Summary
This Step-by-Step guide reviews how to create a contract with a two Responsible Parties, or RP's splitting the orthodontic expenses and a portion covered by Insurance. Familiarity with Creating Contracts in Cloud 9 is recommended before reading this article. Make sure the Transaction Type is set up and Pre-Requisites met before creating the contract.
Pre-Requisites to Creating Contracts
Pre-requisite 1: Verify Financially Responsible Party.
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 individual(s) 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.
Steps to Create Contract with an RP and Insurance
Step 1 - From the patient ledger, click the "Contracts" Button.
Step 2 - Click the "+Add" blue button to add a new contract.
Step 3 - Verify "Provider", "Assigned Location", and "Posting Location" fields are correct. If any information needs to be changed, edit it before moving on.
Step 4 - Click the magnifying glass next to "Charge Type" and pick the applicable charge type for this field. The "Plan Description" field will automatically fill after the "Charge Type" is selected.
Step 5 - Click the magnifying glass for "Discount" if a discount needs to be added. If not, move to step 6.
If adding a discount type, make sure to select the check box and enter the discount amount, then click "Select".
Step 6 - Ensure "Plans" field has the correct parties selected for the contract. Since this contract is for split RP's and an Insurance Plan both the RP's and Insurance Plan should be selected. If you need to add the insurance, click the box next to Cigna, then click anywhere else in the contract outside of the plans box and it will update.
Step 7 - If the contract is being started today, skip this step. If the contract is not being started today, fill in the "Expected Start Date" and "Expected First Charge" fields.
Step 8 - Ensure the "Treatment Fee Amount" field is correct. Some practices may have this auto-fill, but it may need to be updated if you are including the Records charge in the contract or if it did not auto-fill.
Step 9 - For each "Plan" tab on the contract, enter the "Plan Amount". The sum of the plan amounts from the RP and Insurance must equal the "Contract Sub Total." Since this example the contract subtotal is $7,500.00 and Insurance is covering $1,500.00 each RP should have a total of $3000.00. "Payment Plan Totals" shows the sum entered in each "Plan Amount". That can be compared to "Contract Sub Total" to make sure they match.
Step 10 - Finish entering the details for the first Responsible Party "Downpayment", "# of Payments" and "Frequency" for the first RP tab. Amounts and number of payments are the only information that will display in this tab until the contract is started.
Step 10 - Finish entering the details for the second Responsible Party "Downpayment", "# of Payments" and "Frequency" for the second RP tab. Amounts and number of payments are the only information that will display in this tab until the contract is started.
Step 12 - Finish entering Insurance Plan tab details on the contract. If an Initial Claim and Continuation Claim need to be generated from the contract select those boxes and a check mark will show. Make sure to enter a "down payment" if applicable and the "number of claims" and "frequency" of claims. The "Initial Claim" box should display the entire amount of the contract. If you are unsure about how the insurance will pay out, you can set it to quarterly and a date in the future so once you receive the EOB you will want to go back in and update the Insurance side of the contract.
Step 13 - At this point, you can use the "Save" button to save the contract if you are not starting it. Otherwise, you can click the "Start" button to start the contract. This will post the charges to the ledger including the down payment. This also unlocks the option to add a payment method and turn on autopay and set the autopay dates if your practice has an integrated payment processor with Cloud 9.
Step 14 - To add Auto Pay to the RP tab, click on the "Auto Pay" button on the RP tab, underneath Future Due. Next, use the "+Add Payment Method" button to add a payment method. Make sure the necessary fields for the merchant, account, and Card or Bank Account is chosen. EMV should be checked if using a card reader. Keyed should be checked if you are manually entering in the payment information. Once payment method is added please be sure to select that payment method in the drop down labeled "Primary Payment Method" then click "Ok".
*Note: You can also add and select a backup payment method if they have one available. You must select Primary Payment Method to finish setting up Auto Pay. To verify, when you look at the main screen of the contract it will have a check mark and account info ending in XXXX as shown below.
Step 15 - On the RP side of the contract, ensure all "Charge Dates", "Charge Amounts", "Autopay Dates", and "Auto pay Amounts" are correct. For the Insurance side of the contract, ensure that all "Dates" "Form Amounts" and "Ledger Amounts" are correct. Then make sure to save your work! You can use the fill button if needed to change dates from one line down.
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.