How to Add a Continuation of Treatment Claim for a Patient

Document created by prcarter Employee on Aug 3, 2016
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Goal:

To add a continuation of treatment claim for a patient.

 

1.  From the main menu of OrthoTrac, click Functions, Patient Chart, Claims.

2.  Select the patient from the OrthoTrac Software Patient Look-up window.

3.  Click OK.

4.  Click Add New.

5.  Select the Policy Holder from the Policy Holders window.  This window will not appear if there is a single responsible party on the account.

NOTE: The policy holder is the Responsible party that has the Insurance assigned under the Responsible Party information window.

6.  Click OK.

7.  Select AAO Cont. of Tx from the Add New Claim window.

NOTE: If the AAO Cont. of Tx option is not in the list, the carrier/employer is not set to accept Continuation of Treatment claims.   Correct the Carrier/Employer in the Carrier Maintenance window.  For further details refer to the section below titled:  Section 1: CHANGE THE CARRIER TO ACCEPT CONTINUATION OF TREATMENT

8.  Click OK.

9.  Click Months Tx. Remaining (field 42) on the claim form to select the 0.  The months of treatment remaining will decrement each month or quarter.  When it reaches zero the claim will no longer be generated.

10.  Enter the number of treatment months remaining.

11.  Click History.

12.  Enter the Last Cont. of Tx.

NOTE: The Last Cont. of Tx date should be one claim period prior to the first claim that should be generated.  For example: A monthly claim to begin March 1 should have a Last Cont. of Tx of February 1.  A quarterly claim to begin March 1 should have a Last Cont. of Tx of December 1.  To include more months on the claim if it was late in being entered, set the date back to the appropriate date of starting treatment and a line will be generated for each month appropriately.

13.  Press <Tab> twice.

14.  Enter the Monthly Charge.  If the Monthly fee is 0.00 the claim will not be generated.

15.  Press <Tab>.

NOTE:  The claim will not be generated unless the 'Generated' drop-down box displays No.

16.  Select the Frequency from the drop-down list.  If the Frequency is set to NONE the claim will not be generated.

17.  Click Close on the Claim History window.

18.  Click OK on the claim form.

19.  Click Close on the Claims window.

The claim is now ready to be generated.  For details on generating Continuation of Treatment claims refer to article: How to Generate Continuation of Treatment Claims.

 

Section 1: CHANGE THE CARRIER TO ACCEPT CONTINUATION OF TREATMENT

1.  From the main menu of OrthoTrac, click Functions, Maintenance/Set-up, Carrier Maintenance.

2.  Select the Carrier/Employer from the OrthoTrac Software Carrier Lookup window.

3.  Click Change.

4.  Click the Continuation of Treatment drop-down list and select the correct setting.

  • If it is set to Range the day of the month can be specified.  Prior to version 11.4 it was the first of the month.  
  • If it is set to Specific the system will use the date the patient was seen in the office.
  • If it is set to Per Visit Only the system will use the date the patient was seen in the office with an additional feature: the claim will ONLY generate when the patient is seen for a visit during that month.
  • If it is set to Last Day of Month the system will use the last day of that month.
  • If it is set to Banding Date the system will use the patient's Banding Date. 

5. Click OK to close the Carrier Maintenance window.

6.  Click Cancel to close the OrthoTrac Software Carrier Lookup window.

NOTE:  The carrier is now set to allow Continuation of Treatment claims to be added to a patient.

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