Keywords: create contract, contract, contract setup, autopay, responsible party, insurance contract
Summary
Contracts in Cloud 9 help patients finance orthodontic treatment and manage autopayments. This article walks through the full contract setup process, whether it’s for a responsible party, insurance, or both. It covers transaction type configuration, prerequisites, and a field-by-field overview of the contract screen, including how to adjust dates and amounts and autopay after the contract starts.
Note: Contracts control autopayments in Cloud 9. Autopayments can only be set up within an active contract, and only if your practice has an integrated payment processor.
Note: This is a comprehensive, field-by-field guide to contract creation in Cloud 9. If you need a quicker read or are looking for something more specific, check out the Quick Guides at the bottom of the page. They walk through how to set up specific contract types step by step.
Contract Transaction Type Setup
NOTE: Skip this section if your contract transaction types are already set up.
You need the correct transaction type to start a contract. Ensure you have the 'Edit Library Items' permission from the practice. Then, go to Edit > Setup > Transaction Types in Cloud 9. For a refresher on transaction type setup, see this article: Transaction Type Setup.
When setting up a contract transaction type, there are some specific options you will want to select in the lower section of the dialogue box. First, select 'Is Contract.' This automatically selects 'Affects Production,' which is intentional. Also, ensure 'Show on Practice Summary' is selected. To confirm consistency, compare with another contract transaction type. Below is a sample screenshot.
You also need to attach the correct CDT code to the Contract transaction type. To do this, click on the second tab labeled 'Transaction Codes.' Next, select the blue '+' to search for and add the correct CDT code. If you cannot find it, you can add the code and description in Edit > Setup > Codes. For the example we are using, it has the CDT code D8020 attached. Be sure to save the changes to the transaction type before exiting. (Screenshot Below.)
Pre-requisites to Creating Contracts
Before creating contracts, a financially responsible individual must be set up in the Edit > Relationships tab for the patient in Cloud 9. If a patient has insurance the insurance plan must also be set up in the Edit > Patient > Insurance tab.
Pre-requisite 1: Verify Financially Responsible Party, (or RP.)
1. From the Home Menu, click Edit Patient.
2. From the Edit > Patient window, click the Relationship tab.
3. Verify that 'True' displays under the responsible party column for individuals responsible for payment.
Pre-Requisite 2: Verify Insurance.
1. From the Home menu, click Edit Patient.
2. From the Edit > Patient window, click the Insurance Tab.
3. Verify Insurance has been entered.
Understanding the Upper Portion of the Contract: Drop Down Menus
To access and add a new contract for a patient, from the patient ledger, click the handshake icon, shown below.
Next, click the blue "+Add" button to open the contract screen.
From this page, there are several fields we will review and define. First we will work in the upper section of the contract, above the blue line. The first three fields at the very top of the left hand side will autopopulate, but it is good to check them.
As shown in the above screenshot, the plan status will always read 'New' when creating a contract. The Provider* and Assigned Location are pulled from the Edit > Patient screen, but double-check these values. The Posting Location defaults to your Cloud 9 location you are currently logged into, but can be changed. Once the fields are verified, proceed to the next column on the right.
*Please note that the Provider Name has a 50-character limit. Provider names over this limit can cause issues in other areas of the software, such as insurance claims.
Let's move on to the second column. Click the magnifying glass on 'Charge Type' and select the appropriate contract transaction type, such as Aligner Phase I. The 'Plan Description' auto-fills from the transaction setup. To apply a discount, click the magnifying glass on 'Discount,' select the applicable discount, and enter the amount; leave blank if none. This leaves the 'Plan' field as the last one to configure (screenshot below).
For the 'Plan' field, click the drop-down arrow. Select an RP or insurance with a blue check mark to make it visible in the contract, then click anywhere outside the field to refresh it. In the example below, selecting Cigna Dental and clicking away causes both the insurance and RP to appear on the contract. Move to the third column next.
The third column's 'Expected Start Date' should indicate the anticipated start date if not starting immediately—but it does not initiate the contract. 'Expected First Charge' should list the projected date of the first charge if not billed today. Both are optional and can be left blank if starting the same day. The 'Treatment Fee Amount' reflects the total contract amount. 'Discount Total' shows any applied discounts, and "Contract Subtotal" is the amount after subtracting discounts from the treatment fee. Move to the last column in this section.
The last column of the upper contract includes 'Origin of Start' and 'Payment Arrangement.' These fields are primary used by practice's with the Gaidge add-on integration for custom reporting. If your practice does not use Gaidge, leave these fields blank. The 'Initial CDT code' defaults to the diagnostic code in Edit > Setup > Transaction Types (see Contract Transaction Type Setup section in the first part of this article). The final field, 'Payment Plan Totals,' must match 'Contract Sub-Total' and draws from data entered in the lower section of the contract, which we'll review next.
This is how the contract fields look at this point for our example before moving to the lower section.
Understanding the Lower Portion of the Contract: RP and/or Insurance Plans
Once the upper portion is filled out, move to the lower portion of the contract, which is everything below the blue line. Since this Patient has a Responsible Party, (RP), and insurance, both sections in the lower portion need to be completed. Let's review these fields. Firstly, ensure the amounts entered in the 'Plan Amount' for each entity, (Tammy Test and Cigna Dental in our example), equal the 'Contract Sub Total' from the upper section. For the example, I will make sure that I have a total of $3,325.00 in the fields below.
In the example above, the RP tab shows a Plan Amount of $1,525.00 and the Insurance tab shows $1,800.00. The combined total of $3,325.00 appears in 'Payment Plan Totals' in the upper section and is correct since it matches the 'Contract Sub-Total.'
The next step is to move to the RP tab of the contract and locate the 'Down Payment' field to enter an amount if applicable. The example has a $500.00 Down Payment entered. The next step is to enter the '# of payments' and select the 'Frequency' for the "Plan Amount." Our example below has 12 payments at a Monthly frequency.
*Note: 'Charge Dates', 'Auto Pay' dates, and 'Auto Pay' amounts cannot be edited until the contract is started.
Next, shift to the right to the Insurance tab. In this tab, the plan amount has already been entered but more details are needed.
The 'Continuation Diagnostic Code' will already be attached and is the periodic contract ADA code that displays on the claim form. If an E-claim will be submitted, make sure the 'Initial' and 'Continuation' claim boxes are both checked. (E-claim submission requires an integration with Dental Xchange.) Enter a down payment if one is expected, along with the 'Initial Claim' amount, '# of Claims,' and 'Frequency.' For our example, the below screenshot illustrates how the Insurance tab of the contract should look prior to the contract start. We have the 'Initial' and 'Continuation' claim boxes checked, with an 'Initial Claim' of $3,325.00, and the 'Number of Claims' is three, with a Quarterly 'Frequency'.
*Note: Initial Claim amount should be the entire amount of the contract.
Once all fields are filled in on both the RP and Insurance tabs, the contract can be saved. It will remain in 'New' status until the '+Start' button is selected. Double-check your work before starting—once the contract is active, most fields above the blue line can no longer be edited. Also note that active contracts will always display as 'Active' in the contracts screen; there is currently no option to mark a contract as Completed.
Once you click '+Start,' the contract becomes active and you can fill in charge and claim dates and/or enable Auto Pay.
Changing Charge Dates, Amounts, and adding Auto Pay to a Contract
Once started, the 'Start' button appears as grayed out in the upper right of the contract, and the charges will post to the ledger. This can be seen in the two screen shots below.
Once the contract is started, dates generate based on the first expected charge date or contract start date. Sometimes the dates or amounts must be adjusted. Let's review how to adjust the dates or charge amounts on the RP tab of a contract.
To adjust the '# of payments', update the value in that field and then click the calculator button. The contract will automatically recalculate the amounts and dates based on the specified number of payments. In this example, I will change the number of payments from 12 to 10 and then click the calculator button, outlined in the screenshot below.
Once the calculator button is selected, the amounts and dates will change based on the newly calculated contract. In this example changing the number of payments from 12 to 10 the switched the payments from $85.42 a month to $102.50 per month.
Let's look at an example if the RP wishes to change dates. In this scenario, the RP first wanted the 15th of the month each month, but has now decided to change this to bi weekly. First, change the "Frequency" to bi weekly. Next, click on the date to be edited and change it to the correct date and then use the 'Fill' button, (icon to the left of the dates with two downward pointing arrows), shown in the screenshot below.
*Note: You must have a line selected as the starting place in order to use the fill button.
After clicking the "Fill" button make sure you have it set to affect charge dates and amounts as needed and then click "Fill" to finalize the changes. Always remember to save any changes before exiting the contract.
If a practice receives an EOB after the contract is set up and needs to update claim dates or amounts, changing the number of claims and clicking calculate will automatically update the claim amounts. Alternatively, enter a specific date and amount and use the Fill button. If the charge date has already passed, move the funds from 'Due Now' back to 'Future Due' first—see THIS ARTICLE for that process. Once funds are moved back into the contract, adjust dates as needed.
Note: On the Insurance tab, 'Form Amount' is the amount entered on the claim form. 'Ledger Amount' is the amount that will hit the insurance ledger when the charge date arrives.
How To Add Autopay Payment Method and Autopay Dates
Once you have 'Started' the contract, you can add and enable autopay. To set up autopay for a contract, you must have an integrated payment processor. As long as you meet this requirement, you may proceed with the following steps to activate autopay. First, click the 'Auto Pay' button located just below the Responsible Party 'Future Due' section to initiate the process.
Once that opens, there will be an option to '+Add' to add the new payment method. Click on this first and add the card or bank account information.
Make sure the correct Merchant and Payment Account is selected and bank account or credit card as needed. 'EMV' is the correct option if you are using a chip reader and 'Keyed' is the correct option if you are entering the card number manually. After selecting the applicable Merchant, Accounts, and Capture Methods, click the green 'Save' button. This will open the integrated payment processor dialogue box.
Next, enter card or bank account information and the billing address in the payment processor dialogue box. When finished, click the 'save' or 'make payment' option. This will let you know if the card or bank account successfully saves and take you back into the Auto Pay Setup box.
In the Auto Pay Setup box, make sure to go into the drop down that is marked as 'Primary Payment Method' and select the card or bank account you just added. This last step is very important and the drop down must have the payment method selected as shown in the screen shot below. Then click 'Ok.'
Remember to save your changes. Once the 'Auto Pay' method has been added and selected as the 'Primary Payment Method', the contract should look something like this:
The check mark on the 'Auto Pay' field, as well as the 'Primary' payment type ending in *********(last four of card or bank account) lets you know the 'Auto Pay' has been added successfully to the contract. Next, The 'Auto Pay' columns should be reviewed to ensure all amounts and dates are accurate, using the same tools as those used for verifying/updating charge dates, claim dates, and amounts from above.
In the example below, the RP has informed me that they need to pay off the balance over 17 months instead of 15. To update this, I will click on the '# of Payments' field and change it to 17. Then, I will select the first line item and update both the Charge amount and Auto Pay amount to $288.24. After that, I will click the 'Fill' button. It will then give the option to fill in both the charge date and amount, as well as Auto Pay details. I will select both options since we are updating the contract with Auto Pay, and then click the 'Fill' button.
This will update the contract correctly in all columns. Make sure after making any changes to the contract to save your work.
This was a high-level overview of the contract sections, fields, and drop-downs in Cloud 9. Below are quick reference guides for specific contract types you may also review.
Contract Creation Step-by-Step Quick Guides:
Contract with a Single RP Quick Guide
Contract with an RP and Insurance Quick Guide
Contract with Split RP's Quick Guide
Contract with Split RP's and Insurance Quick Guide
Other helpful Contract articles:
How to Write Off a Contract
How to Delete a Contract
As always, if you have any further questions please do not hesitate to reach out to Cloud 9 Support by emailing us at cloud9support@planetdds.com, or chatting us online using the chat bubble on the lower right at https://cloud9support.planetdds.com/hc/en-us, or giving us a call during our business hours of 8:00 AM EST to 8:00 PM EST at the 1.800.394.6050 option 2.