Creating a course of treatment
Before you can begin charting services you need to create a Course of Treatment (COT).
- In the Patients Chart tab, click the +1 COT button to display the Add COT window.
- Specify the Payor, this will default to the payor set in their patient details but can be overridden. For Private treatment leave it blank.
- You can set the number of expected Appointments and set the Planned Colour/Do Not Charge colour.
- Click the OK button.
A Course of Treatment has been created and will sit as a COT tab. You can have multiple COT tabs if required.
Charting a Service
You can chart services using the Quick Chart, Quick Plans or individually.
Once you have created a new COT you can search the Service list/Service Categories on the right-hand side. Once you have found the required service highlight it (left click).
You can now click on the appropriate tooth/surface to chart that service or double click if you prefer. If you double click and it needs more information, such as tooth/surface, then it will prompt you for this information. Repeat this for all services that are being performed in that appointment.
Editing a Service
Editing a Service can be done anytime before the treatment is charged, otherwise it needs to be resubmitted.
To edit a service you can either double click the treatment on the COT or right click and select edit.
From here you can edit the Provider, Planned/Completed Date, Estimates/Actual Time, Tooth number and the fee. You can also add clinical notes here.
Adding Appointments to a Treatment Plan
- When the first service is charted in a patient’s Treatment Plan, an entry automatically appears in the Treatment Planning area along with the Course of Treatment number, the first Appointment and the selected Service to be provided.
If your computer is not creating the first appointment automatically, 1) Select Configure > User Settings, 2) Tick the Auto-Create Course of Treatment checkbox and enter 1 in the Default Number of Appointments field.
- Right-click on any line in the Treatment Planning Area and choose Add Appointment.
- A new appointment will be added directly below the line you initiated the command from.
Moving Services into Appointments
Provided services have not been completed, they can be moved around within and between appointments by dragging them with the mouse, as follows:
- Click on the service name within the treatment plan line, and keeping the left mouse button pressed down, drag the service into the required appointment.
To select multiple services together in the treatment plan, click the first service, then hold down the SHIFT key and click the last service.
If the services you wish to select are not adjacent to each other, hold down the CTRL key then click on each service required.
To make it easier to select services that are commonly used together in a Course of Treatment, set them up with adjacent codes in the Services List and/or group them in service categories.
Editing Appointment Length
EXACT automatically adds the time required to complete each Service into an overall appointment length.
The estimated time to complete each Service is defined within each Service’s parameters.
To assist Reception Staff to accurately schedule the patient’s future appointments, it is possible to change the estimated time for each appointment in the Current Course of Treatment area.
To assist the provider, notes can be added to an appointment, for example a reminder to check a tooth that had been causing the patient discomfort.
To edit the Appointment Length
- Double-click on the appointment in the Treatment Area. This is displayed on the Appointment line in bold black text.
- An Edit Appointment window will display.
- Click in the Expected Time field and type in a time, or use the up/down arrow buttons to enter the new required appointment length. The first two digits indicate hours and the next two digits indicate minutes.
00:25 represents 0 hour and 25 minutes
01:30 represents 1 hour and 30 minutes.
- If you wish to make any changes to the appointment description or add a note, click in those fields and type in the text you want to appear. Click the OK button to save changes.
To Hide Treatment Within Appointments
Treatment within appointments can be ‘hidden’ from view using the ‘+’ and ‘–’ icons on the Appointment Line. This feature is ideal when dealing with complex Treatment Plans with multiple appointments. The Current Course of Treatment area can be altered to hide areas you do not need at the moment and only view the current appointment.
Click on the “-” or “+” buttons to hide/collapse and show/expand appointments
Moving Treatment between Treatment Plan Tabs
Once a Treatment Plan has been created, it may be necessary to move treatments between the COT tabs. Treatment can either be dragged from one tab to another, or you can copy, cut and paste treatment between the tabs.
To Drag Services between Treatment Plans
- Click the item you wish to move. (Select multiple items by holding down the CTRL key as you click on each item).
- Keeping the mouse button depressed, drag the item(s) to the correct tab, using the mouse cursor (arrow) as a guide.
- Hover the mouse cursor over the tab the item(s) are to be placed in; that tab will become prominent enabling you to then drag the item(s) to the correct appointment within that tab.
- Release the mouse button.
To Copy, Cut and Paste between Treatment Plans
- Click on the item you wish to move. (Select multiple items by holding down the CTRL key as you click on each item).
- Right-click on any of the selected items, to display the drop-down menu:
If you are copying, select Copy; if you are removing from the original plan, select Cut.
- Click on the appropriate tab; use the arrow within the Treatment Plan as a guide to find the appointment that you wish to place the item into. Right-click and select Paste
Deleting a service
If you need to delete a service highlight the service, right-click and select delete or simply press the Delete key on the keyboard. This can only be done if the treatment has not been charged yet.
Multiple Treatment/Service Items
EXACT gives you the ability to chart multiple items at once, such as several adjacent extractions or implants when fitting appliances, or the charting of multiple different treatment items if you do your charting after the patient has left the surgery or at the end of the day. Charting is performed by selecting a tooth on the chart and highlighting a service, or vice-versa. To chart items such as bridges that span multiple teeth, you choose the appropriate service code, then click on the first tooth to be selected. Hold down the mouse button, and drag the rectangle that is displayed on the chart over the teeth you wish to include. All teeth that the rectangle passes over will be highlighted when you release the mouse button.
Alternatively, you can double-click on a service, to display a window:
As the instructions above indicate, you can either enter the number for the tooth or teeth the service applies to, or select using the left mouse button for individual teeth, or the right mouse button for multiple adjacent teeth.
To edit Services
To edit multiple services uses the same method as above, except once you have highlighted the items, right-click with your mouse, and select 'Edit' from the drop-down menu:
This will open a window similar to the following example:
As indicated by the instructions on the screen, you can update (edit) a particular field or fields by entering the appropriate value in that field, For instance, if treatment had been charted to one provider erroneously, or that provider was now no longer available, you could change the 'Provider' code. Similarly, either of the dates, or the Price Code or Fee Schedule could be altered (note however that the Completion Date can be changed only for completed treatment).
If you wish to change the Price Code, but the "Don't Recalculate" checkbox is ticked for that service, the price will not be overridden.
The Tooth field enables you to enter a different tooth number, either by typing it in, or selecting using the “Tooth” button. Note that you can use this on only one tooth at a time, as it would be nonsensical to change the charting for more than one tooth to a single tooth. If you need to do this, then it is better to delete the charting and re-enter the correct tooth.
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