athenaOne Dental (for FQHCs) — Appendixes

A-1: Procedure Codes with Stages

What is a staged procedure code?

Some dental procedures require multiple encounters to complete but are only billable once the final stage finishes, i.e., dentures. For accurate documentation about the face-to-face encounter, athenaOne Dental provides a non-billable instance of the code to complete during the corresponding encounter. If, as a rule, multiple stages of the code in question are, in fact, billable, it would not be considered a staged procedure code.

Which procedure codes in athenaOne Dental contain stages?

All stages except the final stage are non-billable and have a zero-dollar charge.

 

Description	Procedure Code	Number of Stages
Space Maintainers	D1510, D1515, D1516, D1517, D1520, D1525, D1526, D1527	One/Final
Crowns	D2740, D2750, D2751, D2752, D2791, D2792	One/Final
Dentures	D5110, D5120, D5130, D5140, D5211, D5212, D5213, D5214, D5225, D5226	One/Two/Three/Four/Final
Immediate Partial Dentures	D5221, D5222, D5223, D5224, D5227, D5228	One/Final
Interim Partial Dentures	D5820, D5821	One/Final
Interim Complete Dentures	D5810	One/Two/Three/Four/Final
Add tooth to existing partial denture	D5650	One/Final
Reline Dentures	D5750, D5751, D5760, D5761	One/Final
Implant Supported Crowns
Bridge – Abutment Supported Crowns	D6057, D6058	One/Two/Final
Bridge – Abutment Supported Crowns	D6059, D6060, D6061, D6062, D6063, D6064, D6194	One/Final
Bridge – Retainer Crowns | ¾ Retainer Crowns | Maryland Bridge Retainer Crowns	D6710, D6720, D6721, D6722, D6740, D6750, D6751, D6752, D6753, D6790, D6791, D6792, D6793, D6794 | D6780, D6781, D6782, D6783, D6784 | D6545, D6548, D6549	One/Final
Bridge – Pontic	D6094, D6205, D6210, D6211, D6212, D6214, D6240, D6241, D6242, D6243, D6245, D6250, D6251, D6252, D6253	One/Final
Occlusal Guard	D9940, D9941, D9942, D9944, D9945, D9946	One/Final
Endodontics	D3310, D3320, D3330, D3346, D3347, D3348	One/Two/Final
Orthodontics	D8680	One/Final

 

A-2: Reporting Utilization Table

 

Report Name	Purpose	Suggestion to Run (Daily, Monthly, etc.)
Adjustment Details	Designed to assist in the validation of the Adjustments Summary Report.	As Needed
Adjustment Summary	Designed for analysis of adjustments by type.	Month End
Appointments – No Encounter Report	Designed to assist in managing encounters by listing appointment, their statuses, and if it contains an encounter.	Daily, Weekly, or Monthly
Batch Report	Intended to be a tool for management to ensure that batches are being addressed.	Daily, Weekly, or Monthly
Billing Status Analysis	Provides encounter ticket level counts and outstanding amounts by the Billing Status.	As Needed
Bulk Patient Statement	Provides a way to compile patient statements by given date range, last name range, or full patient balances.	Monthly or As Needed
Charge and Payment Details	Designed to assist in the validation of the Charge and Payments Summary Report.	As Needed
Charge and Payment Summary	Portrays the Charges, Payments, Adjustments, and Net Changes to Accounts Receivable for a specified date range.	Month End
Daily Balance Report	Designed to assist with balancing charges, payments, and adjustments for the end of the day.	Daily
Daily Schedule Report	Lists the scheduled patient appointments per day by location including appointment reason, insurance, and treating provider.	Daily or As Needed
Deposit Slip Details	Designed to assist in the validation of the Deposit Slip Summary report. Provides detailed financial data regarding deposits.	As Needed
Deposit Slip Summary	Provides the financial data regarding the deposits.	As Needed
Encounters Detail Report	Designed to assist in the validation of the Encounter Summary Report providing the specifics for the encounters.	As Needed
Encounter Status Report	Designed to assist in the management of daily encounters.	As Needed
Encounters Summary Report	Portrays the encounter counts and financial data for a specific date range.	As Needed

Financial Summary	Combination of Monthly and Daily Financial Summary	Daily, Monthly, or As Needed
Overages and UACs Detail	Assists with the management of payment Overages and Unapplied Credits as it provides the patient payment details.	As Needed
Overages and UACs Summary	Provides a summary of the patient payment Overages and Unapplied Credits financial information.	As Needed
Treatment Plan Phase 1 Details	Provides the details including the percentage for patients who completed their Treatment Plans within a specific time frame.	As Needed
Treatment Plan Phase 1 Summary	Provides a summary of patients who completed their Treatment Plans within a specific time frame.	As needed
Procedure Date Aging	Lists account receivables for patient and insurance balance totals separated by aging category.	Month End or As Needed
Sliding Fee Encounter Details	Designed to provide an overview of patient population and encounters grouped by Sliding Fee Set.	As Needed
Time of Service Collection Details	Designed to assist in the validation of the Time of Service Collection Summary Report.	As Needed
Time of Service Collection Summary	Designed to assist with the analysis of payments collected from payers.	Monthly, Yearly, or As Needed
Tooth Ledger Report	Designed to help manage the clinical data entered and lists the contents of the Tooth Ledger fields.	As Needed
UDS Table 5 Report	Assists with regulatory reporting by providing the necessary data for the Staffing and Utilization Profile regulations.	Annually or As Needed
UDS Table 6A Report	Provides the data related to selected diagnoses and services rendered for regulatory reporting.	Annually or As Needed
UDS Table 6B Sealants Details (formerly Clinical Measure Details)	Designed to assist in the validation of the Clinical Measure Summary Report.	Monthly, Yearly, or As Needed
UDS Table 6B Sealants Summary (formerly Clinical Measure Summary)	Designed for clinical measure group analysis by measure year.	Yearly or As Needed
UDS Table 9D Core	Provides a summary of the patient-related revenue required data for the UDS Table 9D.	Annually or As Needed
UDS Table 9D Details	Designed to assist with validation of the UDS Table 9D Core report providing details of the patient-related revenue.	Annually or As Needed

 

A-3: Sample Patient Statement

Figure 1: Patient Statement, page one

 

Figure 2: Patient Statement, the back of page one

 

Figure 3: Patient Statement Details, page two

 

A-4: Sample Patient Treatment Plan

The following is an example of multiple treatment phases with at least a 6-month Treatment Plan.

 

A-5: Sample Batch Report

 

A-6: Sample Predetermination Form – ADA Dental Claim Form

Note: The patient example and information on the form are not real.

A-7:Multiple Provider Encounters for a Single Patient

What is the workflow for a single patient who has multiple encounters on a single day?

Some patients may see multiple providers on the same day; for example, a patient has a cleaning with the hygienist and a detailed oral exam with the dentist. For accurate documentation about multiple face-to-face encounters, athenaOne® Dental provides a workflow solution. The patient’s appointment will contain both the treating provider and the hygienist. The following steps provide the office workflow for this patient’s multiple encounters.

 

Create or Update the Appointment

1. Navigate to the Scheduling Module.

2. Locate the day of the patient’s appointment and use Find Patient to select the patient.

3. Click the patient’s time slot.

   • If this is a new appointment, select the desired patient time.

   • If this is an existing appointment, click the patient’s name in the time slot.

4. Review and complete the required fields for the patient’s appointment.

5. Use the drop-down menu to select the Treating Provider and the Hygienist the patient will see.
   
   

6. Click Save.

 

Encounter and Clinical Notes

It is the day of the appointment, and the patient arrives in your office. For this example, the patient will see the hygienist (provider 1) for cleaning and then the dentist (provider 2) for periodontal cleaning.

1. Update the appointment with the Arrived status.

2. Complete the Check-In process and click Check-In.

3. Bring the patient back and navigate to the Clinical Huddle.

4. Locate the patient’s appointment and click Start Encounter.
   

5. Update the Dental Chart, Patient Overview sections with the Intake documentation.

6. Navigate to Charting.

7. The hygienist (provider 1) would use Procedures, Quick Actions to document the applicable prophy codes.

8. Verify Tooth Ledger accuracy.

9. Click the procedure items radio buttons, and click Set Complete.
   

10. Click the Clinical Notes tab. Add the necessary Clinical Notes and Sign.
    Important: Do not attest the Clinical Notes until both provider 1 and provider 2 input their applicable encounter notes.
    

11. Then, the dentist (provider 2) sees the patient.

12. The dentist will navigate to the same encounter for the patient and use Procedures or Quick Actions to document the periodontal cleaning procedure(s).
    

13. Verify Tooth Ledger accuracy.

14. Click the procedure items radio buttons, and click Set Complete.
    

15. Click the Clinical Notes tab and enter the necessary Clinical Notes.
    Important: Reminder, do not attest the Clinical Notes until both provider 1 and provider 2 input their applicable encounter notes.
    

16. Click Attest.
    

 

Check Out

The patient Checks Out, makes a payment (if applicable), schedules any follow-up appointments (if needed), and leaves the office.

 

Use your standard office workflow for this process or refer to Appointment Check Out for additional help.