athenaOne Dental (for FQHCs) — Role-Based Workflows

This section addresses the following modules:

• Patient Information

• Scheduling

• Clinical

• Administrative

• Dental Chart

There are three main roles that follow different workflows inside every encounter:

1. Patient Services Representative (PSR)

2. Clinician: May include one or more of the following

   • Registered Dental Assistant (RDA)

   • Registered Dental Hygienist (RDH)

   • Dentist (DDS/DMD)

3. Billing

PSR Workflow

PSR workflow involves the following steps of a patient appointment inside the athenaOne Dental application:

1. Patient Information Module:

   • Finding/Registering patients
   • Editing patient profiles

2. Scheduling Module:

   • Creating patient appointments
   • Confirming appointments
   • Editing appointment information
   • Checking in patients
   • Checking out patients

3. Dental Chart

   • Review Treatment Plans

   • Review Ledger

Finding/Registering New Patients

Upon initial communication, the user attempts to find an associated profile for the patient. To find patient(s):

1. Click on Find Patient search bar in the athenaOne Dental Header.

2. Search and select the patient from the drop-down menu.

3. If you cannot find the patient in the system, it means they are not registered.
   

 

Users will need to create a patient profile if the patient does not have a profile in the system. To register new patients and create a new patient profile:

1. Click Add Patient button at the bottom of the search window.

2. Fill out all required fields for the patient profile.

3. Click Save Patient Profile to save the new profile.
   

Editing Patient Profiles

To edit existing patient information:

1. Locate the patient using Find Patient.
   

2. Click Edit Patient and edit the patient profile.

3. Click Save Patient Data to save your changes.
   Refer to Editing Patient Information for more details.

 

Creating Patient Appointments

If requested, schedule an appointment for the patient. To create an appointment for a patient:

1. Locate the patient using Find Patient.

2. Once the patient’s profile is open, access Scheduling from the athenaOne Dental Header.

3. Inside Scheduling, verify the location of care and change the date to the day you want to schedule the appointment.

4. Click on a time slot in the Schedule of the appointment.

5. Complete the information for your patient’s appointment.

6. Click Save to save your appointment. Refer to Making an Appointment for specific steps to complete this task.

Confirming Patient Appointments

Update patient appointment confirmation status. To change the confirmation status:

1. In the Schedule, right-click on the appointment to confirm.

2. Select Confirmation Status from the drop-down menu.

3. Select the appropriate confirmation status from the drop-down menu list. Refer to Confirmation Status for specific steps to complete this task.

Editing Appointment Information

To edit appointment information in Scheduling:

1. Click on the appointment to enter the Appointment Overview window.

2. Edit the information in the Appointment Overview tab as desired. Refer to Editing Scheduled Appointments for more details.

Canceling Appointments

To cancel patient appointments in Scheduling:

1. Right-click on the appointment in the Schedule.

2. Select Cancel Appointment from the drop-down menu. Refer to Cancel Appointments for more details regarding this step.

Arriving Patients

Once a patient arrives/signs in for an appointment, indicate that they have arrived.

 

To update patient arrival status:

1. Right-click on the patient’s appointment inside the Schedule.

2. Select Patient Tracker from the drop-down menu.

3. Click Arrived. Refer to Patient Tracker for more details on how to complete this task.

Checking In Patients

Once a patient arrives for an appointment and is ready to check in, go through the Check In process. To check in a patient:

1. Right-click on the patient’s appointment inside the Schedule.

2. Select Patient Tracker from the drop-down menu.

3. Select the Check In status from the drop-down menu.

4. Inside the Appointment Check In window, complete the check in process.

5. Click Finish Check In to complete the process. Refer to Appointment Check In for more details on this task.

Reviewing Treatment Plans

To review Treatment Plans with the patient:

1. Enter the Dental Chart and navigate to Treatment Plans.

2. Review Treatment Plans and their phases if applicable. Refer to Treatment Plans for more details.

Reviewing Payments

Review the payment history, post payments, pre-payments, and any adjustments inside the Ledger.

To review a patient’s payment history before checkout:

1. Enter the Dental Chart and navigate to the Ledger.

2. Review Payments with the patient as well as post payments and adjustments. Refer to Ledger for more details.

Checking Out Patients

Once an encounter has finished, the user completes the appointment by checking out the patient. To Check Out a patient:

1. Locate the appointment on the Schedule.

2. Click the Ready for Check Out hyperlink inside the appointment block.

3. Inside the Appointment Checkout window, fill out all information and post payments as required.

4. Use one of the scheduling options to schedule the patient’s next appointment, if necessary.

5. Select Finish Check Out. Refer to Appointment Check Out for specific steps on this task.

Clinician Workflow

The following user roles follow the Clinician workflow and may complete different tasks based on their

healthcare organization’s policies:

• RDH

• RDA

• DDS/DMD

 

A user following the Clinician workflow works the following parts of the encounter inside Clinical:

1. Clinical Module/Dental Chart

   • Creating Encounters

   • Changing Encounter Status

2. Dental Chart

   • Patient Intake

   • Dental Charting

   • Perio Exam

   • Clinical Note Preparation

   • Prescriptions

   • Clinical Note Attestation

     The following sections describe the necessary steps to complete these actions in the recommended order.

Creating the Encounter

From the Clinical Dashboard, create the encounter to document the patient’s dental visit.

1. Navigate to the Clinical Huddle inside the Clinical Dashboard.

2. Locate the patient’s appointment block and confirm the Patient Tracker status is Ready In Lobby.

3. Then click Start Encounter.

4. Once selected, the user is redirected to the new encounter inside the Dental Chart. Refer to Creating An Encounter for specific steps to complete this task.

Changing Patient Tracker Status

The user is expected to change the Patient Tracker status as the appointment progresses. To change the Patient Tracker status:

1. By default, the Patient Tracker is set to Ready in Lobby. This status means that the Check In process is complete.

2. As an Encounter progresses, locate and select the Status drop-down menu in the upper right-hand corner of the Dental Chart window and select the appropriate status for each phase of the Encounter. Refer to changing Encounter Status for more details.

Patient Intake

After creating the encounter, the user is automatically directed to Overview inside the Dental Chart, where they can review and update the patient’s medical and dental history.

 

To review the chart with the patient:

Inside Overview, scroll or use the navigational menu to review and make updates as necessary to the following sections:

1. Problems (requires review and approval)

2. Allergies (requires review and approval)

3. Vitals

4. Medications (requires review and approval)

5. Dental encounter history

6. Questionnaires

7. Immunizations/Vaccines

8. Documents

   Refer to Overview for more details.

Dental Charting

After completing the intake process in Overview, the user will complete the dental Charting process. To complete the dental charting process:

1. Enter Charting from the Dental Chart Menu.

2. Use the charting features to record all existing conditions along with all referred and treatment related procedures. Refer to Charting for more details.

Soft Tissue Exam

Upon completion of the Charting process, the provider performs and records a Soft Tissue Exam if necessary. To record the exam results:

1. In the Charting section, select the Quick Actions Tab.

2. Click Soft Tissue Exam at the bottom.

3. Fill out the provided form with all information regarding the soft tissue exam performed.

4. Click Save to submit the form. Refer to Adding Soft Tissue Exam for more details.

Prescriptions

If any medications are to be prescribed to the patient in relation to upcoming or performed procedures, add a

prescription to the patient’s chart.

To add a prescription:

1. In the Charting section, click the Quick Actions Tab.

2. Click +Rx at the bottom.

3. Fill out the prescription information as required.

4. Click Send to Queue once completed. Refer to Adding Prescriptions for more details.

Clinical Note Preparation

After finishing the dental charting process, add any clinical documentation to be reviewed and attested by the provider.

To enter clinical documentation:

 

1. Navigate to the Clinical Note tab in the bottom right-hand side of the Charting window.

2. Inside the Clinical Note text field:

   • Enter your notes manually into the text field if necessary.

   • Select Quick Notes and use the Add All option (Recommended) or use the individual Quick Notes options to enter Encounter Reasons, Problems, Allergies, etc.

   • Use the Procedure Templates option to enter pre-determined details about completed procedures. (Recommended)

3. After entering and reviewing the Clinical Note, indicate that the notes are ready for review by selecting Ready for Provider in the top right corner of the window. Refer to Clinical Note for more details.

Perio Exam

After documenting all conditions, procedures and diagnoses inside Charting, the user performs a perio exam based on their findings with the initial dental charting.

1. Enter Perio from the Dental Chart Menu.

2. In Perio, to create a new exam, click New Exam.

3. Once inside the new exam, record all relevant findings. Refer to Perio Exam Overview and Workflow for more details.

Creating Treatment Plans

Once the dental charting and the perio exam are completed, the user creates a Treatment Plan for the patient.

1. Select Treatment Plans from the Dental Chart menu.

2. Click Create New Treatment Plan.

3. Create the phases of your Treatment Plan using the procedures from the Pending Procedures List.

4. Review all pricing estimates with the patient.

5. Have the patient sign the treatment plan by clicking Sign Treatment Plan and entering their digital signature.

6. Click Save in the Signature window to complete your treatment plan. Refer to Treatment Plans for more details.

Clinical Note Attestation

After the encounter process, return to Charting to review and attest the notes. To review and attest the clinical notes:

1. Click Charting from the Dental Chart menu.

2. Locate and click the Clinical Note.

3. Inside the Clinical Note tab, attest the notes by clicking on Attest. Refer to Attesting Clinical Notes for more details.

Clinical Note Addendums/Amendments

After the clinical note is signed, it may be necessary to amend the patient’s note.

 

To add an addendum:

1. Click Charting from the Dental Chart menu.

2. Use the Notes Hx or, if in the encounter, the Clinical Note tab to locate desired note.

3. Click Addendum.

4. In the Text Editor, enter the addendum and Sign & Save it. Refer to Addendum Note for additional details.

Ending the Encounter

At the end of the patient’s encounter, the user changes the patient status to Ready for Checkout to prepare the patient for the checkout process (Required).

To end the encounter:

1. Locate the Status drop-down menu in the Encounter Tracker.

2. Select Ready for Checkout status to indicate to the PSR that the encounter has ended, and the patient is ready for checkout.

Billing Workflow

The following user roles follow the Billing workflow and may complete different tasks based on their healthcare

organization’s policies:

• Senior Admin: Office Managers
• Billing: Patient Billing Representatives/Billing/Billing Supervisors

A user following the Billing workflow uses the following areas inside the Administrative and Reporting Modules:

1. Dental Chart

   • Reviewing Patient Ledger
   • Posting Patient Payments and Adjustments

2. Administrative Module

   • Add/edit Insurance Authorizations

   • Manage Pending Authorizations

   • Manage Authorization Documentation Requests

   • Review Visit Summary

   • Review Patient Encounters for Coding Accuracy

   • Review/Edit Patient Information

   • Add/Update Billing Notes

   • Set Encounters Ready to Bill

3. Reporting Module

   • Report to help with daily balancing

   • Report to focus payer collection efforts

     The following sections describe the necessary steps to complete these actions.

Reviewing Patient Ledger

Review the payment history with the patient from the Dental Chart and print a patient statement from the Ledger.

To review a patient’s payment history or print an invoice:

1. Enter the Dental Chart and navigate to the Ledger.

2. Review the patient’s payment history. Refer to Ledger for more details.

3. Print a statement for the patient. Refer to Ledger or Print Invoice for more details.

Post Patient Payments and Adjustments

The user will post patient payments, pre-payments, and any adjustments inside the Ledger. To post any patient payments or adjustments:

1. Enter the Dental Chart and navigate to the Ledger.

2. Post the patient payments from the Patient Balance/Enter Payment button. Refer to Ledger or Enter Payment for more information.

3. Post patient account adjustments from the Enter Adjustment button. Refer to Ledger or Enter Adjustment for more details.

Adding or Editing Insurance Authorizations

From the Administrative Module, the user will work from the Predetermination Requests Worklist to add and maintain insurance authorizations for patient procedures.

Adding Insurance Authorizations

The user will first indicate when an authorization request submits to insurance before adding the insurance authorization to the patient procedure.

To indicate authorization submission:

1. Enter the Administrative Overview dashboard and navigate to Predetermination Requests.

2. Generate the list for authorization “Required” status.

3. Locate the patient and contact the insurance payer to submit the request.

4. Update the patient’s status to “Submitted.” Refer to Predetermination Requests for additional details.

Once the insurance payer sends the authorization, add it to the patient procedure. To add a patient’s insurance authorization:

1. Enter the Administrative Overview dashboard and navigate to Predetermination Requests.

2. Generate the list for the procedure authorization “Submitted” status.

3. Locate the patient, update status to “Approved,” and add the patient’s authorization information. Refer to Predetermination Requests for additional details.

Editing Insurance Authorizations

The user may occasionally need to update a patient’s insurance authorization information from denied to approved or to review it for accuracy.

To edit or maintain authorization information:

1. Enter the Administrative Overview dashboard and navigate to Predetermination Requests.

2. Generate the Predetermination Requests for the desired procedure authorization status: “Denied,” “Required,” or “Approved.”

3. Locate the patient. Review and update the status and patient’s authorization information as needed. Refer to Predetermination Requests for additional details.

Manage Pending Authorizations

Users occasionally need to update an authorization request as pending the insurance company. To update to Pending status:

1. Enter the Administrative Overview dashboard and navigate to Predetermination Requests.

2. Generate the Predetermination Request for authorization the desired status: “Required” or “Submitted.”

3. Locate the patient and update the status as “Pending.” Refer to Predetermination Requests for additional details.

Manage Authorization Documentation Requests

An insurance payer may request additional procedure-related information before approving an authorization. To manage items needing additional documentation:

1. Enter the Administrative Overview dashboard and navigate to Predetermination Requests.

2. Generate the Predetermination Request for the desired procedure authorization status: “Pending” or “Documents Required.”

3. Locate the patient.

4. Review and send documentation to the insurance company as directed. Update the information status to “Documents Required.” Refer to Predetermination Requests for additional details.

Review Visit Summary

The Ready to Review Worklist, from the Administrative module, allows the user to view the visit summary as a part of the billing preparation process and indicate if the visit contains an amendment.

To view the Visit Summary:

1. Enter the Administrative Overview dashboard and navigate to Ready to Review.

2. Generate the worklist for the desired location, provider, payer, or specific patient. Refer to Ready to Review and Visit Summary for more details.

3. Locate the desired patient from the list and click the Visit Summary icon.

4. Review the Visit Summary contents.

5. Complete the information for an amendment if needed. Refer to Amendment for additional information.

Review Patient Encounter for Coding Accuracy

After reviewing the Visit Summary, the Ready to Review enables users to verify the accuracy of the procedure codes listed in the encounter.

To view the Encounter procedure codes:

1. Enter the Administrative Overview dashboard and navigate to Ready to Review.

2. Generate the Ready to Review for the desired location, provider, payer, or specific patient. Refer to Ready to Review for more details.

3. Locate the desired patient from the list and click the Expand Procedures down arrow. Refer to Expand Procedures for additional details.

4. Review the listed procedures for accuracy.

   • If there is any inaccuracy, update the Billing Note and follow your organization’s process for correcting and/or amending. Refer to Billing Note and Amendment for additional information.

Review and Edit Patient Information

The biller should review and edit (if needed) the patient account information as a part of the billing process. To view and edit patient information:

1. From the Administrative Overview dashboard, navigate to Ready to Review.

2. Generate the Ready to Review for the desired location, provider, payer, or specific patient. Refer to Ready to Review for more information.

3. Locate the desired patient and click the Patient name hyperlink. Refer to Patient Profile for more details.

4. Review the Patient Profile. Edit any information as needed and Save it.

Add or Update Billing Notes

It is recommended that the biller document any procedure or insurance-related issues in the Billing Notes. To add or update Billing Notes:

1. From the Administrative Overview dashboard, navigate to Ready to Review.

2. Generate the worklist for the desired location, provider, payer, or specific patient. Refer to Ready to Review for more information.

3. Locate the desired patient and click the Billing Notes hyperlink. Refer to Billing Note for additional details.

4. Add the specific procedure billing notes and save them.

Set Encounters Ready to Bill

Once the biller finishes reviewing/editing, the encounter procedure(s) is set to Ready to Bill and sent to the billing server.

To set Encounters Ready to Bill:

1. From the Administrative Overview dashboard, navigate to Ready to Review.

2. Generate the Ready to Review for the desired location, provider, payer, or specific patient. Refer to Ready to Review for more information.

3. Locate the patient(s) that are ready.

4. Click the radio button to select them and click the Ready to bill button. Refer to Ready to Bill for more details.

5. The patient procedures are sent to the billing server and removed from Ready to Review.

Report for Daily Balancing

The Daily Balance Report, from the Reporting Module, helps users balance the charges, payments, and adjustments for the end of the day and serves as a comprehensive daily balancing tool.

To run the Daily Balance Report:

1. Click the Reporting Module icon. Refer to Reporting Module for more information.

2. Click the Daily Balance Report from the report’s menu.

3. Generate the report for the desired date(s) and filters. Refer to Daily Balance Report for additional details.

Report for Payer Collections

The Procedure Date Aging Report, from the Reporting Module, assists billers in determining which payer represents the largest accounts receivable and which payers hold the oldest balances.

 

To run the Procedure Date Aging Report:

1. Click the Reporting Module icon. Refer to Reporting Module for more information.

2. Click the Procedure Date Aging Report from the report’s menu.

3. Generate the report for the desired date(s), aging buckets, and filters. Refer to Procedure Date Aging Report for additional details.