Patterson Dental

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MISSION & PHILOSOPHY

Patterson Dental partners with dental practices of all sizes to help oral health professionals practice extraordinary dentistry.

Patterson’s history of serving dental professionals dates back to our company’s founding in 1877. Since then, Patterson has grown to meet the needs of private practices and large group dental networks through more than 70 branch offices in the United States and Canada. As one of North America’s largest providers of dental products and solutions, Patterson Dental offers more than 100,000 products and a wide range of innovative equipment, software, technology solutions and services. The high demand for dentistry and rapidly advancing technology are the hallmarks of growth in the dental segment.

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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

Note: "Computer keyboard" by newfilm.dk is licensed with CC BY-NC 2.0. To view a copy of this license, visit https://creativecommons.org/licenses/by-nc/2.0/

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