Creating coverage table templates

Dentrix Ascend provides two default templates (which are named "All Procedures") and allows you to create various templates that you can use in your organization for setting up the coverage tables of insurance plans.

Note: Coverage table templates are global (available to all locations across your organization).

To create a coverage table template

1. On the Coverage Table Setup page, do one of the following:

   • Create new - To make an all new coverage table template, click (or tap) New Coverage Table.

     

   • Base on existing - To make a coverage table template based on an existing template, select the template that is similar to the one that you want to create.

     

     Note: The templates are grouped by type. Expand Insurance Coverage, % to view templates that are based on insurance coverage percentages, or expand Patient Copayment, $ to view templates that are based on fixed, patient copayments.

   The options for adding or editing the coverage table template appear. The options that are available depend on whether you are creating a new template or making one that is based on an existing template and whether the template is based on insurance coverage percentages or fixed, patient copayments.

   New

   

   Based on Existing

   

   Insurance Coverage, %

   

   Patient Copayment, $

2. Enter or change the Template name. The name must be unique relative to the templates of the same type (Insurance Coverage, % or Patient Copayment, $).

3. If you are creating a new template, from the Type list, select either Insurance Coverage, % or Patient Copayment, $ to specify whether the coverage should be based on a percentage or a fixed amount, respectively. Once you save the template, you cannot change the type.

   With a Type selected, the options for creating the template become available.

   

   Insurance Coverage, %

   

   Patient Copayment, $

4. Do one of the following:

   • For an Insurance Coverage, % template, add, edit, and delete the procedure code ranges as needed.

     Do the following:

     1. Click (or tap) Add Range to add a procedure code range, or select an existing range to edit that range.

        

     2. Set up the following options for that range as needed:

        • Code Range - The ADA or custom procedure code range. These boxes accept dashes (-), periods (.), numbers, and letters, and they can be up to 10 characters in length. Make sure there are not any overlaps and gaps in the sequence between the starting and ending codes in the range and between other ranges.

          You can include an alias procedure codes in a range by typing a period (.) in either box. The Code Range boxes change to allow for entering suffixes. Enter a suffix in either or both suffix boxes. If you need a period in either of the main code boxes (the boxes to the left of the suffix boxes), you must type the period again in that box.

          

          Note: When you change a range and then click (or tap) somewhere else, the text of the range that you modified turns bold. Also, any ranges that overlap or that are invalid become highlighted in red, and you cannot save the changes to the coverage table until those errors are resolved.

        • Category - The procedure category for the procedures in the range.

        • Deductible Type - The type of deductible that the procedures in the range apply to.

        • Coverage % - The percent that the insurance carrier pays on covered charges (after any deductible, up to any allowed amount, and up to any maximum allowed benefit) for procedures in the range.

     3. Repeat the steps a - b for any other ranges that you want to add or edit.

     4. To delete a range, click (or tap) the corresponding Remove button , and then click (or tap) Delete on the confirmation message that appears.

        Important: If you are deleting the only range in the coverage table, the entire template will be deleted. However, you cannot delete all the ranges in the default template (which is named "All Procedures").

   • For a Patient Copayment, $ template, add, edit, and delete the procedure codes as needed.

     Do the following:

     1. To add procedures codes, do the following:

        1. Click (or tap) Add Procedure.

           

           The Add Procedures dialog box appears.

           

        2. Select the check boxes of the procedure codes that you want to add to the coverage table. You can select or deselect the check box in the column header to select and deselect all the procedure codes at the same time.

        3. Click (or tap) Add Checked.

           Note: If you are adding procedure codes to a coverage table that already has procedure codes, the procedure codes are added at the top of the table, which might not be the correct order; however, when you save the template, the procedure codes will be listed in the correct order.

     2. To edit an existing or newly-added procedure code, select it.

        

     3. Set up the following options for that code as needed:

        • Deductible Type - The type of deductible that the procedure applies to.

        • Copayment $ - The patient co-pay. Patients will pay the specified amount for the procedure.

     4. Repeat the steps a - c for any other codes that you want to add or edit.

     5. To delete a code, click (or tap) the corresponding Remove button , and then click (or tap) Delete on the confirmation message that appears.

        Important: If you are deleting the only code in the coverage table, the entire template will be deleted. However, you cannot delete all the codes in the default template (which is named "All Procedures").

5. To add, edit, or delete exceptions to the coverage for specific procedures, click (or tap) Manage Exceptions.

6. Do one of the following:

   • For an all new template, click (or tap) Create.

   • For a template based on another, click (or tap) Save As New Template.