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PAYOR: ACC (CHARTING AND CLAIMING)

This guide confirms the process for creating ACC Treatment Plans and recording ACC payments for claims.

Creating an ACC Treatment Plan for a patient

Overview:

1. Open a new ACC Treatment Plan for a patient

2. Add ACC Service Codes to the Treatment Plan

3. Complete the ACC Treatment Plan

4. Send Claims to ACC

5. Confirm that an ACC Payment has been received

To create an ACC Treatment Plan for a patient

Open a new ACC Treatment Plan for a patient:

1. Select +1 (new treatment plan) on the patient’s Chart Tab to open the Create Treatment Plan window.

2. Select ACC in the Payor field on the Create Treatment Plan window, and click OK.

This will create a new treatment plan with a header that clearly identifies it as “ACC”.

Usually the treatment plan will be a distinct colour (often red) which is different from Private Treatment Plans.

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Add ACC Service Codes to the Treatment Plan:

3. If you’ve created a custom ACC Service List, select it to display just the ACC codes in the Service List.

See also: Option: Create a custom ACC Service List Category, page 9 If you don’t have a custom ACC Service List, simply scroll to display the ACC service codes (EXACT prefixes them with “ACC”) in the list.

4. From the Service List select relevant ACC Treatment codes to apply them to teeth and/or list them under the Treatment Plan at left.

Complete the ACC Treatment Plan:

5. As with a Private Treatment Plan, tick the ACC Service Codes that you have completed, and select Charge.

EXACT will allocate the ACC charges to the Payor ACC file in EXACT.

Send Claims to ACC:

6. Complete ACC Claim forms either by hand, writing onto provided ACC Forms, or by entering details onto the ACC website.

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Confirm that an ACC Payment has been received:

7. Select the ACC desktop:

If you have it set up in the workspace bar, select the Payors icon > ACC

- or -

Select File > Payors to open the Payors desktop, then select the ACC code:

8. Select the View Payor Transactions [$] button, or press Ctrl-T to open the View Payor Transactions window:

9. Select the Payment button in the View Payor Transactions window to open the Payor Payment window:

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10. Confirm details on the Payor Payment window:

a. Date - Confirm the Date the payment from ACC was received as per the Practice bank account records.

b. Provider - Confirm the Provider for the ACC Claim.

c. Payment Amount - Confirm the amount received from ACC.

d. Payment Method - Confirm the payment was from either ACC (if you have ACC setup as a payment method) or AP – Automatic Payment.

e. Finally tick the ACC invoice that relates to the payment.

f. Select OK.

11. You will see a record of the payment back in the View Payor Transactions window:

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Adding a Patient Fee to the ACC Treatment Plan

ACC allows the Dental Practice to charge a Patient Fee on top of the ACC fees.

The Patient Fee is paid directly by the Patient to the Practice in addition to the fees that may be paid by ACC.

There are two methods to achieve this:

Edit the ACC Service Code chart item for which the Provider wishes to add a Patient Fee.

- or -

Instead of adding the Patient Fee to ACC Service Code(s) the Provider may wish to create and use a new Service Code called ACC Patient Fee.

To add a Patient Fee to the ACC Treatment Plan

Method 1: Edit the ACC Service Code chart item for which the Provider wishes to add a Patient Fee

Under the Treatment Plan, double click the ACC Service Code for which you want to add a Patient Fee, to open the Edit Chart Item Pop-Up Screen:

The Fee field shows the default fee amount.

Add the amount of your Patient Fee to this default Fee, and type in the total Fee charged to the patient.

For example, if the default Fee is $300 and you wish to charge the Patient an additional $100, type $400 in the Fee field.

CAUTION: Don’t add the patient fee to the Patient Portion field or EXACT will deduct your additional fee from the Payor Portion instead of adding it!!

NOTE: When you edit the Fee field the Patient Portion figure will automatically re-calculate.

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Method 2: Create and apply a new Service Code (call it ACC Patient Fee)

Use this code to add an overall patient fee as a line item in the Treatment Plan,

1. Click the [+1] button below the Service List, then create a new Service Code in the Add Service Item window, giving it a descriptive name such as “ACC Patient Fee”.

2. Add this Service Code as a line in the patient Treatment Plan:

3. Double click this line and update the Fee field as required:

4. Tick this Service code along with the rest of the ACC Service Codes completed today, then Charge when ready

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Confirming an ACC Payment when ACC has not paid the full amount claimed

To confirm the full amount when ACC has not paid the amount claimed

1. Follow the payment procedure instructions as outlined above.

2. Payment Amount - Confirm that the amount received from ACC - even if this does not match the amount claimed.

3. Payment Method - Confirm that the payment was from ACC.

4. Tick the ACC invoice which relates to the payment

5. Select OK

The difference between the amount paid and the amount due will display on the Amount Open column on the Payor Transactions screen:

See Transferring an outstanding balance back to the Patient…

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Transferring an outstanding balance back to the Patient

(ACC has not fully covered their treatment and further payment for the treatment is required)

To transfer an outstanding balance back to the patient

1. Select the ACC Payor File as follows:

If you have it set up in the workspace bar, select the Payors icon > ACC

- or -

Select File > Payors to open the Payors desktop, then select the ACC code:

2. Select the [$] button to open the View Payor Transactions window.

3. In this window select the applicable transaction.

4. Select the [Transfer] button to open the Transfer Transaction window. Use this to confirm from which Invoice the Amount is being transferred.

5. If not displayed, type the Patient Code of the Patient on the Invoice.

6. Type the amount to be tranferred.

7. Select the [OK] button.

8. Send the Patient an invoice and letter to confirm that the ACC has not fully covered their treatment and further payment for the treatment is required.

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Option: Create a custom ACC Service List Category

Objective: Create an ACC Service Category for selection in order to conveniently display just the ACC services when creating an ACC Treatment Plan:

To create a custom ACC Service List Category

1. From the Chart Service List pane, select the Configure [Spanner] button to open the Service List Setup Wizard:

2. Tick the option to Create new service categories… (as shown above)

3. Select the Next > button to move to the next wizard page.

4. In the Select the services required in each category… page, proceed as follows:

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a. Click the selector box to open the View Service Categories window.

b. Click the [+1] button to open the Add Service Category window.

c. Type “ACC” as the Description and tick the checkboxes as required.

d. Click OK to return to the View Service Categories window.

Note that at this point you will be prompted… select OK to continue:

e. Click OK to return to the wizard page.

5. “ACC” is selected as the Category. Now tick all services that you want to see in this Category:

6. Select Finish.

7. The ACC category should now be available for selection in the Service List dropdown.