Quotes Manual | 4th Dimension EMR Help Center

Creating a Quote

If a patient does not have any previous quotes clicking on the Quotes section of their record will automatically open to the Quote Creation screen. Otherwise, a new quote can be created by clicking the NEW button, filling out the New Quote Form, and clicking Save.

Filling out the New Quote Form

When filling out the quote it is generally best to start at the top right and work down the form.
First, select the provider who will be completing the procedure if your practice has multiple providers. This will affect many options in the quote such as available procedures, facilities, and pricing based on the configuration for each provider.
Select the appropriate Quote Template from the dropdown. This will impact the appearance of the quote including the text at the top and bottom of the quote as well as the confirmation items listed in any linked appointments.
If the quote should only be valid for a certain number of days ensure the correct number is entered. A defaulted expiration date is entered based on the selected quote template. If the quote does not expire enter a value of 0.
1. Procedure Lines – New quotes have one procedure line added by default. Additional lines can be added by clicking the icon. Any blank lines are automatically removed when saving the quote.
2. Adding a procedure – Click in the black space to activate the Procedure line and select the procedure to be quoted. A listing of pre-configured procedures is available by either typing a partial procedure name and selecting it from the resulting search results or clicking on the icon. However, procedures can be manually entered by not selecting an entry from the list. When manually entering procedures, it will be necessary to enter all pricing, duration, and supply information.
3. If quoting a procedure on the provider’s procedure list the cost will automatically be entered. However, it can be overridden by clicking in that cell and typing in the correct price.
4. A discount can be added either by a % or a total amount. When entering a % discount the Discount Amount will fill in with the corresponding dollar amount rounded down to the dollar. For example, while 15% of $25 is $3.75 the discount amount will be $3. A discount reason can be selected from a pre-configured list of options.
  1. To remove a % discount or discount reason select the blank option at the top of the drop-down lists.
5. A service or procedure can be removed from the quote by clicking the icon.
Supply Lines – Procedures can be configured to automatically include surgical supplies, products, packages and other inventory items. They can also be manually added, removed, or modified similarly to services and procedures.
1. Add a new item by clicking the blue icon to the right of Supplies. In the description box type the name of the item.
2. The price and quantity can be modified by clicking into the respective boxes.
3. A supply item can be removed by clicking the icon.
4. When a quoted procedure is completed any attached inventory items will be removed from inventory.
5. Packages that are added as supply items are available to the patient either at the completion of the procedure or after the first payment is applied to the quote based on a setting in the package configuration.
The location of the procedure should be the location the procedure will be performed.
The Duration of the surgery. This can be loaded automatically based on the provider and procedure combination.
Facility Fee – the amount charged to use the surgery facility. This can be calculated automatically based on the provider, location, duration, and a pre-configured fee schedule. This can be configured to be billed separately or combined with the provider’s fees.
Consultation Credit – If patients are charged a consultation fee that is later credited towards their surgery the credit amount can be entered here. This can also be pre-configured based on the selected Quote Template.
Anesthesia Type – The Type of Anesthesia to be used
Anesthesia Group – The anesthesiologist to be used.
Anesthesia Fee – The amount charged by the Anesthesiologist. This can be calculated automatically based on the anesthesia group, duration, and a pre-configured fee schedule. This can be configured to be billed separately or combined with the provider’s fees.
Scheduling Fee – If enabled, the scheduling fee box will display the deposit required to schedule an appointment. By default, the quote template can be configured to calculate a deposit based on a specified percentage of the quote. Otherwise, the dollar amount can be entered on an individual quote basis. If a scheduling fee has been specified there will be an additional option to bill the patient the specified amount when checking out. See Billing a Quote for more information.
Message – Any patient specific information that should be included on the printed quote
The total amount billed to the patient is indicated. This will include Facility and Anesthesia fees even if billed to the patient separately.

The Quotes Tab

Once a patient has a quote, clicking on the Quotes tab will no longer default to the New Quote form. Instead, it will display a listing of quotes and actions that can be taken.

At the top of the screen is a Status Filter Bar that can be used to change the displayed quote listing from Active, Inactive, or Completed quotes.

Each quote will display a series of action actions:

Quote Versions

Each time a quote is modified a new version will be created. This allows for the creation of multiple versions of a quoted procedure using the same Quote ID. The currently selected version is indicated by the numbers after the ‘.’ in the Quote Id. Clicking on the icon will display a listing of all versions of a quote. If multiple versions exist, the active version can be changed by moving the bullet point to the desired version.

When changing the active version, any applied payments will transfer to the new version. If the prepaid amount is higher than the new quote total the overpayment amount will be unapplied and will display in the Money section as a payment option or can be refunded to the patient.

Sending a Quote to be Signed

While signing quotes is not required to schedule, bill, or complete a quote in 4th Dimension EMR it is a good practice to have patients sign the quote to indicate receipt and understanding of the quoted terms.

To Send a Quote to be signed:

Open the patient’s profile and click on the Quotes tab
Click on the icon
Select the method to be used:
1. Sending an email to patient to sign in the patient portal – Uploads the quote to the patient portal and emails the patient a HIPAA compliant email containing a log-in link.
2. Send the patient portal to sign in the office – Uploads the quote to the patient portal. The patient can then use a tablet or iPad to access the TePe portal (https://tepe.stage4md.com/) and sign the consent in the office.
  1. Office staff will need to log into the TePe portal and select the patient from the list of scheduled patients.
3. Display and Sign on this device – Opens the quote for viewing and signing on the current device.

Scheduling a Quoted Procedure

Scheduling a quoted procedure is a very straight forward process.

Open the Schedule
On the desired date, time, and provider create an Existing appointment.
Select the desired patient. A dropdown containing the last 5 accessed patients can be found by clicking the icon.
Select the appropriate appointment type. If the appointment type has been configured as a quoted type, a new dropdown containing any active quotes will display. Select the quote to be scheduled from the drop down.
1. If configured, the appointment duration can automatically change to match the quoted duration.
Make any additional changes to the appointment and click Save.

Confirmation Items

Quote templates can be configured to list Confirmation items on appointments linked to quotes. Confirmation items can be anything that has to happen prior to the surgical or procedural appointment such as receiving a negative COVID test, collecting deposits, collecting surgical/anesthesia fees, obtaining/reserving surgical supplies, or any required paperwork. These items will be the same for all quotes using a specific quote template however it is possible to create multiple quote templates with different Confirmation Items.

Confirmation Items can be seen by opening the appointment for editing and clicking the Refresh button. To indicate a Confirmation Item has been completed it is necessary to manually check the Ready checkbox for each check.

The status of Confirmation items is visible on the appointment by various icons. A icon indicates that the appointment has Confirmation items that are not completed. Once all Confirmation Items are completed the icon will change to .

Billing a Quote

Quotes are billed in the Money section.

Click on Money
Verify the correct patient is selected. If they are not, search for the correct patient in the patient search bar.
If an active quote has a balance due, an Item Tile for the quote will be displayed at the top of the listing for the current balance amount. The title will always list the current balance on the quote and will also display a subtotal of applied payments.
Click the green Add to Cart button to add the quote to the shopping cart. Any other items to be billed can also be added to the shopping cart at this time.
Enter the total amount being paid towards the quote in this transaction or click the Pay Scheduling Fee button to bill only the scheduling fee and click.
When ready to check out click the Checkout button to check out.
Select the payment method on the left.
1. If using multiple payment methods click the next to the payment method in the payment listing and change the payment value to the correct value, then select the next payment method. Repeat for each method.
Click Complete Sale button to complete the tractionsaction.
The receipt can be printed or emailed to the patient.

Completing a Quoted Procedure

A quote will be marked completed when:

The appointment that a quote is linked to has been marked Checked Out
A chart note associated with the linked appointment has been signed by the provider
The icon on the Quote List has been clicked and a completion date has been entered.