How to Enter a New Care Plan to a Patient's Case
Please note: If you are your office provides certain types of Care Plans in the office, you can create a template to save time. You would create your template in Admin > Care Plan
How to Enter a New Care Plan
Go to the Patients file
Select Care Plan Tab
Select "Start from Scratch" and hit "Next" Button
Plan Name - Be as detailed or as general as you would like.
(keep in mind, this name will help you identify the plan that may best apply to different patients)
Plan Length - Select the duration of the care plan. You decide the length by Weeks or Months.
Automatically extend the plan length, until all "Visits" are used
This area is designed for you to tell the care plan which is most important: visits or the length of time the patient is on the care plan.
- a) If you check this box= Plan Stop date will extend (keep going) until ALL visits are used
- b) If you Do Not check this box= Once the care plan reaches the Stop date the care plan will end and any unused visits will be lost.
Once finished, select Next button
Plan Amount - Enter total amount of care plan the patient is responsible to pay: This will be the amount paid for all services specified in care plan i.e.: Adjustments, Exams, X-rays, Supplement or any other service. This amount will include the discount you have provided for the patient.
For Example: You typically charge $80.00 for an Adjustment but, if a patient prepays for 10 visits, they get a $100.00 discount. $800.00- $100.00= $700.00
This makes the patient responsible to pay 700.00 and should be entered in this area so, the care plan knows the proper discounts to apply.
- a) Option One- Payments- Select the Number of payments and select the drop-down to indicate when the payment is to be collected. Weekly, Bi-Weekly, Monthly or Quarterly.
- b) Option Two- Down Payment plus payments - Add in the amount the patient is paying to start the plan today, followed by the number of payments they will be making and select the drop-down to indicate when the payment is to be collected. Weekly, Bi-Weekly, Monthly or Quarterly.
- c) Option Three- Pay in Full -Paying the full amount owed today.
(Please keep in mind- You can alter the payment option when you add the template into a patients file, If you choose to do so.)
Once you have finished selecting the best option for this plan, Select Next
SELECT one of these:
- Apply patient discount AFTER patient plan credit has been exhausted -This will allow the money the patient has paid for the care plan to be applied to the beginning dates of service and then write off the ones towards the end. This option works like a Buy 3, get 2 free
- Apply patient discounts, evenly across "Visits - This option will evenly distribute the plan amount over the length of the care plan. This is a great option if the patient wants to submit the charges to their Insurance payer via Super Receipt for reimbursement.
For Example: If the care plan is set up to be $200.00 for 10 visits of care, this means each visit is worth $20.00. Anything over $20.00 will be written off.
Every State has its own laws on how discounts can be legally applied. Please make sure you know your State's Laws on discounts so, you know if you must use one option vs. the other or if both are available.
Once you select the Option that is right for your clinic/plan, Select Next
Number of "Visits" included in the plan - This is where you add in how many visits the patient gets under this Care Plan.
Then, Select one of these:
Visit number is for the entire length of the plan
(Example: In this image below, it shows the patient gets 24 visits over the course of the care plan. Which roughly breaks down to 4 visits a month over 6 months. But, adding it in this way allows the patient to use the 24 visits however is needed before the end of the care plan. So, if a patient needs to come in a 5th time in the month, that is ok.)
- Visit number is for each _____ of the plan - Options include Week or Month.
(Example 2: You could add in the number 4 instead and select the second option "Visit number is for each _____ of the plan" and select Month from the drop-down to indicate that 4 visits a month are covered in the care plan but, if the patient comes in a 5th time, they pay for that out of pocket.)
Visit Code Pool - Now, it is time to tell the Care Plan what services will count as a "visit".
- You will scroll to find the code in the CPT code Library and then drag and drop it to the above window.
See the example below, in the image. It shows 98940 and 98941 in the Visit Pool. Those codes were selected because an Adjustment will be performed at every visit. Making the Adjustment code responsible for counting down the visits for the care plan.
(Please keep in mind, if a 98940 and 98941 were both selected in the patients visit, that would count as 2 Visits against the Care Plan.)
Select your Price list
Once you are done making your selections, Select Next
SELECT one of the following:
- End Care plan once all "Visits" have been used, regardless of time frame - This option means that the number of visits specified is most important. If the patient uses all visits allowed in the Care Plan before the time allotted, the Care Plan will End and make the patient responsible for any additional visits
- "Visit" codes (above the number allowed in the care plan) will be FREE for the duration of the plan- This option means that the length of the Care Plan is more important. You want to see them for a certain amount of time and if they end up having a few extra visits then you thought, they are covered in the Care Plan and the Care Plan will do what is needed (increasing the discount to the already applied charges) so, all care will fall into the dollar amount specified in the care plan.
Once you select the option that is right for your plan, select Next
Additional Code Pool - This area allows you to select additional Services, Supplements or Products that are included and DO NOT count against the care plan as a visit.
- You will Drag and Drop those extra charges into the window provided. Once they are displayed, you will change the Unit amounts to reflect the number of times that CPT code can be used in this Care Plan. Once the allotted units are completed, any additional times the code is applied to a patient visit, the patient will be responsible to pay for the extra service.
See image below for example: example shows the patient can have 1 Single view X-ray; 1 Cervical X-ray; 6, 30 min massages and 1 Tempurpedic pillow.
Once you are Done, Select Finished!!!!
Once you are finished, part of your Care Plan info will display
If you would like to see all information, Please X out of the Patients file and Reopen patient - care plan tab
To Print or Export a copy of the Care Plan for the Patient, select the Print Button
- A window will pop up with the following info (see image below of sample):
- Patients Name
- Care Plan Description
- When the Plan Starts and Stops
- Number of Visits Included
- Financial Obligations
- Treatment codes offered in the Plan
- Anything Extra
- Payment Schedule
You can Print this Information for the patient or use one of the 3 export options. X=Excel, A=Adobe, W= Word
Under the Ledger Tab, you will see 2 sections:
- On top - the running Ledger is ONLY for the Care Plan amounts. This excludes any other charges the patient may have in their file. In Most cases, this area DOES NOT match the patient’s actual ledger.
- On the bottom section - you will see the Scheduled Payments for the Care Plan.
- You can select the Print Ledger button to Print the ledger if needed
- Use the Edit Payments button if you need to change the payment dates (see 2nd image below)
- The Payment Dates will appear and any payment date that is in the future will have a drop-down, so you may change the payment date
- Once you have made your changes, Select Save and Close
3 things you will see in the
Patient File>>Ledger>>Charges Tab
when using Care Plans
Care Plan Down payment:
- Any Money Due on the Care plan will appear as a Care Plan Down payment, in Black.
- You will not see CPT codes changing the Patient Balance.
- Only the care plan payments that becomes due, will change the balance.
- As Payments become due, they will alter the patients balance so the office staff can collect payment from Patient.
- If you are using Auto-debits, (Forte or Heartland Merchant services), the payment will charge their credit card on the payment date that was selected in the care plan.
Care Plan Charges in Blue:
- Any and ALL charges added in the patient’s appointments, that are to be Covered by the Care Plan, will display Blue.
Charges in Black:
- Any Charges that appear in Black, (such as 97012 in this example) indicate a service was performed that was not covered by the care plan.
- The patient will be responsible to pay ANY charges in black as they are outside the agreed Plan.
***Please Note: You CANNOT Add CPT codes to an existing care plan. If you want to include more CPT codes, you have 2 options:
- You can delete the current Care Plan and redo the entire care plan and include all cpt codes and back date the start date to the first appointment. If you do this, we suggest taking snapshots of how your care plan is set up so you can redo it.
- Or, you can keep the current care plan as is and write off the extra cpt. Adding in the reason for write off (ie: cpt included in care plan)
Training Video Reference