Patterson Dental Article Archive

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What is Fuse and how does it differ from Eaglesoft?

By Ann-Marie DePalma, CDA, RDH, MEd, FADIA, FAADH

Technology Advisor II, Patterson Dental

 

Q: I have seen information about Fuse. What is it and how does it differ from Eaglesoft?

 

A: Eaglesoft is Patterson’s Windows-based, server-based software. Fuse is Patterson’s browser-based practice management software that can be used across devices and platforms.

 

Designed by dental professionals, Fuse offers the best of Eaglesoft with the contemporary look and enhancements that dental practices are seeking. Yet, Fuse is not Eaglesoft on the cloud. It is a different software with the ability to view information from multiple locations or a single location. Whether using Smart Screens, Walk Me’s, the Clinical Timeline, or Imaging, practices have unlimited information that allows for better practice metrics and software optimization. Patterson has developed Fuse with dental professionals involved in the entire process incorporating users positive and negative feedback to develop a product that dental professionals want and need. FAQ 39341 provides information regarding hardware and compatibility requirements for Fuse.

Eaglesoft will continue to be a growing software for practices that want a server-based product. Enhancements are constantly in development for future versions. In fact, FAQ 4404 allows team members to submit Eaglesoft product enhancements that they feel would benefit the software so that the developers can review and possibly include. The latest software, version 21.00.18, includes the ADA 2019 insurance claim form and enhanced security. Future updates will include other requested enhancement suggestions.

Following HIPAA guidelines, it is always best to be on the latest version of a software to protect both the patient and the practice. Checking the Eaglesoft RSS feed on either the practice management or clinical home screens will keep you updated when new updates become available. Scheduling an Eaglesoft checkup with a Patterson Technology Advisor is a great way to review the practice’s goals and use of the software.

Since Eaglesoft is server-based, there are costs in acquiring the software and hardware and any related monthly IT fees. Fuse’s monthly subscriptions are directly related to revenue generating activity, including the number of providers and eService enhancements. Providers are doctors and hygienists and are based on full- or part-time status within the practice. Any administrative team or non-producing team members are not considered in the subscription pricing. This pricing model allows for flexibility as the practice needs grow. Fuse’s pricing structure allows for an insurance suite bundle, file storage and electronic prescriptions. Other electronic or patient engagement services can be added as well. 

Every practice and team are unique in its wants and needs. What is best for one practice may not be the best solution for another. Patterson now has two practice management solutions to offer dental professionals that provide that uniqueness and customization that is required in today’s dental environment.

Contact your Patterson sales rep, the local branch, your Software Technology Advisor or me at annmarie.depalma@pattersondental.com to learn more about which will be best for your practice.

What are some best practices to optimize Eaglesoft performance?

By Ann-Marie DePalma, CDA, RDH, MEd, FADIA, FAADH

Technology Advisor II, Patterson Dental 

 

Q: What are some best practices to optimize Eaglesoft performance? 

 

A: For Eaglesoft to perform to its optimum efficiency, there are several steps that should be taken on a daily and weekly basis. Just like performing end-of-period processing allows for accurate information, performing system optimization provides the best performance for Eaglesoft and can reduce the number of errors or freezes that sometimes can occur. Always consult with your IT professional to determine the best practices from their perspective as well. Working with IT professionals who are familiar with dentistry and our unique requirements is important to maintain optimum system functionality and security. 

Reviewing the latest hardware and networking requirements for the version of Eaglesoft the practice is using is an important component of system optimization. FAQ 5073 provides the latest hardware and networking for Eaglesoft while FAQ 2119 offers the version requirements and upgrading checklist that should be used prior to any upgrade. For security reasons, it is always best to be on the most current version of any software. Beyond the checklist and requirements, daily and weekly maintenance of the server and workstations is important. 

For daily server maintenance, it is imperative to stop the Eaglesoft database engine prior to obtaining a backup. If a backup is attempted while the database is running, the files may not copy successfully and there will be an invalid backup. There are several backup options that are available from Patterson. Ensuring that all computers are logged out of Eaglesoft correctly and on the Windows screen will also assist in obtaining accurate information. Many team members do not understand the correct way of exiting from Eaglesoft, which can create issues for others. 

Weekly maintenance also includes doing a weekly reboot of the server. By doing this, it allows the server to refresh. Computers store information in short-term memory and refreshing the server allows for quicker retrieval. Once the cache or temporary storage gets too large, it can cause slowness, lockups, or other issues. This reboot also allows for any necessary Windows updates to be applied to the computer. This reboot, however, should be done outside of normal business hours. 

Workstation maintenance is as important as server maintenance. Shutting down or rebooting work stations weekly is key to allowing computers to perform faster. Like clearing the cache on the server, clearing the cache on the workstation improves functionality. Some IT professionals also recommend turning off workstations at night (other than any computers that will be used for remote log in) and restarting in the morning. 

Any third-party applications the practice utilizes are also set up for regular syncs or tasks with the practice’s computers. It is recommended to perform these tasks and syncs outside of normal business hours at a time when patients are not seen. Again, this helps with keeping computer and software functionality at its best. 

With the practice’s use of patient’s protected health information, it is imperative that the practice follow the most up-to-date standards for information security. Review FAQ 19885 to learn the best information security practices for small businesses. 

To ensure that you are running the most current version and to allow for any software-related concerns, Patterson offers support through phone, chat, emails, or FAQ. For a monthly investment, team members or IT personnel can contact the Patterson Technology Center for any software-related questions. If a practice decides not to enroll in support, any upgrades or questions are charged at the prevailing rate. 

All these steps will assist the practice in using Eaglesoft and their computer technology to achieve the best for their patients and practice. As a patient’s periodontal foundation is important to restorative health, performing routine maintenance on the server and workstations provides the foundation for all practice management functions.

Contact your local Patterson Software Technology Advisor or me at annmarie.depalma@pattersondental.com to assist or to learn more.

Let’s talk about insurance and Eaglesoft

By Ann-Marie DePalma, CDA, RDH, MEd, FADIA, FAADH

Technology Advisor II, Patterson Dental 

 

Q: How are insurance payments and adjustments entered? Can I submit claims electronically? 

A: During a walkout, if the patient has insurance either as a policy holder or family member, once the walkout is saved, the Process Insurance Window will open. Depending on settings within the software, for example to print now, print later, or send claims electronically, the claim will be sent to the claims queue. Other information in the insurance window includes the pre-authorization number, remarks for unusual services, or the narrative, and choosing a provider for the claim. Once in the claims queue, the practice can decide whether to print or send electronically as appropriate.

Insurance companies currently are accepting the ADA 2012 and the new 2019 claim form (which is available in Eaglesoft 21.00.18). At some point soon, insurance companies will stop accepting the ADA 2006 form, so it is advisable to update Eaglesoft to the appropriate insurance form. See FAQ #93 on how to change insurance forms. 

Once a claim has been submitted electronically, it will go to a clearinghouse. Patterson’s clearinghouse is Change Health Care (CHC). CHC reviews the information on the claim, making sure there is information in appropriate areas. CHC doesn’t know if the information is accurate, only that there is information in the appropriate spaces.

During the time when claims are reviewed, they are listed in the claims queue in Eaglesoft as “in process.” When the next batch of claims are sent to CHC, those “in process” claims move to the “open” status. If there are any issues with the previous claims, the report that is returned will highlight the issues for the practice to address. The claims that are rejected by CHC are returned to the claims queue and remain there until the practice addresses the issue on the claims. Once CHC approves the claim information, the claim is sent to the appropriate insurance company and will become “open” in the claims queue. Claims can then be tracked by date or insurance company for processing. Once a claim payment is received, depending on settings in file/preferences, the claim is closed and cleared from the queue. 

Actual claims for payment are listed in the open list as black while treatment pre-authorizations are in green. Based on practice settings, pre-authorizations are closed when the claim is submitted for payment. 

When an insurance payment is received, the practice opens the patient’s account, goes to the insurance tab, and makes sure the correct patient and the correct claim are selected. The total of the insurance check is entered, along with the insurance check number and other appropriate information. If this is the final payment on the claim, the checkbox next to the check amount is checked. Most claims are final payments. Occasionally, however, there are instances when there may be additional payment on the claim (for example, if the insurance company requests further information on a line item). The payment is entered based on each line item from the explanation of benefits (EOB). If there are any comments on the claim, such as patient deductible not met, or maximum reached, this information can be entered as a note in the note history with the “display note on account statement” checked to inform the patient on the next billing statement.

Once “save” is clicked on the insurance screen, if there are any adjustments to be made or secondary insurance to be submitted, another window opens to enter adjustments or submit the secondary insurance. 

Patterson offers insurance processing eServices along with claims processing including eAttachments, Real Time Eligibility, eClaims Connect, and Electronic Remittance Advice. Contact your Software Technology Advisor or annmarie.depalma@pattersondental.com to learn more about insurance processing and Patterson’s insurance suite of electronic services.

What are SmartDocs and how should they be used?

By Ann-Marie DePalma, CDA, RDH, MEd, FADIA, FAADH

Technology Advisor II, Patterson Dental

Q: What are SmartDocs and how do we use them?

A: SmartDoc is a document storage area that allows you to add, create, and save documents in Eaglesoft. Think of SmartDoc as an electronic filing cabinet. In an actual filing cabinet, we use folders. Within SmartDoc, the folders are called document groups. When information is scanned into SmartDoc, the team can put any information into the correct document group so that all the appropriate information will be easily retrievable rather than scrolling through the long list of recent documents. Documents in Smart Doc can be saved as Word documents, PDF files, Excel spreadsheets, PowerPoint presentations, or as an image JPG.

Many practices only use SmartDocs for patient information. On the Practice Management home screen under File/Preferences, the SmartDoc preferences allow the office to create and save documents in a variety of areas beyond the patient. SmartDocs can be saved in the patient, the providers, the practice, insurance company, laboratory and referral recipient areas of Eaglesoft. Patient SmartDocs preferences include statements (saved in the responsible party’s SmartDoc), letters, recall letters, walkout statements, medical histories, payment plan contracts (saved in the responsible party’s SmartDoc), treatment plans, and informed consents. Signatures can be required for payment plans, treatment plans, and informed consents if the practice so desires. End of period reports can be saved in the practice’s SmartDoc under practice information. End of period SmartDocs can eliminate the practice’s printing and storage of end of day, month, or year reports. Quick reports can also be saved into the practice’s SmartDoc. Insurance contracts, laboratory documents, and referral information can all be saved in their appropriate SmartDoc.

Any document that requires a signature can be saved in SmartDoc as a read-only file. Once a signature is acquired, the document cannot be edited or deleted. Any unsigned documents can be deleted by right-clicking on the document in recent documents and remove document. A document can also be renamed or put into a document group by right-clicking on the document in recent documents, choosing Document Information, and adding a name or document group. You can even transfer documents from one patient to another, should a document be entered in SmartDoc in error, by also right-clicking on the document and choosing Transfer Document.

Document groups can be found under Lists and contain EOD/EOM/EOY, informed consent, insurance, medical history, patient identification, and many other groups. The office can create any other document groups that are specific to their needs. Documents can also be exported from or imported into SmartDoc. Many practices also use SmartDoc for image storage in addition to using Advanced Imaging.

In creating a SmartDoc, a letter or document can be created from an existing document or can be created using the letter merge types and fields. A letter merge field allows the practice to merge information into the document such as patient name, address, date, balance, etc. The letter merge type will determine where the letter can be accessed. For example, a letter merge of “patient letter” will only be available from the edit person window and the patient SmartDoc. To learn more about letter merges, visit FAQ #20190.

Utilizing SmartDoc is a great way for the practice to keep track of documents including documents that patients can complete during their initial or continuing care appointments or that are uploaded from patient engagement programs such as RevenueWell, OperaDDS, or Solutionreach. As practices become chartless or paperless, utilizing SmartDocs is an essential component.

To learn more about SmartDoc, review FAQ #2015, contact your local software technology advisor, or email annmarie.depalma@pattersondental.com

Where can we put documents in Fuse?

By Ann-Marie DePalma, CDA, RDH, MEd, FADIA, FAADH

Technology Advisor II, Patterson Dental

Q: In our previous software, we had an area where we put documents. Does Fuse have something similar?

A: In Fuse, any document that is completed, scanned, or uploaded from patient engagement programs such as RevenueWell will be stored in the document center. The document center can be accessed from the patient overview screen by entering the patient’s name in the search bar and in the lower right corner of the patient overview window is the document center.

New patient registration and insurance information can be printed and then scanned into the document center as new patient forms. The patient’s medical history can be completed from the clinical area, health tab and will be saved into the patient’s document center. Treatment plans and informed consents can also be found in the document center.

Documents can be scanned after a one-time download of a TWAIN scanner driver, uploaded from the desktop or other file, or moved to another patient if the document was entered to the wrong patient. Documents can also be grouped into document groups or file folders. Document groups can be created in the Forms and Documents area of the business center and are accessible from other areas of the software.

The communication center of Fuse allows a central location to review and record conversations and all communication with patients. The communication center for each patient is available as a navigation tool, along the patient overview, appointments, clinical, and account areas in the upper right-hand corner of the header bar. The options from the header bar navigation include email, in-person, phone, text, US mail, or other. Choosing an option opens the communication center where patient communication can be sorted by newest to oldest or a date range, along with whether it is a specific account, insurance, patient care, or miscellaneous communication. Each category can be viewed independently, or all communications can be viewed. In fact, patient notes can be found under patient care of the communication center! The right-hand area of the patient’s communication stores the message center. The message center allows for team members to record any type of patient communication, whether a call, text, mail, or in-person conversation. A patient specific to do list can also be generated. If letters have been created in the Forms and Documents area of the business center, they can be accessed from the message center. An icon in the upper right corner of the message center allows team members to view the patient overview information without having to open another tab.

There are numerous ways to save documents into Fuse. For more information, contact your local software technology advisor or annmarie.depalma@pattersondental.com.

What is the best way of handling insurance adjustments in Fuse?

By Ann-Marie DePalma, CDA, RDH, MEd, FADIA, FAADH

Technology Advisor II, Patterson Dental

Q: What is the best way of handling insurance adjustments in Fuse?

A: Adjustments in Fuse are created in the Practice Settings section under Billing, Adjustment Types. An adjustment type is then added, but can be either positive or negative. A positive adjustment type increases the patient balance (debits the account) while a negative adjustment decreases the patient balance (credits the account). To help distinguish between a positive or negative adjustment, it is advised to put a + or – sign in the description. Since most practices utilize Plans within Fuse that allow for adjustments to be applied at the time of service, negative insurance adjustments should affect production while a positive adjustment can affect adjustments or collections depending on the situation.

When processing an adjustment, click on the search bar and locate the patient’s account. Within the account window, apply adjustment. When applying an adjustment, determine if it is a positive or negative adjustment at the top of the adjustment window and choose the appropriate dropdown for the type of adjustment. A negative adjustment can be applied to any account member or to the entire account. A positive adjustment can be applied to a specific provider. Selecting a negative or positive adjustment will determine the type of adjustment seen in the adjustment type dropdown. Enter the amount of adjustment and note if appropriate. Adjustments will be applied to the oldest balance first, but can be manually entered and placed on the appropriate line item and applied.

The adjustments can be reviewed in either the account summary by date of service or in the transaction history by posting date. Posting date is when the transaction is entered into Fuse while the date of service is the date the treatment occurred.

Several reports can be reviewed for adjustments, including adjustments by type, adjustments by provider, and benefit plans by adjustment types. As in all reports, the report selected appears blank but then appropriate filters can be applied. A report can also be saved as a favorite report by choosing the ellipsis on the right of the report and can either be printed or exported.

For more information about adjustments, contact your local software technology advisor or annmarie.depalma@pattersondental.com

Note: "Question mark sign" by Colin_K is licensed with CC BY 2.0. To view a copy of this license, visit https://creativecommons.org/licenses/by/2.0/

What is the best way of handling insurance adjustments in Eaglesoft?

By Ann-Marie DePalma, CDA, RDH, MEd, FADIA, FAADH

Technology Advisor II, Patterson Dental

Q. What is the best way of handling insurance adjustments in Eaglesoft?

A. Depending on several factors (ranging from how Eaglesoft is set up to how the practice is wanting the see adjustments), there is no “best” way to set adjustments. Depending on how providers are paid, whether on production or collection, will determine the “best” way for the practice. Additionally, if a practice is working on true production or adjusted production, the setup for adjustment types may be different. Each practice should work with its accountant to determine the best direction when dealing with how and what adjustments should impact.

Adjustment types are found under Lists, General Set Up, Adjustment Types. Adjustment types can affect adjustments, production, or collection, depending on how the practice would like to use them. For example, offices will often use insurance adjustments affecting adjustments, while refund adjustments affect collections, yet every practice will view their adjustments differently as to how adjustments will affect their productivity and reporting.

An adjustment can be either a credit or debit adjustment. Depending on how a debit or credit adjustment is utilized, it will affect the patient balance and thus the outstanding accounts receivable. A debit adjustment should increase the patient balance while a credit adjustment should decrease the balance. FAQ #173 provides a reference for adjustment types and the area of impact. Depending on the type of adjustment and how it is set to affect productivity, the adjustment itself may or may not appear on specific reports. FAQ #173 will describe how a debit or credit adjustment will appear on reporting since some adjustments are designed to appear on certain reports and others not.

To ensure proper usage of a credit adjustment, select the type of adjustment from the adjustment tab in the account. Determine whether the adjustment is to affect adjustment, collection, or production (if correctly set up, this will be a default for the type of adjustment chosen). A note can be entered to further explain the adjustment, if needed. For example, a Delta adjustment may affect adjustments and the note may state the patient or date of service (DOS). If the practice is in-network with many third-party providers, it is recommended to have adjustment types set for each insurance company so that the amount of adjustments each period can be determined and evaluated. Enter the adjustment amount and whether it will affect line item, patient, or provider (line item includes both patient and provider while patient and provider only affect one or the other) and distribute appropriately.

For a debit adjustment, the practice will have the ability to age the adjustment (current, 30, 60, 90 days) and select an appropriate provider to which to apply the adjustment. Like the credit adjustment, the debit adjustment can affect adjustment, collection, or production, and a note can be entered while making certain that the appropriate distribution is performed, especially in multi-provider practices.

For more information about adjustments, contact your local software technology advisor or annmarie.depalma@pattersondental.com

Note: "Question mark sign" by Colin_K is licensed with CC BY 2.0. To view a copy of this license, visit https://creativecommons.org/licenses/by/2.0/

Going from chartless to the cloud with Fuse

By Ann-Marie DePalma, CDA, RDH, MEd, FADIA, FAADH

Technology Advisor II, Patterson Dental

Q. Our practice was chartless in our old software. Now that we are using Fuse, how can we maintain clinical documentation?

A. In Fuse, there are several options for maintaining documentation, including the Communication Center and Clinical Note Templates. For information on the Communication Center see the information in the Patterson page on IgniteDDS.com titled, “Where Can We Put Documents in Fuse?”

For clinical notes, a template can be created to allow for easy clinical note entry. From the business section, under chart, go to clinical note templates. Initially, a category must be created. Categories can include hygiene, restorative, diagnostic, perio, endo, crowns, or whatever the practice would like to use to classify and categorize the clinical note.

From the category, a template can be created. Name the note template and add a section. The entire note can be in one section or separate sections.

There are several ways to create notes that can be pre-populated with information for ease of entry. Pre-populated prompt areas include multiple choice, yes/no, true/false, ad-lib, link tooth, or note text. Depending on the information requested will determine the type of prompt that is used. For example, a multiple-choice question allows for additional information to be added and allows for multiple answers. A yes/no or true/false question simply requires one of the answers. An ad-lib question offers a before and after response. For example, with blood pressure, the before would be the systolic measurement while the after is the diastolic. Link tooth ensures that the tooth being worked on is noted as a chart note, while note text allows for free form writing of the note information. Any prompt other than note text can be required to be completed for the note to be considered complete and prompts can be skipped to allow for manual entry. Notes can be previewed, moved up or down, or deleted prior to saving.

In the clinical section of Fuse, the note sections and templates will appear on the left-hand side of the note area. Choose the type of note and complete as appropriate, click finish. If areas of the note have not been completed and are required, the system will not finish until the areas are corrected. Once finished, the note will appear and any manual entries can be added. After completing the note, click save. The user will have the option of finalizing the note now or keeping the note open for 1 day or 24 hours. Since the saved clinical note is part of the patient’s legal document, any changes are noted by drawing a line through the initial information. If the note is left open for 24 hours, the user can go back and make any additions or corrections as needed without having the deletion lines drawn. This allows for team members to complete notes as is best for them, whether during working hours or after work. Once the 24-hour period has elapsed, the note automatically is locked and is legal. Notes will appear on the patient’s time line as well as in the communication center.

For more information on notes or patient communication contact your local Patterson branch software technology advisor or me, ann-marie.depalma@pattersondental.com

Note: Question Mark by ryanmilani is licensed with CC BY 2.0. To view a copy of this license, visit https://creativecommons.org/licenses/by/2.0/

What is the best way to write clinical notes in Eaglesoft?

By Ann-Marie DePalma, CDA, RDH, MEd, FADIA, FAADH

Technology Advisor II, Patterson Dental

Q. We are going chartless in our practice and there has been discussion about how to handle chart notes. What is the best way to write clinical notes in Eaglesoft?

A. If the practice is on Eaglesoft version 20 and above, in addition to Auto Notes, a new feature, Smart Notes, makes writing notes easier and stress-free. Auto notes can be used as templates to automatically add text to clinical notes without having to type the note each time. A Smart Note allows the user to use the Auto Note with prompts that can be prepopulated with responses. For example, during a Hygiene Auto Note, the hygienist must manually add or delete the type of radiograph taken during the visit from the Auto Note. When a Smart Note is added to the Hygiene Auto Note, the hygienist will only have to click on the type of radiograph taken from the pre-populated list, thus saving valuable time.

In order for all team members to access Auto Notes or Smart Notes, the security profiles must be set accurately. To ensure that all security settings are appropriate, go to the security profile settings for each security profile or if the practice has set each person’s security individually, go to providers/staff and edit the person’s security. On the drop down for the Show Security Zone, go to Lists Items/Setup and scroll through to allow view, add, edit, or delete as per practice protocols, Auto Notes, Note Types and Smart Notes. See FAQ #427 (Creating and Using Auto Notes) and FAQ #35354 (Create and Use Smart Notes).

Smart Notes are set up so that, when adding a new Smart Note, the following information is needed to create the Smart Note:

  • Prompt Name: The name of the Smart Note.
  • Description: This is an indicator that is displayed asking or stating what the response is asking.
  • Prompt Text: This is how the prompt will appear in the note to notify that a response is available to populate. The Prompt Text will appear as <>.
  • The individual response choices.

Once the Smart Note is created, go to the Auto Note and place the cursor at the point where the Prompt Text should be located and add the Smart Note.

Since many third-party payors are now requesting clinical notes rather than narratives for the claims processing, utilizing Smart Notes and Auto Notes provides the administrative team with the clinical information that is needed to process the insurance claims. Following the SOAP note format (Subjective, Objective, Assessment, Plan), the clinical team can create and use their created Auto Notes and Smart Notes to easily provide the documented treatment information in a timely manner by a few simple clicks. Auto notes can easily be edited to add any additional patient specific information that is not already prepopulated.

For more information on notes or patient communication contact your local Patterson branch software technology advisor or me, ann-marie.depalma@pattersondental.com

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