tennessee customization with overnight processes university of tennessee college of dentistry frank...

Tennessee Customization with Overnight Processes

University of Tennessee College of Dentistry Frank Pancratz


This presentation will cover 4 areas where overnight processes have helped us:

1. Managing Payment Allocations2. Managing Student Evaluations3. Managing Patient Recalls4. Managing Record Locks

MANAGING PAYMENT ALLOCATIONS


Managing Payment Allocations

• Tennessee Business Rules1. ADA procedure codes requiring more than one

visit to complete and costing more than $100 require at least half-payment at time code is put “In-Progress”.

2. ADA procedure codes requiring lab fabrication must receive at least half-payment before fabrication will begin.


• Situation (aka the Problem)1. Patient needs 2 crowns. 2. The patient pays $365, which is half of the price

of both crowns.3. Existing FIFO logic applies $365 as payment in

full for the 1st crown and leaves the 2nd crown unallocated.

4. Lab manager refuses to fabricate 2nd crown until system shows at least half-payment has been received.

Managing Payment Allocations• Solution:

1. TENN_APPLY_ALL_PAYMENTS and TENN_APPLY_ALL_PREPAYMENTS

These customized processes apply unallocated patient payments so that half of the total cost is satisfied on ADA procedure codes identified in table PROCEDURE_BILL50 that have a status code of “IN-PROCESS”.

2. APPLY_ALL_PAYMENTS and APPLY_ALL_PREPAYMENTS

These standard processes are run, after the processes in #1 above, to perform FIFO processing of any remaining unallocated payments.

NOTE: Our cashiers actually allocate 90% of patient payments, so these processes serve more as a “Safety Net” to catch and process unallocated payments.


D1510 D2790 D5213 D6068 D6720

D1515 D5110 D5214 D6069 D6740

D1520 D5111 D6053 D6072 D6750

D1525 D5120 D6054 D6075 D6780

D2710 D5121 D6058 D6076 D6783

D2720 D5130 D6059 D6077 D6790

D2740 D5140 D6062 D6210

D2750 D5141 D6065 D6240

D2780 D5211 D6066 D6245

D2783 D5212 D6067 D6250

ADA Procedure Codes included in table PROCEDUR_BILL50 for half-price processing

MANAGING STUDENT EVALUATIONS


Managing Student Evaluations

• Situation (aka the Problem)1. Our Axium grade forms are not consistent.

2. We want to give our department directors the flexibility they need.

3. We want to account for Grades/Evaluations and Points that students earn in any discipline, for any period (even prior to Axium) on one consolidated report.

Managing Student EvaluationsDifferent data elements arecaptured from the grade forms depending on the Discipline and Form involved.

In the examples shown, the highlighted data is what we want to capture from each of these particular grading forms.


In FPROS dept, Points and Grades are awarded on ADA procedure codes. Emphasis ison the number of procedures completed.


In ORAL SURGERY dept, the grades are recorded in the upper section of the grade card.The emphasis is on number of encounters, not number of procedures.


• Solution:1. UT_POINTS_SELF_SERVICE

This process collects and merges data from Axium and our prior system and creates a new database table UT_GRADE which is then used for producing grading reports using Crystal Reports. (The disadvantage to this method is that grades and points reflect the prior day’s totals, instead of up to the minute tallies.)

2. UT_BUILD_POINTSThis process collects points awarded from Axium and our prior system in the various disciplines by provider and creates a new database table UT_POINTS which is then used to produce point reports using Crystal Reports.


Example of Grading Report using new database table UT_GRADE


Example of Points Report using new database table UT_POINTS. By using Points we could easily compare student-to-student and year-to-prior year benchmarks.


• FYIThe University of Tennessee is currently in the process of transitioning away from a point system in favor of… a hybrid system consisting of multiple clinical requirements.

For a copy of the current University of Tennessee Clinical Expectations documents please send me an e-mail at: [email protected]

mailto:[email protected]

MANAGING PATIENT RECALLS


Managing Patient Recalls

• Goals for automated process1. Eliminate duplicate recalls2. Set recalls that have been satisfied to status

‘COMPL’3. Update recall provider to the student currently

assigned as the patient’s primary care provider4. Consolidate PERIO, HYG, GHYG, and GPERIO

recalls into one recall (the last one entered)

Managing Patient RecallsDiscipline ADA Procedure Codes Triggering ADA Codes Satisfying

ENDO D3310, D3320, D3330, D3331, D3332, D3333, D3346, D3347, D3348, D3351, D3410, D3421, D3425, D3426, D3430, D3450

D3998

PEDO D1120, D1203, D1510, D1515, D1520, D1525 Any ADA Code

PERIO D1110, D4132, D4910 D4910, D1110

HYG D1110, D4132, D4910 D4910, D1110

GPERIO D1110, D4132, D4910 D4910, D1110

GHYG D1110, D4132, D4910 D4910, D1110

Our process looks at the TRX.”Procedure” for the ADA Code that satisfies the recall. Itthen updates the PTRECALL.”Status” to ‘COMPL’ where the PTRECALL.”RecallDate” < TRX.”TreatmentDate”

MANAGING RECORD LOCKS


Managing Record Locks

• Our overnight processes for managing record locks fall into two categories:

1.Financial Locks – basically require the patient to stay current with their financial obligations to the College of Dentistry.

2.Insurance Locks – aid us in verifying patient data so that payment can be received.


The PROM – Financial Lock begins by the staff member accepting partial payment froman emergency clinic patient. By entering the keyword “PROM” in the Code section wecan then track the presence of this word in our automated process to LOCK the record.When the patient pays the staff member removes the word “PROM” from this note so our automated process will not LOCK the record. (The automated process looks for PTNOTE.”NoteCode”=‘PROM’ and sets PATIENT.”Office1”=‘PROM’)


In Axium, Maintance/Chart Tracking Locks/Electronic Chart Lock, we have anOffice Code = PROM, which triggers the actual record lock.


The BALOD – Financial Lock starts with a patient having a debit balance for 90 days orlonger. In our automated process we use the PTBAL database table. As part of our overnight processing we refresh PTBAL using the Axium standard process OVERNIGHT_STD_PKG.GENERATE_PTBAL. We also include the TRX database table in ourProcess to exclude any patients that have an “In-Process” transaction status. This keepsus from locking out any denture or crown patients waiting to pay their balance upon delivery. Our process sets the PATIENT.”Office2” =‘BALOD’.

Managing Record Locks• Insurance Locks

– Allow verification of coverage before treating patient

– Allow pre-certification of ADA procedure codes required by some insurance payers

– Once coverage is verified patient account is unlocked for the day. Then evening process relocks the record based on presence of insurance (database view POLICY.”Company”)

– We are primarily concerned about patients with insurance were our school accepts insurance assignment as payment in-full

In Conclusion• This has been a small taste of what we do with

custom processes at the University of Tennessee.

• Affordable consulting on custom Oracle programming and custom Crystal Reports is available.

• Further details about any of the processes presented are available by contacting me, Frank Pancratz, at [email protected]


Questions?

• Contact Information:– Frank Pancratz, [email protected]– University of Tennessee, College of Dentistry (Memphis)

– (901) 488-9059


tennessee customization with overnight processes university of tennessee college of dentistry frank...

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