Care Plan Workflow Extensions

Care Plan Workflow Extensions

Estimated reading time: 6 min

Care Plan Discounts in Procedures and Bundles

Care plan discounts can be configured at the following levels:

  • bundle
  • procedure
  • item

In previous versions, when a bundle was charged out in a consultation no discounts would be applied to individual items or procedures that were built into the components, it would only apply the discount at bundle level. The bundle would have to be available within the Care Plan components to trigger any discount, and it would apply to the total value of that bundle.

In 4.9 Care Plan Discounts are applied in a flow chart manner when a bundle or procedure is charged:

Apply to Existing Charges

Care plans in 4.8 and earlier can only be applied as charges are entered. There are scenarios when a clinic may wish to retrospectively apply a care plan, such as the following:

  1. when work is performed and the owner is then subsequently “upsold” onto a care plan (perhaps during the payment process)
  2. when a care plan has not been fully or correctly applied to a consultation, or charges have been incorrectly unlinked from the plan

Care plan discounts can be applied to existing visits by using the Apply Care Plan function in the visit tools section of the ribbon.

To apply the care plan:

  1. register the patient for the required care plan using the Care Plan Manager
  2. navigate to the required consultation
  3. select Tools from the ribbon and then Apply Care Plan
  4. if the visit has previously been finalised it will be made incomplete
  5. all charges in the consult will then be checked for an available discount:
    • if the charge is part of a procedure then any procedure-level discounts available on a care plan will be applied
    • if no discount given above, then the charge is checked for any item-level discounts available on a plan
    • if an available discounts is found then the charge is linked to the corresponding care plan component
  6. the available care plan discounts will then be applied

Apply Care Plans when Transferring Estimates

An estimate that is transferred to a consultation will now have all available care plan discounts automatically applied. This process works as follows:

  1. transfer the estimate charges into a new consultation for the patient
  2. check if patient is registered in an active care plan
  3. apply appropriate discounts to consultation

Use Care Plan Discounts within Estimates

Patient care plan discounts can now be applied to estimates. When an estimate is saved, any available care plan discounts that apply to charges on the estimate will be automatically applied, and the corresponding discount calculated and added.

Firstly, add the estimate as usual and create the appropriate charges:

When the estimate is Finalised, the charges are checked to see if any care plan discounts are available. If so they are applied and the care plan discount is created:

Care Plan End Of Life

Care Plans will now automatically set the status of ‘Finished’ when they have reached their End Of Life, as long as they have not been cancelled previously.

The End Of Life date is calculated by using the patient care plan expiry date in conjunction with any offset periods set up on the care plan components.

For example if you have an annual patient care plan which is due to expire on 01/01/2017 on 02/01/2017 this care plan will be marked as finished.

Unless the care plan is configured to have any component instances available past the life of the care plan.

For example if there is a component instance with an ‘Offset Days/Date End’ of 395 days then this will plan will not be marked as finished until 31/01/2017 (30 days offset past the 365 day plan). When the care plan is finished any outstanding care plan balance can be optionally transferred to the client’s financial ledger, and then again optionally written off depending on whether it is a credit or debit.

This option is controlled by the ‘Workflow Settings’ on each individual care plan configuration:

Under ‘End Of Life Closures’ you have the following options:

Transfer balance to client ledger

when enabled any outstanding care plan balance will be transferred to the client’s financial ledger by generating a transaction of type 24 – ‘Care Plan Balance Transfer’, this will bring the care plan balance to 0.00 and will leave the balance in the standard financials.

Write Off Credit at end of life

This option is only available if you have decided to transfer the care plan balance when the plan is ‘Finished’. If this option is enabled then if the outstanding care plan balance is a credit, i.e. they have made more payments than the value of discount they have received, this will be written off on the client’s financial ledger after being transferred. This is done by generating a transaction of type 25 – ‘Care Plan Balance Write Off’.

Write Off Debit at end of life

This option is only available if you have decided to transfer the care plan balance when the plan is ‘Finished’. If this option is enabled then if the outstanding care plan balance is a debit, i.e. they have made fewer payments than the value of discount they have received, this will be written off on the client’s financial ledger after being transferred. This is done by generating a transaction of type 25 – ‘Care Plan Balance Write Off’.

Changes to Cancellation Workflows

Cancellation Requests:

Care plans can now be configured to generate cancellation requests to integrated wellness providers (currently AHC only). This can be controlled per care plan by editing the care plan configuration workflow settings as below:

The option to ‘Enable Cancellation Requests’ can now be ticked. By enabling this option you remove the ability for patient care plans to be cancelled directly in the program once they have been registered with a wellness provider, as simply cancelling the plan in RxWorks does not inform the wellness provider. When this option is enabled if you attempt to update the status of a patient care plan which is registered with a wellness provider you will see the option ‘Request Cancel’ rather than ‘Cancel’:

In the event a plan needs to be cancelled it will either be done so by the client contacting the wellness provider, if this occurs the status change will be downloaded and received from the wellness provider as per the current process.

If the client contacts the clinic to cancel the plan a cancellation request can be created using the above option.

When a cancellation request is generated it will go into a queue and will be sent to the wellness provider overnight. The wellness provider will then action the status change within their data and will send this to RxWorks via the automated status import.

Once the status change has been actioned by the wellness provider and the status update has been received by RxWorks the plan will be cancelled in RxWorks applying any balance resolutions set within the workflow settings (see below).

In the interim period (while the wellness provider is applying the status change and resolving any outstanding/in progress payments) the user will be prompted to suspend the plan so no further treatment is applied whilst the cancellation request is being actioned.

The plan is also marked to show there is an outstanding cancellation request:

As the cancellation requests are sent to the wellness provider once a night it is possible for the request to be cancelled at any point up until it is sent. At which point it will not be possible to delete the cancellation request, as once it has been sent it will be actioned by the wellness provider.

If cancellation requests are enabled these will be automatically generated for any patient care plan where the patient has been marked as deceased.

Cancellation Balance Resolution:

It is now possible to control what will happen to any outstanding care plan balance upon a care plan being cancelled.

This is whether the cancellation occurs via an automated process, i.e. an automated wellness provider status feed, or if a plan is manually cancelled.

The options for what to do with the outstanding balance can be found under the workflow settings of each individual care plan configuration:

Transfer balance to client ledger

When enabled any outstanding care plan balance will be transferred to the client’s financial ledger by generating a transaction of type 24 – ‘Care Plan Balance Transfer’, this will bring the care plan balance to 0.00 and will leave the balance in the standard financials.

Write Off Credit if active

This option is only available if you have decided to transfer the care plan balance when the plan is ‘Cancelled’. If this option is enabled then if the outstanding care plan balance is a credit, and the patient is active, i.e. they have made more payments than the value of discount they have received, this will be written off on the client’s financial ledger after being transferred. This is done by generating a transaction of type 25 – ‘Care Plan Balance Write Off’.

Write Off Debit if active

This option is only available if you have decided to transfer the care plan balance when the plan is ‘Cancelled’. If this option is enabled then if the outstanding care plan balance is a debit and the patient is active, i.e. they have made fewer payments than the value of discount they have received, this will be written off on the client’s financial ledger after being transferred. This is done by generating a transaction of type 25 – ‘Care Plan Balance Write Off’.

Write Off Credit if Deceased

This option is only available if you have decided to transfer the care plan balance when the plan is ‘Cancelled’. If this option is enabled then if the outstanding care plan balance is a credit, and the patient is deceased, i.e. they have made more payments than the value of discount they have received, this will be written off on the client’s financial ledger after being transferred. This is done by generating a transaction of type 25 – ‘Care Plan Balance Write Off’.

Write Off Debit if Deceased

This option is only available if you have decided to transfer the care plan balance when the plan is ‘Cancelled’. If this option is enabled then if the outstanding care plan balance is a debit and the patient is active, i.e. they have made fewer payments than the value of discount they have deceased, this will be written off on the client’s financial ledger after being transferred. This is done by generating a transaction of type 25 – ‘Care Plan Balance Write Off’.

Was this article helpful?
Dislike
Views: 0