Lab Cases 

In the Main Menu, select Lists | Lab Cases. Or, use the LabCases button at the right of the Appointments module.

This gives you a list of lab cases that are attached to appointments within the given date range.  Double click on the lab case to change the status from within the Lab Case Edit window.  Lab cases are usually created from within the Appointment Edit window, usually as part of setting up the Planned Appointment, but also possibly from within a regular appointment.  They can also be created from the LabCase button in the toolbar at the top of the Chart module.

Some procedures involve more than one appointment. For crowns, bridges, dentures, partials, etc, there is usually a prep or impression appointment and then a seat or deliver appointment. You probably already have policies in place that specify whether the fee is charged at the first appointment or the last appointment. You need to decide which method to use before setting up your procedure codes. Here is how you handle each situation:

Fee due at first appointment
The advantage of making the fee due at the first appointment is that it is a more effective way to ensure that the practice collects the money for the procedure. The responsibility then falls on the patient to follow up and to make sure the crown gets seated, etc. They are charged whether or not they return. This makes sense because most of the time and money that is invested by the dentist is at the first appointment and the lab work. Some insurance companies also prefer the procedure to be billed on the prep date, although many of them do instead request to be billed on the seat date. In spite of any insurance company's preference, you are probably within your rights to bill on the prep date. The treatment is substantially finished, and whatever crown or appliance comes back from the lab will not fit any other patient. Beware, however, that the insurance company may have a clause that the coverage date of the patient may only apply to the seat date. This may affect annual renewal dates and termination dates, so always keep the insurance company's peculiarities in mind when scheduling and billing. Make sure to include a sentence in the financial agreement that new patients sign explains that the fee for major cases involving lab work is due when the work is initiated. When they sign and agree to those terms, it will make following up on their bill easier.

The first appointment would be scheduled as the crown, denture, or whatever. The procedure would be the standard ADA code with the proper fee attached. Your default note that you set in the Procedure Code would be notes for the prep or impression, for instance: 3 carps 2% Lido-1:100k epi, prep, cord with hemostat, PVS, etc. -or- Alginate impression, opposing alginate, shade 102, etc. The second appointment would then be a special no-fee code that would not get billed to insurance. The code should not look like an ADA code. You can use a beginning N for no-fee instead of the usual D. The procedure might be "Crown Seat" or "Denture Deliver". The procedure note would be your standard note for seating or delivering. For instance: Removed temp, checked contacts and bite, showed to patient, cemented Fuji. -or- Delivered. Checked fit, bite, appearance, etc. Also be sure when setting up the second appointment to mark it "do not bill to ins", and set the fee to $0.

Fee due at the second or last appointment

The advantage of making the fee due at the second appointment is that it tends to follow more closely to most insurance company policies. There will be less arguments with the insurance companies, less surprises, and less incidents of accidently scheduling the patient in such a way that insurance will not cover the procedure. If the patient does not return for their second appointment, you should have policies in place to follow up and charge the patient for the lab fee that they incurred. It may be hard to explain to the patient, however, that they did not originally owe anything, but since they did not come back, they now owe a fee.

See the explanation in the above section on what procedure code to use for the first and second appointments. The difference would be that the first appointment would be the no-fee procedure, and the second appointment would be when the ADA code would be entered and billed. So the no-fee code would be something like "Crown Prep" or "Denture Imp", with the appropriate notes for that procedure.