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kevin_moloney
Moderator
Moderator

Sensei Cloud Release 0.1.6913 (Part 3)

Sensei Cloud

Weekly Release

Build 0.1.6913  |  October 10th, 2021

This week’s Sensei Cloud updates continue to expand core application functionality and deliver on recent customer requests.

 

[0.1.6913 RELEASE UPDATES CONTINUED FROM PART 2]

Handling Orthodontic Contract Pre-Payments

This week’s release also includes workflow improvements for handling pre-payments made towards active orthodontic contracts. When patients - or their guarantors - make an advanced payment towards a current contractual obligation, you can now post a financial adjustment to automatically update the contract terms accordingly. These enhancements provide you - and your patients - with more flexibility in how a guarantor’s charge schedule can be adjusted when needed.

When a pre-payment is being made, first select the applicable (active) ortho contract from the patient’s list of contracts [Patient Tab > Financials > Contracts]. Then click the new ‘Pre-Pay Contract’ action in the side panel to display the ‘Adjust Balance’ dialog. The ‘Contract Adjustment’ balance adjustment type is selected by default, as is the selected contract. Specify the pre-payment amount, up to the remaining guarantor balance for the contract (which is displayed) and add some comments to provide additional context for the posted ledger transaction. Finally, click ‘Save Changes’ to post the adjustment to the patient ledger, making that portion of the guarantor’s balance current (reducing the guarantor and contract balances accordingly). Once the payment is posted to the Patient Ledger, it now offsets the current balance (realized by the contract adjustment) rather than creating a credit balance.

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In addition, the guarantor’s current Charge History and Schedule is automatically modified, reducing the scheduled number of future charges while maintaining the agreed upon charge amount and frequency. The posting of this pre-pay adjustment (‘Pre-Pay’ charge) is also added to the guarantor’s schedule details to maintain a record of this change to the original terms of the agreement. NOTE: If desired, the active contract can be edited to modify the charge frequency, next charge date, or charge amount in response to the advanced payment.

NOTE: You can also perform this action directly via the patient’s ledger [Patient Tab > Financials > Ledger]. Click on ‘Adjust Balance’ in the side panel and then select the ‘Contract Adjustment’ type. If the patient has multiple active ortho contracts, then first select the applicable contract. Next, specify the (pre-pay) adjustment amount, up to the guarantor’s remaining balance for the selected contract (which is displayed). Add some comments and click ‘Save Changes’ to post the adjustment and shift the portion of the guarantor’s contract balance to current.

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To provide workflow flexibility, Sensei Cloud also prompts you with the option to create a contract adjustment whenever a patient payment is posted that produces a credit balance for patients with active ortho contracts. Click ‘Yes, Pre-Pay’ to create a (pre-payment) contract adjustment that covers all or part of the resulting current credit balance. As previously described, the pre-payment adjustment shifts the specified portion of the guarantor’s balance (of the selected contract) to current and adjusts (shortens) the guarantor’s charge schedule accordingly. NOTE: Alternatively, you can always choose to accept a pre-payment as payment in advance for scheduled contract charges (e.g., ‘No, Leave Credit’). Assuming that patient payments are up to date, simply post the payment to the ledger without making a contract adjustment. The resulting credit balance, allows the future, scheduled contract charges to naturally correct it as they are levied against the ledger over time.

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We look forward to your feedback on how these enhancements support your ongoing management of orthodontic contracts. Please let us know what works well and what additional improvements or contract-based adjustments would be helpful.

Post-Hoc Changes to Insurance in Orthodontic Contracts

Sensei Cloud now also provides improved support for handling post-hoc changes to patient insurance that affect an active orthodontic contract. New insurance schedules can be added, existing insurance schedules can be removed, and insurance coverage amounts can be adjusted within an active orthodontic contract. Depending on the change, the guarantor responsibility is automatically increased or decreased and the associated charge schedule is lengthened or shortened accordingly (while holding the guarantor’s agreed upon charge amount constant).

To add more insurance coverage to an existing contract, first edit the selected contract [Patient Tab > Financials > Contracts]. Then click the ‘Add Charge Schedule’ hyperlink below the existing insurance and/or guarantor schedules. First, select from the available policies (as defined in the Patient Record) and enter the anticipated coverage amount. Next, define the rest schedule details (e.g., charge frequency, charge amount, number of charges, etc.), including any expected downpayment from the payer. Once the insurance coverage amount is defined, the guarantor’s terms adjust accordingly - reducing the amount, number of charges remaining, remaining balance, and shortening the Charge History and Schedule. NOTE: For pending ortho contracts with existing pre-authorization claims (previously generated for any existing insurance schedules), a pre-auth claim automatically generates for each new insurance schedule upon saving the contract. For active ortho contracts, initial service claims are automatically generated for each new insurance schedule upon saving the contract.

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To remove defined insurance coverage from an existing contract, edit the selected contract. Then click the ‘Remove Schedule’ at the bottom of the insurance schedule. Once removed, the guarantor’s terms adjust accordingly - increasing the (guarantor) amount, number of charges remaining, remaining balance, and extending the Charge History and Schedule. For pending contracts, the removal of an insurance schedule is fairly transparent, with simple adjustments being made to the guarantor’s proposed schedule. For active contracts, the removal of an existing insurance schedule automatically stops the generation of any future CoT claims and shifts the remaining balance to the guarantor (adjusting the guarantor’s schedule in the aforementioned ways). The insurance Charge History and Schedule is retained, providing a record of any insurance-based contract transactions that have already occurred. NOTE: You will need to manually cancel or address any generated pre-auth or service / CoT claims that have been generated but may not apply.

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Whenever insurance coverage associated with a pending or active ortho contract becomes invalid, you are prompted to update any affected contracts. This can happen if you mark an insurance policy as ‘Inactive’ or remove it via editing of the patient’s record [Patient Tab > Patient Record]. Clicking ‘Yes, Update’ automatically redirects you to the patient’s contracts list where you can edit the applicable contract(s) and remove the associated insurance schedule(s). Removal of the invalid (inactive) insurance schedule updates the contract terms (and the guarantor schedule) as previously described.

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Lastly, adjusting the ‘Amount’ (of coverage) in an insurance schedule of a pending or active ortho contract modifies the guarantor ‘Amount’ accordingly. Increasing or decreasing the amount of insurance coverage adjusts the guarantor schedule details, decreasing or increasing the ‘Amount’, ‘# of Charges’ (or ‘# Chgs Remaining’), and ‘Remaining Balance’.

We hope that these enhancements make it easier to manage changes to insurance coverage that occur during the course of a treatment contract. We look forward to your feedback on what works well and what additional changes can be made in support of your ortho contract management workflows.

 

[0.1.6913 RELEASE UPDATES CONTINUED ON PART 4]