Navigate to a patient's Estimates tab in order to start a new estimate. This can be quickly done from the 3 dot menu on the patient information bar or patient registration if they are checked in. Otherwise the tab can be accessed at the top of the patient's chart.
The patient does not need to be checked in to create a new estimate as long as they have previously checked in for a visit in Instinct.
When viewing a patient’s estimate screen for the first time, a new estimate will be created automatically. The name of the estimate defaults to the current date/time and can be edited in the Estimate Name field. We suggest changing the name of the Estimates to help you locate them more easily.
If the patient already has items on their invoice, current invoice charges can also be added or removed from an estimate by toggling Start With Current Invoice Total and new estimates can be created by clicking + New Estimate.
Please Note: Estimates can be created for patients who are not checked in (as long as the patient has had a previous visit in Instinct). If the patient has never had a previous visit, you can temporarily check them in to the OTW Board to create an Estimate.
Using an Estimate Template
Navigate to the Estimate screen for a Patient
Search for keywords and select the corresponding Template
Estimate Templates appear under the Templates header, while Product Groups are displayed under the Groups header.
➕ Adding Items to an Estimate
Use the search field to add individual items via Product Name or PIMS ID, and use the associate drop down boxes to quickly add Exam, Ward, and Hospitalization charges.
Any Products with a default Frequency, Quantity, or Low/High (set in Admin) will be added to an estimate with the same defaults.
To rearrange the line items according to your preference, simply drag & drop.
💲 Low/High Quantity and Amount
When a line item is added, the AMT LOW and AMT HIGH is calculated by the QTY and UNIT you are estimating for. Alternatively, you can manually set a different quantity or amount range on the estimate.
Manually changing the LOW QTY and HIGH QTY automatically calculates the new AMT LOW and AMT HIGH dollar amount. Once a LOW and HIGH number has been entered, the FREQ, QTY, AMT LOW, and AMT HIGH columns will be locked for editing and you’ll need to remove the line item and add again if you want to adjust them.
Manually changing the AMT LOW and AMT HIGH will also lock the row preventing any changes to other calculation fields.
You are now able to enter a number greater than the high quantity or amount fields. For instance, if you wanted to provide an estimate for radiographs to be included on the low end only, you can do that without receiving an error message.
You can also do this with your price fields as well!
When declining a line item with edited QTY LOW/HIGH fields the amounts are preserved.
⚖️ Estimated Taxes
Any applicable taxes will automatically be calculated and displayed on the low and high estimate totals.
⏰ Automatic Charges and Estimate Duration
If an order is added to an estimate with an Automatic Charge associated with it, both the original order and the automatic charge will show on the estimate. Similar to the Treatment Sheet, you are not able to add just the automatic charge to an Estimate and would have to order the item that has the automatic charge linked to it for it to appear on the Estimate.
Please keep in mind the low and high price is dependent on the Frequency, Quantity, and the Estimate Duration. This duration button will default to Duration Once which is useful for outpatients or same day procedures, but if you are making a hospitalization estimate, you can set this for the duration of the hospital stay and Instinct will provide a financial range on your Estimates.
Duration “once” for OP estimates
Duration range for IP estimates
🏥 Patient Safety Warnings
Dosing calculators, Patient Safety Warnings, and Plumb’s information are available for each medication product on the estimate when clicking the Quantity field. The dosing calculator is hidden on the estimate screen for any medications that charge by strength.
📝 Editing/Removing Items on an Estimate
To remove an item from an Estimate, simply click the corresponding checkbox next to the item name and select Remove at the bottom of the screen. Removing a Product with an Automatic Charge(s) will only remove the Product from the Invoice, and the associated Automatic Charge(s) must be removed separately.
Line item names are editable which allows the flexibility to add a miscellaneous product code to the estimate for procedures or products that are not currently in the system. Renaming the miscellaneous product assists in conveying the exact procedure, treatment, or medication to the client. Click on the orange check box to confirm the changes made to the item label.
For diagnostics or procedures you may or may not need, simply change the AMT LOW price to $0, and keep the AMT HIGH price as is. The client will be informed of the price if you do decide to move forward with that item.
If the low/high QTY or price of a Product is manually changed on the estimate, the row will lock and you will no longer be able to enter or edit the quantity or frequency for this product. In order to edit the quantity or frequency, this Product must be removed and re-added to the estimate.
If your Estimate is empty, you can easily delete it by using the 3-dot menu in the top right corner.
The Delete option will be greyed out if the Estimate has any line items.
After removing all of the line items, you’ll be able to delete the estimate.
⛔ Declining Items on Estimates
If a client declines an offered service, that line item can be marked as Declined. There are two ways to decline an item:
Check the box to the left of the item and click the Decline button.
2. Drag and drop the item into the Declined Items section at the bottom of the Estimate.
Please Note: Drag and drop is only possible once at least one item has been declined.
How to Undo a Declined Item
There are two ways to move a Declined item back to the elected section:
Check the box to the left of the item and click the Undecline button.
2. Drag and drop the item out of the Declined Items section.
After Declining an Item
The Declined Items section defaults to expanded view but can be collapsed by clicking the up/down button. The number of declined items will always display to the right of the section header.
Once declined, line items will not be editable. You will need to Undecline an item in order to make changes.
Declined items will not be displayed when generating a Tx Sheet or an Invoice from the Estimate.
Declined items will display on the printed Estimate, but the cost of the declined item will be omitted.
You can also print completed/approved Estimates from the Invoice screen.
🧾 Estimate Sidebar/Current Visit
The estimate sidebar is located towards the left side of the Estimates screen and includes all current and previous estimates for the selected patient.
The ‘Current Visit’ estimate is labeled with an asterisk (*) and typically, the most recent completed estimate is the current visit estimate.
If multiple estimates are marked with an asterisk (*), this means these are associated with separate visits.
✍️ Digital Signature Approval
An Estimate can be placed into two statuses: Sign and complete and Complete without signing.
Marking an Estimate as Complete without signing is a way that your hospital can attach and email the Estimate via the Comm Log. You can also directly proceed to the digital signature, and once signed, the estimate will be marked as Complete.
Once the client reviews and approves it, the estimate can then be digitally signed.
After an estimate is Complete and/or Signed, you have the option to View Signature, Generate a TX sheet, or Generate an Invoice.
Need to make changes? Unsigned Estimates can be moved back to the editing phase by selecting the Undo Complete button.
However, once a client digitally signs an Estimate, it becomes a legally binding document, and no further modifications can be made. If changes are necessary, you can create a new Estimate to make those adjustments and submit it for client review.
You can email a copy of the completed Estimate to the client through the Comm Log. Please note that the client cannot currently sign and approve via email.
🚨Important note: if an Estimate is moved to an Invoice but then the same item is completed on the Treatment Sheet, it will be displayed on the Invoice twice and may need to be voided based on your workflow.
The Exam, Ward, and Hospitalization dropdowns will always need to be manually selected on the Treatment Sheet after the estimate is complete. For safety reasons, the Frequency and Quantity entered on the estimate will not export to the treatment sheet group and these fields will follow the normal product default Frequency and Quantity set in the product Admin. If no default Frequency or Quantity is set, these fields will be blank and can be selected upon ordering.
Completed/Signed Estimates can also be added to the Treatment Sheet by clicking on the search bar. This is also why we suggest changing the name of the Estimates to help you locate them more easily.
🔎 View Log
View Log allows you to see the revision history of the estimate, and includes who Created, Updated, Completed, and Signed the Estimate.
ℹ️ Patient Info bar
The Billing section on the patient info bar includes the high amount for the visit’s current estimate. This amount does not impact predicted billing and is for communication purposes only.
🖨 Save/Print an Estimate
To download a PDF of the estimate to your computer to print, simply click the Print button and select Print w/all prices or Print w/total only.
For hospitals that prefer a physical signature, Estimates can then be signed on paper and uploaded as a PDF into the Charts section. Alternatively, the Comm Log or Charts consent forms can include recordings of the agreement to an estimate.
For details on getting client consent in Instinct, check our Pick the Brain blog.
