated before you finish completing this appointment, or someone can do it at a later time.

  4. Treat conditions associated with completed treatment-planned procedures as needed by clicking (or tapping) the corresponding Condition buttons . If you have not already completed the treatment-planned procedures that were performed to treat those conditions, you can do so before you finish completing this appointment, or someone can do it at a later time.

  5. Click (or tap) Complete Appt.

  6. According to whether your location uses or does not use the workflow compliance feature for appointment tasks, do one of the following:

    • With workflow compliance: If there are incomplete tasks on the routing panel, a warning message appears, and the incomplete appointment tasks on the routing panel have a yellow background.

      Note: The appointment status will remain as "Checkout" until you complete all the appointment tasks or until you specify a reason for not completing all the tasks.

      Do the following:

      1. Complete all the appointment tasks, or at least those that can be.

        Under Appointment Tasks, do any of the following:

        • Add New Recare - Click (or tap) the button to attach recare types to the patient's record or to modify or remove recare types.

        • Schedule Recare - After all the necessary recare types have been attached to the patient's record, click (or tap) Schedule Recare, and then click (or tap) the Unscheduled link to schedule the next recare appointment.

          Note: Only primary recare types are required.

        • Collect Phone Number - Click (or tap) to enter a contact phone number.

        • Collect Email - Click (or tap) to enter a contact email address.

        • Collect Payment - Click (or tap) Patient Walkout to enter a payment and perform other actions (such as creating claims) in the Patient Walkout dialog box.

      2. Do one of the following:

        • If all appointment tasks are now complete (the yellow background disappears, and the tasks have green check mark symbols next to them), complete the appointment from the routing panel or the appointment information panel. Ignore the steps that follow.

        • If all appointment tasks are still not complete, click (or tap) the provide a reason for skipping incomplete tasks link. Proceed to the next step.

          The Reason to Skip Completing All Tasks dialog box appears.

      3. Select a reason why tasks were not completed. If you select Other, enter an explanation in the box provided.

      4. Click (or tap) Save Reason to complete the appointment.

    • Without workflow compliance: The appointment is marked as completed. According to whether you posted or did not post the recare, do one of the following:

      • If you did post the recare, the Schedule Appointment message appears.

        Click (or tap) Schedule Appointment to schedule the patient's next recare appointment.

      • If you did not post the recare, the Update Patient Recare message appears.

        Click (or tap) Proceed to Recare to attach the correct recare to the patient's record. Next, you will need to schedule the next appointment for the newly-attached recare type (using the Unscheduled link).

    Note: If you complete the appointment without posting the recare procedure and without scheduling the next recare appointment, the due date of the corresponding recare type attached to the patient does not get updated, and that recare type becomes unscheduled for that patient.

    The corresponding patient now appears under Complete on the routing panel.

Posting patient payments

You can post a payment from a patient to that patient's ledger.

To post a patient payment

  1. 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.

  2. Do one of the following:

    • On the Patient menu, under General, click (or tap) Overview. The patient's Overview page opens. Click (or tap) the Ledger box.

    • On the Patient menu, under Financial, click (or tap) Ledger.

    The patient's Ledger page opens.

  3. On a patient's Ledger page, click (or tap) Payment.

    The Enter Payment dialog box appears.

  4. Leave the current date entered in the Date box, or click (or tap) in the box to select a different date. However, you cannot backdate a transaction to a date that would cause it to become locked based on your organization's transaction lock setting.

  5. Enter the Amount of the payment.

  6. Select the Method of payment received from the patient (such as a check, cash, or credit card).

  7. Enter the payment details, such as the check number and amount.

    Set up the following options:

    • Check # - The check number. This option is available only if the payment type is a check.

    • Reference # - The reference number of the transaction or electronic funds transfer (EFT). This option is available only if the payment method is patient financing, an electronic transfer, or an electronic insurance payment.

    • Bank/branch # - The bank account number on the check. This option is available only if the payment type is a check.

    • Apply to charges for - The payment goes towards charges for the patient whose record you are viewing or another member of his or her household. If you select [Guarantor], you can apply the payment to charges for any household members.

    • Paid at patient visit - The payment was made at the office when services were rendered. Statistics regarding payments collected during visits appear on the Payment Analysis Report.

  8. The payment amount is applied automatically to the procedure with the oldest date of service and then to subsequent procedures based on the date until the payment amount is used up. However, you can change the Applied amount for any procedure in the procedure list as needed.

    For your reference, the following amounts appear:

    • The Amount Not Applied is the payment Amount minus the sum of the amounts in the Applied column. This amount will appear as a credit on the account of the patient whose record you are viewing, another household member, or the guarantor, according to the selection that you made from the Apply to charges for list.

    • The Amount Applied is the sum of the amounts in the Applied column.

    Notes:

    • If you are entering a payment for procedures on the same date as the date of service or for procedures prior to the current date that are attached to a claim, Dentrix Ascend automatically calculates the estimated guarantor portion of the charges (if the patient has insurance coverage). However, if you are entering a payment for procedures prior to the current date that are not attached to a claim, Dentrix Ascend automatically calculates the estimated guarantor portion to be 100 percent of the charges.

    • If the patient has insurance coverage, and the estimated insurance portion for a given procedure is 100 percent, that procedure does not appear in the Enter Payment dialog box.

  9. On the Tags tab, add tags to the payment as needed.

  10. On the Notes tab, enter any notes regarding the payment.

  11. Click (or tap) Save.

Generating a patient's billing statement (if a walkout has not already been generated)

You can generate a billing statement for a specific patient or account. You can then print and send that statement to the patient or guarantor.

To generate a billing statement

  1. While viewing a patient's record, on the Patient menu, under Financial, click (or tap) Billing Statement.

    The Billing Statement dialog box appears.

  2. Set up the following options:

    • Statement Start Date

      • From Last Zero Balance - Select this option to include transactions that were entered on the account's ledger since the account last had a zero balance.

      • Other - Select this option to include transactions that were entered on the account's ledger since the date you enter. The current date is entered by default, but you can change the date.

      • Walkout (Today Only) - Select this option to include transactions that were entered on the account's ledger today.

      Note: On the statement, a balance forward amount will appear for the account's balance up to the specified date.

    • Statement View

      • Guarantor View - Select this option to include transactions for the current patient, all patients who have the same guarantor as the current patient, and the guarantor (if not the current patient).

      • Patient View - Select this option to include transactions for the current patient. This option is not available if the patient is the guarantor for only himself or herself (the Guarantor View option will be used).

    • Statement Message - Type a message that you want to have appear at the bottom of the statement. This message will be saved for the current patient (and appear on this patient's individual statements and walkouts from now on) when you click (or tap) Print. In addition to this patient-specific message, a general message may also appear at the bottom of the statement (if a default message exists for batch statements).

    • Include credit card payment options - Select this check box to have credit card payment options appear on the statement.

    • Include due date as - Select this check box to have the specified date entered as the due date on the statement.

      Note: You can choose a date that is 1 to 180 days in the future. However, industry consultants recommend that the due date be 30 days, which is the default.

  3. To record a summary of the statement in the patient's connections history and save a copy of the statement in the patient's Document Manager, set the Add to Patient Connection switch to Yes. To not record the statement as a patient connection or save a copy of the statement, set the switch to No.

    Notes:

    • With this switch set to Yes, the patient's "last billed date" is updated, which affects which statements get generated if you generate a batch of statements in the future using the Only generate statement if not billed since option.

    • With this switch set to Yes, if the Guarantor View option is selected, a patient connection is added to, a copy of the statement is copied to, and the "last billed date" is updated for not only the current patient but the patient's guarantor (if not the same) and all patients who have that guarantor.

  4. Click (or tap) Print.

    A .pdf version of the statement, which you can print, appears.

Note: Printed statements fit in #9 single- and dual-window envelopes and #10 single-window envelopes.

Creating claims

You can quickly create claims for procedures that are not attached to insurance claims. Also, you can edit any unattached procedure before you create a claim for that procedure.

Tip: You can create a claim for a patient's procedures while performing a patient checkout.

To create claims

  1. On the Home menu, under Insurance, click (or tap) Create Claims.

    The Create Claims page opens.

  2. On the Create Claims page, do one of the following:

    • To create claims for all procedures for all patients listed, leave the All check box at the top of the page selected.

    • To create claims for specific procedures for a specific patient, clear the All check box at the top of the page, and then, under the appropriate patient's name, select the check boxes of the procedures to include or the All check box to include all procedures.

    Note: For an unattached procedure to appear on the Create Claims page, the service date of that procedure must fall within the coverage dates of a patient's insurance plan, and that procedure must be marked as billable to insurance.

    Tips:

    • To edit a procedure before creating a claim for it, click (or tap) the procedure code link, make the necessary changes, and then click (or tap) Save.

    • To hide the procedures and show only the patient names, click (or tap) Collapse All.

    • To hide or show the procedures for a specific patient, click (or tap) the header with that patient's name.

  3. For the selected procedures, the associated diagnoses appear. You can have up to four ICD-10 codes per claim. If you have more than four, either remove ICD-10 codes from the claim (by clicking, or tapping, on the coresponding codes), or split the procedures between separate claims (clear the check boxes of the procedures that you do not want on this claim, so you can create one or more additional claims for those procedures).

    Note: Removing ICD-10 codes from a claim does not affect the corresponding procedures. All diagnoses remain attached to their corresponding procedures as currently posted in the patient's ledger and progress notes.

    If there are two, three, or four ICD-10 codes, select the one that you want to be the primary diagnosis.

  4. Select the Place of Service for the claims that will be created for the selected procedures.

    Note: You can change the place of service for a claim later if needed.

  5. Click (or tap) Create Claims.

    For each patient with procedures selected, separate claims are created for the service dates of the selected procedures.

    For example, Billy has six unattached procedures selected with varying service dates:

    • Procedure 1 - 10/10/2013

    • Procedure 2 - 10/10/2013

    • Procedure 3 - 11/11/2013

    • Procedure 4 - 11/11/2013

    • Procedure 5 - 11/11/2013

    • Procedure 6 - 12/12/2013

    Three claims will be created (one for procedures 1 - 2, one for procedures 3 - 5, and one for procedure 6).

Posting credit adjustments

You can post a credit adjustment, which decreases an account balance, to a patient's ledger.

To post a credit adjustment

  1. 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.

  2. Do one of the following:

    • On the Patient menu, under General, click (or tap) Overview. The patient's Overview page opens. Click (or tap) the Ledger box.

    • On the Patient menu, under Financial, click (or tap) Ledger.

    The patient's Ledger page opens.

  3. On a patient's Ledger page, click (or tap) Credit Adjustment.

    The Enter Credit (-) Adjustment dialog box appears.

  4. Enter the adjustment details, such as the type 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 transaction to a date that would cause it to become locked based on your organization's transaction lock setting.

    • Type - The adjustment type, such as Credit Adjustment or Professional Courtesy.

    • Amount (Adjustment) - The amount of the adjustment.

    • Apply to charges for - The adjustment is to be applied toward charges on the current patient's account or the account of another member of his or her household. If you select [Guarantor], you can apply the adjustment to charges for any or all household members.

  5. The adjustment amount is applied automatically to the procedure with the oldest date of service and then to subsequent procedures based on the date until the adjustment amount is used up. However, you can change the Applied amount for any procedure in the procedure list as needed.

  6. On the Tags tab, add tags to the adjustment as needed.

  7. On the Notes tab, enter any relevant notes regarding the adjustment.

  8. Click (or tap) Save.

Posting charge adjustments

You can post a charge adjustment, which increases an account balance, to a patient's ledger.

To post a charge adjustment

  1. 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.

  2. Do one of the following:

    • On the Patient menu, under General, click (or tap) Overview. The patient's Overview page opens. Click (or tap) the Ledger box.

    • On the Patient menu, under Financial, click (or tap) Ledger.

    The patient's Ledger page opens.

  3. On a patient's Ledger page, click (or tap) Charge Adjustment.

    The Enter Charge (+) Adjustment dialog box appears.

  4. Enter the adjustment details, such as the type, provider, 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 transaction to a date that would cause it to become locked based on your organization's transaction lock setting.

    • Type - The adjustment type, such as Charge Adjustment or Patient Refund.

    • Amount (Adjustment) - The amount of the adjustment.

    • Provider - The provider to associate with this adjustment. Only providers who have access to the current location are available.

    • Select Visit for - The adjustment is to be associated with a visit from the current patient or another member of his or her household. If you select [Guarantor], you can apply the adjustment to a visit from any member of the household. The selection cannot be changed after you save the adjustment.

    • Visit date - The date of service (for the patient or guarantor selected from the Select Visit for list) to associate the adjustment with. Select [None] if the adjustment is not to be associated with a visit date. This option is available only if the current patient's name or [Guarantor] is selected from the Select Visit for list. The selection cannot be changed after you save the adjustment.

  5. On the Tags tab, add tags to the adjustment as needed.

  6. On the Notes tab, enter any notes regarding the adjustment.

  7. Click (or tap) Save.