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For crowns, bridges, dentures, partials, etc, there is usually a prep or impression appointment and then a seat or deliver appointment. The fee is either charged at the first appointment or the last appointment. Decide which method to use before setting up your procedure codes in the Procedure Codes.
Fee due at first appointment
A more effective way to ensure the practice collects the money for the procedure. The responsibility falls on the patient to follow up and make sure the crown gets seated, etc. The patient is charged whether or not they return.
Note: Some insurance companies prefer the procedure to be billed on the prep date, though many do request to be billed on the seat date. The insurance company may have a clause that the coverage date of the patient may only apply to the seat date.
- Schedule the first appointment. For the procedure use the standard ADA code with the proper fee attached. Your default Procedure Notes would be notes for the prep or impression. Example: 3 carps 2% Lido-1:100k epi, prep, cord with hemostat, PVS, etc. -or- Alginate impression, opposing alginate, shade 102, etc.
- For the second appointment, use a special no-fee procedure code that is marked do not bill insurance and has a fee of $0. The code should not look like an ADA code (e.g. use a beginning N instead of the usual D to indicate no-fee). The procedure might be Crown Seat or Denture Deliver. The procedure note would be your standard note for seating or delivering. Example: Removed temp, checked contacts and bite, showed to patient, cemented Fuji. -or- Delivered. Checked fit, bite, appearance, etc.
Fee due at the second or last appointment
This method tends to more closely follow most insurance company policies. If the patient does not return for their second appointment, follow up and charge the patient for the lab fee they incurred.
- Schedule the first appointment using the no-fee procedure code that is not billed to insurance such as Crown Prep or Denture Imp, with the appropriate procedure notes (see above).
- For the second appointment, use the standard ADA code that is billed to insurance.
In Process Procedure Status
Procedures that occur over multiple appointments can be grouped together to ensure claims are sent at the correct time.
There are two ways to do this:
- From the Chart Module, highlight all procedures, then right-click and select Group for Multiple Visits.
- Set up Procedure Buttons to automatically group for multiple visits.
When one of the grouped procedures is set complete, it will display with a status of Complete (In Process) in the Procedure Info window and Account Module. Once all procedures in the group have been set complete, the In Process status will be removed.
Claims cannot be created until all procedures in the group have been completed.
Note: Procedures that have been grouped together can only be ungrouped if all original procedures are selected before the Ungroup from Multiple Visits option is selected from the right-click menu.