The Treatment Plan feature is a tracking and monitoring system for invoiced items, allowing you to track the total number or value (cost) of consultations with a patient within a set date range.
Treatment Plans are beneficial when dealing with third-party payers that approve a certain number or value of treatments, such as Medicare Chronic Disease Management (CDM) plans, formally known as Enhanced Primary Care (EPC) plans, NDIS budgets and more.
Treatment Plans also have optional features to prevent invoicing when the plan limit has been reached, and funding periods designed to help manage patients with NDIS funding.
Creating a Treatment Plan on a Patient Account
To create a Treatment Plan, go to Patient File, select the Accounts tab and then select Edit.
Scroll down to the Treatment Plan section and select Add.
You will then need to configure the Treatment Plan properties outlined below:
Plan Name
Enter a descriptive Plan Name to identify the Treatment Plan. This name will be used when displaying the plan on the patient file and in the Treatment Plan report.
Plan Dates
Start Date – Choose the start date for tracking billed items. Items billed before this date will not factor into the tracking.
End Date (optional) – To include an End Date, enable the checkbox and select a default duration relative to the start date.
For example, if set to 12 months, then upon applying this Default Treatment Plan, the patient’s plan will automatically be created with an end date 12 months from the current date.
Use Account Dates – Enable this if you want the plan to automatically match the Start and End Dates of the patient’s Account.
Plan Type
Select how the Treatment Plan should track invoiced items. The following options are available:
Number of Items – Tracks the number of individual items billed.
Number of Items (by Distinct Days) – Tracks one increment per day, regardless of how many items are billed that day.
Item Quantity – Tracks item usage based on the item quantity, including decimal values.
Item Dollar Value – Tracks usage based on the total dollar value of billed items.
Plan Limit and Alerts
Plan Limit – Enter the total number, quantity, or dollar value that represents the plan’s maximum allocation.
Alert – Enter the value at which alerts should begin appearing to users (for example, when 4 of 5 visits have been used).
Prevent invoicing if plan limit has been reached – Optionally enable this to block further invoicing once the plan’s limit has been used. New invoices cannot be created once the limit has been reached.
Tracked Item Codes (optional)
If required, you can specify which items should contribute to this plan’s usage:
Choose a specific Item, Schedule, or Item Group.
If left as Any Item, all billed items will count toward the plan.
Treatment Plan State (optional)
Select an optional, customisable Treatment State to apply, e.g. “Active”, “Complete”, “In Progress”. This can assist with reporting and filtering.
Funding Periods (optional)
Designed for NDIS patients, Funding Periods allow a Treatment Plan to be divided into multiple sub-periods, each with its own allocation. For example, a 12-month plan may be split into 4 quarterly periods, tracking usage and rollover between them.
For more details on how Funding Periods work, see: NDIS Funding Periods
After choosing your preferred settings, click Save to finalise your changes.
To avoid having to create Treatment Plans from scratch, as shown in the steps above, you can instead configure Default Treatment Plans.
Once configured, Default Treatment Plans can be quickly inserted into a patient's account with minimal setup required.
Treatment Plan Examples
Below are some common use cases for Treatment Plans.
Medicare CDM/EPC Example
The example below is set up to track 5 billed items over 12 months, and will display an alert on billing the 4th item. Tracked Item Codes are limited to our Medicare Item Group so that only these items impact the tracking.
Dollar Value Example (NDIS Budget or Workcover Funding)
The example below is set up to track $5,000 of allocated funds. Tracked Item Codes are limited to our NDIS Item Group so that only these items impact the tracking.
We have also enabled Funding Periods and 'prevent invoicing if plan of funding period limit has been reached'.
Treatment Plan Status and Alerts
Treatment Plan usage and alerts are displayed in several places in PracSuite.
Accounts Tab of the Patient File
From the Accounts tab of the patient file, you have a clear overview of the Treatment Plan usage. You can also toggle the option to 'include future appointments' to see how these will impact the Treatment Plan limit.
An example of a Treatment Plan with Funding Periods enabled is shown below:
Appointment Details
Appointment Tooltip
Alerts When Booking and Invoicing
When booking an appointment and when entering the invoicing process, the following prompt will be displayed if the Treatment Plan alert trigger is reached, if the end date has lapsed, and when within one month of the end date.
Including Future Appointments in Treatment Plan Usage
Treatment Plans have an option to visualise how future appointments impact the plan limit, which can be toggled on from the accounts tab of the patient file.
This option will include future appointments in the “used” total based on the item code set on each unbilled appointment, up to the treatment plan end date. If hourly billing is enabled, quantities are based on appointment duration. This helps forecast usage and stay within the allocated funding.
It's also possible to include future appointments in calculations when using the Treatment Plan report.
A Future Appts column is displayed when using this option, which will also factor these amounts into the remaining figure.
Viewing Transactions Contributing to a Treatment Plan
To view the transactions contributing to a Treatment Plan, go to the Accounts tab of the patient file and select the View Transactions button.
A grid will appear, displaying the item details that contribute to the plan. You can also use the pie chart to visualise usage by business, practitioner, profession, item code and schedule.
Reporting on Treatment Plans
The Treatment Plan Report is designed to report on treatment plans across all patient files. Common uses for the Treatment Plan report are:
Viewing Treatment Plan remaining balances across all patients
Viewing Treatment Plans that are due to expire soon
Viewing Treatment Plans for patients with upcoming appointments
Viewing Treatment Plan Funding Period usage per patient account
Viewing Treatment Plan balances when factoring in future appointments
Sending out bulk emails/SMS to patients with matching Treatment Plan criteria