Many dental practices use Dentrix Ascend for invisalign or other small ortho cases that are often done by general practitioners. There are numerous benefits to using Ascend for ortho, namely that this saves the practice from the cost of an additional ortho software and the subsequent separation of information between multiple systems. At the same time, Dentrix Ascend is not an ortho software, meaning it does not include cephalometric tracing features nor the classic ortho tooth number structure and financially, it does not include a future due payment plan feature so ortho cases must be charged out in full.
One patient record for both general dentistry and ortho treatment has several benefits:
- Save time by having all clinical notes, appts, contact/recare info, etc. in one account
- Able to pull reports based on provider or code
- Ascend will track both general and ortho insurance benefits on 1 account
- Line item accounting ensures payments easier to track
- Will not throw off your total active patient numbers
- If insurance default set up to use the provider of service, no need to change tax IDs
- Patient receives one statement
- Could add a “location” ortho in future as location grouping is available for multi-locations
- Right now because Ascend charges out the full ortho case, it’s easy to see what the total payout for the ortho case would be – just use a walkout statement
- Can run AR including/excluding/targeting the ortho procedures
Basics of the Ortho Workflow
- Patient dental benefits include both general dentistry and ortho
- Charge out full ortho case, create ortho claim, collect down payment, set up payment plan
- In ortho procedure – enter placement date and # months remaining
- Most ortho plans pay automatically from the initial claim; some require claim to be submitted to generate payment monthly or quarterly
- Best practice to simply resubmit the same claim with updated months remaining; when applying payment – just enter partial payment
- To track patients that need claims resent – can create a recare named ortho insurance, add to this patient and then establish a recare system for ortho claims
- Enter claim payments as partial payments to keep the ortho claim open
Limitations of Ortho with Dentrix Ascend
- No future due payment plan feature – So, the entire ortho case is charged out at one time, inflating AR and showing the full ortho amount due on walkout statements.
- To determine actual AR, run Aged Receivables with or without ortho procedures
- Another option to avoid inflating AR – Manually charge out the ortho charge each month
- No ortho specific clinical features – ceph tracing, ortho numbering, etc.
- Coupons are not available
- Payment plans dates do not limit the walkout statement/ledger expecting the next payment – i.e. even if the next ortho payment is not due for 3 weeks, if the patient comes in today for a filling Ascend will show as due today both the filling copay and the next ortho payment.
When charge out ortho case – Can enter placement date and # months remaining
Ascend handles dental insurance and ortho benefits per plan
To send additional claims to ortho insurance, enter partial payment on the initial claim and then edit the claim to change the months remaining and total months – if you entered a placement date in the procedure, the months remaining will automatically calculate.
Ascend has ability to run AR including or excluding ortho procedures
Train your team for Ortho / General Dentistry patient collections
We recommend creating an ortho account for training your team and then review how it looks when general dentistry is performed.
Step 1: Create ortho tx plan
Collect down payment
Set up payment arrangement
Step 2: Treatment plan for filling
It’s easy to see on this treatment plan that the patient owes $30.80 for this filling.
However, once this filling is charged out into the ledger – the walkout statement wants us to collect the $30.80 for the filling PLUS the monthly ortho payment (even though I set the payment arrangement to start next month). AND, look at the bottom of the statement – it’s showing $3,280.80 as patient portion.
If I collect the $166.21 – then I have overcollected on this account.
When you're using one patient account for both ortho and general dentistry, then coach the team to only collect the “Please pay this amount” if the ortho payment was due as well. Otherwise, I’d recommend they use the treatment plan amount to know how much to collect.
Handling a change in Ortho Insurance
If ortho insurance ends and new ortho insurance begins – it's easy to end the coverage date and then start new coverage for the patient. If this happens during ortho treatment, then we recommend:
- Post a production credit adjustment (see image below) for any outstanding amount unpaid by the current plan
- Close the ortho claim
- Post the ortho procedure (call the carrier with any questions regarding the fees/adjustments they expect in this situation) and submit the claim
- Post a production credit adjustment for the amount that has already been paid – this will leave a correct balance due
- Then, continue to enter partial payments to keep the claim open
- Resubmit the original claim as needed to the carrier to trigger payments