Frequency Limitations

A procedure's insurance frequency limitations may or may not affect estimates of treatment planned procedures, depending on your preferences. When insurance frequency checking is enabled:


Example: Frequency limitation for BWs is every 2 years. On 12/28/2016, patient had BWs taken and a claim was sent and received.

In the Treatment Plan Module:

When scheduling an appointment:

Set up and Enable Frequency Checking

Step 1. In Treatment Plan Module Preferences, check Enable Insurance Frequency Checking and select the codes affected by each limitation. The defaults are:

Step 2. Enter the plan's frequency limitations on the Benefit window (Benefits). Click More to add additional frequency limitations.

For each frequency limitation procedure code, a row will show in the Family module, Insurance Plan area.

View Estimates for Treatment Planned Procedures

In the Treatment Plan module, click the Estimate as of dropdown and select the date. Click Refresh to update calculations based on the date.

When a procedure is not covered due to a frequency limitation, the procedure's description will indicate it.