Check for Service Restrictions

Check for Service Restrictions While Adding a Procedure

To check for service restrictions by adding a planned or completed procedure:

  1. Select the desired tooth/teeth.
  2. Click the appropriate button on the palette or use the Services button.
  3. In the Procedure Details window, complete the fields as required.
  4. Click Save.
    If service restrictions apply to the procedure, an alert displays.
  5. Review details of the alert.
  6. If you determine that a service restriction does not apply to the selected procedure, select the Acknowledged check box next to the alert, or, to acknowledge all alerts for a particular service code, select the Acknowledged All check box. Acknowledged alerts will be shaded green.
  7. Click OK.
    Note: If a procedure has unacknowledged service-restriction alerts, it can still be planned; however, the procedure may not be covered by the carrier.

Check for Service Restrictions from the Chart Details

You can check procedures for service restrictions directly from the Chart Details section of the Tooth Chart.

Note: Users should always check a previously planned procedure to ensure that any requirements have been met before completing the procedure.
To check restrictions from the chart Details:
  1. Select one or more procedures from the Chart Details section of the Tooth Chart.
  2. Right-click the selected items, and select View Service Restrictions.
    Note: Service items with an unacknowledged service restrictions will have an alert icon ( ) in the SR column. Service items with acknowledged service restrictions will have a green check mark ( ) .
    The system displays a list of service restrictions for the selected services.
  3. If you determine that a service restriction does not apply to the selected procedure, select the Acknowledged check box next to the alert, or, to acknowledge all alerts for a particular service code, select the Acknowledged All check box. Acknowledged alerts will be shaded green.
  4. Click OK.
    Note: If a procedure has unacknowledged service-restriction alerts, it can still be planned and completed; however, the procedure may not be covered by the carrier.

Check for Service Restrictions from a Treatment Plan

The Service Restrictions button in the Treatment Plan module allows you to view service restrictions for selected procedures.

To check for service restrictions from the Treatment Plan module:

  1. Open the Treatment Plan module by clicking the TxPln Entry icon on the toolbar.
  2. Select one or more services by selecting the check boxes next to them in the first column.
  3. Click Service Restrictions.
    The system displays a list of service restrictions for the selected services.
  4. If you determine that a service restriction does not apply to the selected procedure, select the Acknowledged check box next to the alert, or, to acknowledge all alerts for a particular service code, select the Acknowledged All check box. Acknowledged alerts will be shaded green.
  5. Click OK.
    Note: If a procedure has unacknowledged service-restriction alerts, it can still be planned and completed; however, the procedure may not be covered by the carrier.

Check for Service Restrictions While Adding an Appointment

When you are adding or editing an appointment, you can check for service restrictions from the Add/Edit Appointment screen, which will provide a View Service Restrictions link for each procedure that has restrictions.

Note: Procedures added via the Quick Add tab are not checked for service restrictions.
To check for service restrictions while adding an appointment:
  1. From the Scheduler create a new appointment or open an existing appointment. For more information see Create Appointments
  2. On the Tx Plans tab, click the View Service Restrictions link next to the procedure for which you wish to view service restrictions.
    The system displays an alert that details the service restriction for the selected procedure.
  3. If you determine that a service restriction does not apply to the selected procedure, select the Acknowledged check box next to the alert, or, to acknowledge all alerts for a particular service code, select the Acknowledged All checkbox. Acknowledged alerts will be shaded green.
  4. Click OK.
    Note: If a procedure has unacknowledged service-restriction alerts, it can still be planned and completed; however, the procedure may not be covered by the carrier.

Check for Service Restrictions on a Patient's Insurance Plan

From both the Patient Info tab of the Tooth Chart, the Add/Edit Insurance Plan screen, and Patient Overivew window, you can view a list of all service restrictions that apply to the patient's insurance plan.

View Service Restrictions

In the Patient Info pane of the Tooth Chart and the Add/Edit Insurance Plan window, you can view a list of all service restrictions that apply to the patient's insurance plan.

  1. Click the Chart icon on the QSI Dental Web main window.
    The Tooth Chart window opens.
  2. In the Patient Info pane, click the View Service Restrictions link next to the patient's insurance details.
    Note: This link appears only if the patient's insurance plan has service restrictions.
    The Service Restrictions window opens, displaying the service restrictions associated with the patient's insurance plan.

    You can search for a particular service restriction by typing keywords in the search box in the upper-right corner of the window.

Check for Service Restrictions from the Patient Overview

  1. Open the Patient Overview window by clicking the Pt Overview icon on the toolbar.
  2. In the Dental Insurance or Medical Insurance section of the Patient Overview are, click the plan ID of the insurance.

    The insurance plan details display in a popup window. The service restrictions on the plan are listed in the lower-right corner of the window.

  3. Click Close to close the window.

Check for Service Restrictions from the Add/Edit Insurance Plan Window

  1. Open the Patient Overview window by clicking the Pt Overview icon on the toolbar.
  2. In the Dental Insurance or Medical Insurance section of the Patient Overview, click the Primary or Secondary link.
    The Add/Edit Primary Dental (or Medical) Plan window displays with the patient's plan information shown.
  3. Click View Ins Plan.

    The insurance plan details display in a popup window. The service restrictions on the plan are listed in the lower-right corner of the window.