Estimate Calculations by Frequency and Treatment Area

In the Clinical >Treatment Plan, users can calculate insurance estimates for treatment-planned procedures linked to a specific treatment area in the mouth (such as a tooth, quadrant, or arch) when a frequency limitation based on the treatment area applied.

Now, if procedure A for the UL quadrant was performed three months ago, and there is a yearly frequency limitation allowed by insurance for procedure A if it is performed on the same treatment area, if you treatment plan procedure A for the UR quadrant today, Ascend Academic recognizes that the previous posting of procedure A was rendered on a different treatment area from the treatment area for today's planning of procedure A, so the correct estimated insurance portion is calculated instead of $0.00.

For a procedure on the Tx Planner tab of a patient's clinical record, an orange warning icon now displays when this coverage exception is applicable. This icon can also display while you are presenting a treatment plan and while you are viewing the guarantor portion using the detailed view of the procedures being presented. You can clicktap the icon to see a message that explains why the procedure is not covered.

The message displays the applicable treatment area and when the procedure for the same treatment area was performed previously (but only the most recent if there are multiple) within the frequency limitation period.