Abstract:
An interactive system and a method for diagnosing, evaluating and treating the condition of Temporomandibular Disorder, where through a series of steps, consultations, procedures and protocols associated with individual appointments, information is gathered and entered into a database by a user through a personal computing device, which is added to or updated as treatment progresses in future appointments. The information gained during the appointments is used to generate printed or electronic reports, letters and insurance claim forms supporting the services rendered, reduce the errors involved in manual insurance claim form coding, supply consistent and proven successful treatment codes to insure payment, and which seek reimbursement from medical insurance coverage by the dentist as opposed to dental insurance coverage in order to maximize the benefits received and allow the patient to avail themselves of the generally higher coverage limits and lower deductibles associated with medical insurance.

Description:
BACKGROUND OF THE INVENTION 
     1. Field of the Invention 
     The present invention relates to a method and interactive system which establis a protocol of appointments, examinations, diagnostics, procedures and therapy in the treatment of Temporomandibular Disorders (TMD) by a dentist, from which properly coded medical insurance claim forms are generated, increasing the probability of approval of payments to the dentist. 
     2. Description of the Related Art 
     Two common health benefits employers provide to employees are medical insurance plans and dental insurance plans. Both medical insurance and dental insurance plans can vary in the types of coverages that are offered. The term “insurance plan” extends to any contractual or other legal arrangement whereby medical and other related expenses are paid on behalf of a beneficiary. Examples of insurance plans include health maintenance organizations, preferred provider organizations, fee-for-service health care plans, employer-sponsored insurance plans, etc. Most insurance plans cover illness and injuries at certain percentage levels and may include co-payments, deductibles and coverage limits. A typical medical insurance plan might be one where the insurer will pay 80% of physician&#39;s bill associated with the diagnosis and treatment of a condition. The patient would be expected to pay the remaining 20% of the bill, after paying a deductible (a predetermined minimum contractual amount that must be paid before the insurance plan begins coverage) and co-payment (a per visit amount paid before coverage is extended). 
     Dental insurance plans can be similar to medical insurance plans, but typically coverages are at lower levels and have higher co-payments and deductible amounts than medical insurance plans. A typical dental insurance plan might cover preventive and diagnostic services at 100% (generally cleanings and checkups), but will cover more involved treatments at lower percentages. For example, basic services might be covered at 80%, major services and orthodontics might be covered at only 50%. In addition, dental insurance plans often have both annual and lifetime maximum benefits, for example, an annual per person maximum of $1,200 or a lifetime per person of $1,500 for orthodontics are routinely used limitations. Further, deductibles and co-payments may apply, further limiting benefit coverage. 
     Typically, medical doctors diagnose and treat medical conditions, and look to medical insurance plans for reimbursement. Dentists diagnose and treat dental conditions, and seek reimbursement from dental insurance plans. 
     In situations where a Dentist provides treatment to a patient where, under medical and dental industry standards, medical insurance coverage could be utilized instead of dental insurance coverage, several advantages could be realized. Because medical insurance coverage percentages and limits are generally higher, a Dentist able to process an insurance claim under a medical insurance plan rather than dental insurance plan could recover greater amounts from the insurer and less from the patient, reducing the need for arranging patient payment of uninsured costs and payment collections, as well as higher patient satisfaction in obtaining services for lower out-of-pocket cost to the patient. 
     Medical claim forms are filled out and submitted to insurance companies containing industry standard numerical descriptions known as ICD 9 (International Statistical Classification of Diseases and Related Health Problems codes) codes and CPT (Current Procedural Terminology) codes. An ICD 9 code describes a specific medical condition or diagnosis. CPT codes describe medical, surgical, radiology, laboratory, anesthesiology, and evaluation/management services of physicians, hospitals, and other health care providers. An additional 2 digit modifier may be added to a CPT code following a decimal point to clarify or modify a procedure. 
     The purpose of the coding system is to provide uniform and standardized descriptions that accurately describes medical conditions and the medical, surgical, and diagnostic services used to treat these conditions. The rules for assigning ICD 9 and CPT codes are complicated and extremely detailed. Training and experience is necessary to consistently and properly apply the appropriate codes in a manner to insure medical health claims are processed correctly and paid promptly. 
     A submitted medical insurance claim form typically contains ICD-9 code or codes, describing a condition. For each ICD code listed in an insurance claim form, a health care provider may decide to implement a treatment or treatments, each of which has a CPT Code that describes it. Together, the ICD code is matched with the appropriate CPT code or codes detailing the diagnosis and treatment of a condition. The codes used are examined, both manually and by the use of computer software to insure that the procedure and the diagnosis are related and that the procedure is one of medical necessity for that diagnosis. 
     A large portion of the medical expenses incurred by patients in this country are paid by private or government based insurance plans. Agencies such as health insurers, health care consultants, government offices (i.e. Medicare/Medicaid) routinely examine health claim forms to verify that the treatments being administered fall within accepted guidelines to avoid paying for unnecessary or unconventional treatments, as well as to prevent overpayments due to improper coding. Also, because of the high rates of insurance fraud, these agencies rely on computer and manual audits to analyze submitted documentation and deny claims when these audits detect irregularities. This necessitates that forms be coded properly the first time to avoid the red tape and bureaucracy that is involved to correct mistakes that result in denial of claims. By automating the process, human error is minimized and coding is done correctly according to industry standards, thereby reducing the rates of claim rejection. 
     The temporomandibular joint connects the lower jaw (mandible), to the temporal bone at the side of the head. Because these joints are flexible, the jaw can move smoothly up and down and side to side, enabling actions such as speech, chewing and yawning. Muscles attached to and surrounding the jaw joint control its position and movement. 
     Temporomandibular Disorder (TMD) describes a group of conditions that affect the Temporomandibular Joint (TMJ) and the related muscles. TMD generally refers to the more general diagnosis of one of the following specific conditions: 
     TMJD (Temporo-Mandibular Joint Dysfunction) 
     TMJ (Temporo-Mandibular Joint) 
     TMD (Temporo-Mandibular Disorder) 
     CFD (Cranio-Facial Disorder) 
     CCD (Cranio-Cervical Disorder) 
     CMD (Cranio-Mandibular Disorders) 
     These various disorders usually involve similar symptoms, which include pain, dysfunction and impairment involving the head, neck, ears and jaws. TMD diagnosis and treatment fall into 2 general categories: 
     Extra-capsular—any condition outside the TMJ capsule 
     Intra-capsular—involving in the working inside the TMJ capsule. 
     Extra-capsular TMDs are considered soft tissue injuries and are typically covered by dental insurance, whereas intra-capsular conditions are considered hard tissue problems involving trauma-related injuries, and may be covered by the patients&#39; medical insurance since they are considered to be medical rather than dental treatments. 
     Because treatment may involve either category of insurance, it is important that not only the proper coding be used but that the coding be classified under the proper type of insurance. Because medical and dental insurance coverages are fundamentally different, proper claim submission for Intra-capsular Temporomandibular Disorders would involve experience and knowledge in two very different areas of insurance claim coding. 
     Because intra-capsular injuries are non-surgical problems, claims may be submitted under a patient&#39;s medical insurance coverage. A dentist treating these conditions must have the ability to effectively code both diagnosis and treatment under the proper ICD 9 and CPT medical codes to insure medical insurance claims will be paid promptly and not rejected. 
     SUMMARY OF THE INVENTION 
     In accordance with the present invention, an interactive system and a method for generating properly coded medical insurance claim forms in the treatment of Temporomandibular Disorders by dental care providers, by using a protocol of steps consisting of appointments, diagnostics, examinations and procedures and compiling the information gained from these steps to effectively treat the condition and classify the treatments to maximize successful health benefit recovery. 
     It is therefore an object of the present invention to provide an interactive system and method to logically, systematically, and efficiently detail a consistent course of evaluation and treatment of Temporomandibular Disorders in which these evaluations and treatments are performed in specific appointments. 
     It is another object of the present invention to provide a system and method that will classify the evaluation and treatment procedures of patients with Temporomandibular Disorders as health insurance claims as opposed to dental insurance claims for purposes of greater insurance coverage, and generate properly coded medical insurance claim forms and other supporting reports and letters as documents in printed or electronic form. 
     It is a further object of the present invention to provide a system and method for preparing properly coded insurance claim forms according to American Medical Association standards for submission, thereby reducing errors and denial or delay in claim reimbursement. 
     Still other objects, features, and advantages of the present invention will become evident to those of ordinary skill in the art in light of the following. Also, it should be understood that the scope of this invention is intended to be broad, and any combination of any subset of the features, elements, or steps described herein is part of the intended scope of the invention. 
    
    
     
       BRIEF DESCRIPTIONS OF THE DRAWINGS 
         FIG. 1  illustrates the client-server-database configuration for the system. 
         FIG. 2  illustrates an overview of the various modules and subroutines of the system. 
         FIG. 3  is a flowchart describing the general method of obtaining, entering and processing background information and preliminary medical findings for new Temporomandibular Disorder patients for the First Appointment. 
         FIGS. 4 ,  5 ,  6 A- 6 D,  7 A- 7 C,  8 ,  9 A- 9 C,  10 A,  10 B,  11 A- 11 D,  12 A- 12 C show examples of user menus and data entry screens associated with the flowchart described in  FIG. 3 . 
         FIG. 13  is a flowchart describing the general method of obtaining, entering and processing of CT and Radiological consultation information for the Second Appointment. 
         FIG. 14  shows an example of data entry screens associated with the flowchart described in  FIG. 13 . 
         FIG. 15  is a flowchart describing the general method of obtaining, entering and processing clinical examination information, and preparing a customized orthotic treatment device for the Third Appointment. 
         FIGS. 16A-16D ,  17 A- 17 D,  18 A- 18 D,  19 A,  19 B show examples of user menus and data entry screens associated with the flowchart described in  FIG. 15 . 
         FIG. 20  is a flowchart describing the general method of obtaining, entering and processing information for the beginning of orthotic therapy for the Fourth Appointment. 
         FIGS. 21A-21D ,  22 A- 22 D,  23 A- 23 B show examples of user menus and data entry screens associated with the flowchart described in  FIG. 20 . 
         FIG. 24  is a flowchart describing the general method of obtaining, entering and processing information for continuing orthotic therapy information for the Fifth through Eighth Appointments. 
         FIG. 25  is a flowchart describing the general method of obtaining, entering and processing information for continuing orthotic therapy information for the Ninth Appointment. 
         FIG. 26  is a flowchart describing the general method of obtaining, entering and processing information for continuing orthotic therapy information for the Tenth through Thirteenth Appointments. 
         FIG. 27  is a flowchart describing the general method of obtaining, entering and processing information for continuing orthotic therapy information for the Fourteenth Appointment. 
         FIG. 28  is a flowchart describing the general method of obtaining, entering and processing information for continuing orthotic therapy information for the Fifteenth Appointment and beyond. 
         FIGS. 29 ,  30 A- 30 D,  31 A- 31 C,  32 A- 32 C,  33 ,  34 A- 34 C show examples of user menus and data entry screens associated with administrative and System Setup subroutines. 
     
    
    
     DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS 
     The present invention relates to a method and system for following a course of treatment, examinations, diagnostics, evaluations and procedures in the treatment of Temporomandibular Disorders, and obtaining and processing data to prepare properly coded medical insurance claims and supporting documents in a dental office. 
     The system  50  depicted in  FIG. 1  includes a server  52  having a memory  54 , and a database  56  defined in memory  54 . The server  52  may be a dedicated server, a minicomputer, a microcomputer, a UNIX machine, a mainframe computer, a personal computer with an Intel Pentium (or the like) processor, a Macintosh computer, or any other suitable computer. The memory  54  is preferably non-volatile and includes storage devices, such as CD-ROMs, hard disks, tape drives, etc. The server  52  has a central processing unit (CPU)  58 , input devices such as a keyboard and mouse (not shown), output devices such as a monitor and printer (not shown), random access memory (RAM)  50 , read-only (ROM)  52 , as well as input/output (i.e. serial, parallel, USB, Firewire (IEEE 1394) ports and the like) ports (not shown). There may also be additional memory (not shown) remote from the server  52  and connected to the server  52  via one of the aforementioned ports. The server  12  may also connect to the Internet via a modem or other networking hardware (not shown). In one embodiment, system  50  is a single computer where the server  52  and components are a single workstation. In another embodiment, server  52  is a separate server, such as a World Wide Web server connected to the Internet. In this embodiment, the server  52  has an operating system that is capable of multiple users and multi-tasking, such as UNIX, Windows NT, or LINUX.  FIG. 1  depicts a user  64 , but could include one or more users  64  and one or more external databases  68  which communicate with the server  52 .  FIG. 1  does not disclose the specific interconnections between and among the various components in the system  50  as this information is well known. User  64  may be an individual directly accessing server  52 , or a minicomputer, a microcomputer, a UNIX machine, a mainframe computer, a personal computer with an Intel Pentium processor, a Macintosh personal computer, a laptop, a personal data assistant (PDA), a pen computer, a kiosk or any other suitable computer on a network. 
     The user  64  may communicate directly to the server  52  in the single computer embodiment or by communication links  66  in an embodiment where server  52  is a separate server, and the external databases  68  may be connected to the server  52  by communication links  70 . The communication links  66 ,  70  between the server  52  and the client machines  64  and between the server  52  and the external databases  68 , respectively, may include a large variety of connections, including a telephone link, a hard-wired connection, a satellite link or other wireless connection, an Internet connection, a local area network (LAN), a wide area network (WAN), any combination of the preceding, or any other suitable type of connection. Multiple users  64  may communicate simultaneously with the server  52 , and each connection may be by a different type of link, e.g., one connection may be by telephone while another may be by the Internet. Similarly, multiple external databases  68  may communicate simultaneously with the server  52 , and each connection may be a different type of link as discussed above. 
     The server  52  may communicate, via communication link  70 , with a particular database  68  by a variety of communication protocols, including file transfer protocol (FTP), electronic mail (e-mail), transfer control protocol/Internet protocol (TCP/IP), ASCII, X-MODEM, Y-MODEM, KERMIT, any combination of the preceding protocols, or any other suitable type of protocol. The server  52  may gather information from a database  68  automatically, e.g., at regularly scheduled intervals, only in response to data requested from a user  64 , or both automatically and in response to a request from a user  64 . Depending on the nature of the information provided by a database  68 , the connection between the server  52  and the database  68  may be “live” at all times or may be established intermittently. 
     After a link is established between the server  52  and user  64 , communication may take place via a variety of communication protocols, as described above with respect to communication between the server  52  and database  68 . The software used by user  64  that accesses information on the server  52  may be a known Internet browser such as Netscape Navigator or Internet Explorer or may be any other type of software suitable for transmitting information to and receiving information from the server  52 . 
     In an embodiment involving multiple users  64 , the server  52  is an independent server. With this platform, CPUs, memory, networking capabilities, storage, and software may be modified as appropriate to meet specific requirements. The selection of a suitable server requires consideration of CPU speed as well as disk subsystem performance and network bandwidth. For example, a disk with a 7200 RPM rotational speed may be a suitable disk subsystem. Once the RAID is selected (RAID 0, 1, 2, 3, 4, or 5), the size of the database and its projected growth must be analyzed as part of the known design considerations. 
     The database  56  on the server  52  may be of any suitable type that may be used for large database applications. 
     In a one embodiment, a user  64  connects to the server  52  via a communication link  66 . The user  64  may then log onto the database  56 . 
     After accessing the server  52 , a user  64  may enter pertinent information into the database  56  concerning the type or types of information desired. As discussed below, a wide variety of data may be entered into database  56 . The server  52  may be connected to one or more databases  56 ,  68 , located internal to the server, external to the server, or in combination of internal and external locations. Once the information from one or more of the databases  56 ,  68  is entered or further processed within the database  56 , a search may be performed using server  52  to identify information requested by a user  64 . The server  52  may then format the requested information appropriately. Once the information is formatted, it may then be transmitted to user  64 . 
       FIG. 2  is a flow diagram showing the various modules and subroutines of the invention and how the user  64  may navigate through system  50 . Navigation through the system  50  may be accomplished via a graphical user interface environment of point-and-click icons and menu choices that directly links a user  64  to desired sections. It is understood that selecting, pointing, clicking, choosing, and the like refer to the use of a mouse and mouse pointer, a stylus, a keyboard or any other device for selecting according to the principles of the invention. The system  50  is accessed initially through Startup  72 . Startup  72  allows access to Main Menu  76  or System Setup  74 . From Menu  76 , system  50  permits the user  64  access to Patient Information Module  78 , TMD Diagnosis Module  80 , TMD Therapy Module  82 , Administration Module  84  and Letters and Reports Module  86 . All information and data entered into the system  50  from any point updates database  56 ,  68  for that patient. 
     Database  56 ,  68  contain schedules of the ICD 9 codes and CPT codes relating to the medical diagnostics and treatments performed by the Dentist. When the dentist performs a diagnostic or treatment step, the entry into the system of the action performed by the Dentist causes system  50  to record to database  56 ,  68  that the action took place. System  50  records to database  56 ,  68  that the action was performed, looks up the corresponding ICD 9 or CPT medical code, looks up the cost of the ICD 9 or CPT code, and records all of this information to the patients file in database  56 ,  68 . When reports are later generated, the action performed and its corresponding ICD 9 or CPT medical code is printed, along with the current cost being charged by the Dentist for that step. Although the action is being performed by a dentist, medical ICD 9 and CPT codes are generated so that the diagnostic and treatment steps taken may be submitted by the Dentist as medical claims rather than dental claims. 
     It is further understood that modules and subroutines within said modules may link to each other even though  FIG. 2  may not show the link. It is also understood that examples of system screens, menus, menu choices and other user interactive screens shown herein are examples of the system  50  user  64  interface, and that the actual interactive screens may differ in appearance due to the differences in software and hardware being used. 
       FIGS. 1 ,  3 ,  4 ,  5 ,  6 A- 6 D,  7 A- 7 C,  8 ,  9 A- 9 C,  10 A- 10 B,  11 A- 11 D,  12 A- 12 C illustrate the sequence of steps and examples of system user interface screens for the First Appointment, which includes initially accessing the system  50 , entering new patient information, tests and evaluations to be performed, entering diagnostic results and documenting the information obtained in the First Appointment. The patient is given a date and time for their first appointment (step  101 ). Either at the Office or in advance, the patient fills out forms regarding basic patient background information, medical history, insurance information and trauma history (step  102 ). System  50  allows the user  64  to begin by accessing the program, initially bringing up System Entry Screen  176 . The user  64  is presented with and may select either Startup Wizard Menu Choice  178 , which is described below in the System Setup section, or Enter Menu Choice  177 , which brings up Main Menu Screen  191 . For The First Appointment, the selection of Patient Information Module Menu Choice  186  accesses the Patient Information Module Screen  192 . From Screen  192 , the user  64  is permitted by the system  50  to select the Initial Patient Form Entry Menu Choice  193 , Health History Menu Choice  194  or Trauma History Menu Choice  195 . By selecting Menu Choice  193 , the system  50  brings up Patient Information Entry Screen  197  from which initial new patient information can be entered. Selecting Menu Choice  194  or Menu Choice  195  allows the user  64  to access Patient Selection Screen  198 . By selecting a patient from the Patient List  199  and selecting the Go To Patient Button  220 , the system  50  accesses that patients health and trauma records. Displayed to the user  64  is the Health/Trauma History Screen  221 , from which the user  64  can access the patient&#39;s health history by selecting the Health History Menu Choice  222  or the Trauma History Menu Choice  223 . Selecting Menu Choice  222  accesses the Health Questionnaire Screen  224 , from which the user  64  can enter patient health information by accessing various screens which allow for data entry. An example is Health Questionnaire Section One Menu Choice  225  where the first section of the patient&#39;s medical and dental history can be entered. Selecting Menu Choice  223  accesses the Trauma Screen  226 , from which the user  64  can enter patient health information by accessing various screens which allow for data entry. An example is Patient&#39;s Current Problems from Accident Menu Choice  227  where information related to current trauma problems can be entered. 
     Upon completing the various sections of Screen  224  and Screen  226 , the user  64  is permitted to select the Done Menu Button  230 . This brings the user  64  back to Screen  221 . Selecting “Done” on this page accesses List of New Charges Screen  228 . The system  50  allows the user  64  to click the Accept Button  229  to accept the charges, which updates the database  56 ,  68  regarding the information entered and amounts charged. This system  50  brings the user  64  back to Screen  191 . 
     After entry of the preliminary data into the system  50 , the doctor meets with the patient, reviews the previously entered data and begins the Initial Cranio-Mandibular Exam (CME I) (step  104 ). 
     From Screen  191 , TMD Diagnosis Module Menu Choice  187  is displayed which when selected, takes the user  64  to Diagnostic Module Menu Screen  239 . From Screen  239 , prior to beginning the examination, the user  64  is permitted by system  50  to select the Existing Patient Information Menu Choice  240 , which takes the user  64  to Screen  197  from which previously entered patient information accessed on Screen  197  in step  103  can be modified, if necessary. The system  50  allows the user  64  to begin the examination by selecting Initial CME I Menu Choice  241 . From Screen  198 , the system  50  displays List  199 , from which the user  64  selects the desired patient name from. Selecting Button  220  accesses the CME I Initial Examination Screen  244 . 
     From Screen  244 , the Doctor can discuss the patients existing health and trauma history. By selecting the displayed Review Health and Trauma History Menu Choice  245 , the system  50  acknowledges and records to the database  56 ,  68  that this step has been completed (step  104 ). Also from Screen  244 , the Doctor can prescribe range of motion testing (step  105 ), Doppler Examination (step  106 ) or prescribe X-ray/CT Scans (step  107 ). These results are reviewed and entered into the system  50  by selecting ROM-Range of Motion Exam Menu Choice  246  and Doppler Exam Menu Choice  247 , which access Mandibular Range of Motion Screen  252  and Doppler Exam Screen  253 , respectively, from which the system  50  allows the findings of these exams to be entered. Clicking “Done” at any of these screens causes the system  50  to return the user  64  to Screen  244 . By choosing Deliver Soft Orthotic Pain Release Menu Choice  248 , the system  50  can update the database  56 ,  68  to acknowledge and record the fee for orthopanographic imaging. If Dental Screening Menu Choice  249  is selected, the system  50  accesses Dental Screening Screen  271 . Selecting the Dental Screening Selection Icon  365  causes the system  50  to bring the user  64  to Screen  198 . The user  64  is permitted to select the desired patient name from List  199 . Selecting Button  220  accesses Dental Screening Data Entry Screen  272 , where findings of the dental examination can be entered. Selecting “Done” from any of the Screen  244  Menu Choices causes the system  50  takes the user  64  back to Screen  244 . Selecting “Done” from Screen  244  accesses Screen  228 . The user  64  clicks Button  229  to accept the charges, which updates the database  56 ,  68  regarding the information entered and amounts charged. The system  50  brings the user  64  back to Screen  239 . 
     A radiological report based on the results of the prescribed X-ray/CT scans is prepared by the Doctor (step  108 ). This report, as well as findings and procedures already entered into the system  50  and stored in database  56 ,  68  are used to generate documentation by the system  50  supporting the procedures performed by selecting Letters and Reports Menu Choice  243  from Screen  239 . This causes the system  50  to access the Letters and Reports Screen  254 , from where letters and reports may be produced containing data retrieved from database  56 ,  68 . From Screen  254 , additional screens may be accessed from which system  50  can generate documents pertaining to the patient&#39;s treatment. By choosing Letters Menu Choice  256  from Screen  254 , Letters Screen  258  is displayed by system  50 , allowing the user  64  to choose from Justification of Procedures Letters Menu Choice  259  and Customizable Letters Menu Choice  260 . Selecting Menu Choice  259  takes the user  64  by system  50  to Justification Letters Screen  261 , where the user  64  can choose from a list of various letters justifying the various procedures. Choosing Menu Choice  260  allows system  50  to bring up Print Letters and Reports Screen  262 , where a list of standard and customizable letters such as procedure justification letters, attorney letters and insurance letters may be generated by system  50 . 
     From Screen  254 , system  50  can generate reports by selecting Reports Menu Choice  257 , which accesses the Reports Screen  263 . By selecting Report Directory Menu Choice  264 , the system  50  brings up Choose Report Screen  267 . From here, the user  64  can select from various reports from Report List  268 . Various parameters may be specified to customize the report. Selecting Letters and Clinical Findings Menu Choice  265  causes the system  50  to take the user  64  to Screen  262 . 
     The letters and forms that are prepared are preprinted and preformatted documents with information fields which are filled in by system  50 . The information placed in the information fields is generated by system  50  through the accessing of data stored in database  56 ,  68 . Upon a request for a document, the system accesses database  56 ,  68 , compiles the necessary data requested by the user for that document (such as indicating that a medical procedure was administered and subsequent findings), performs any mathematical processes (such as adding charges for a total) and places the information in the appropriate field in that document. 
     All necessary documents to support the claim are printed (step  109 ). Selecting Invoices and Statements Menu Choice  266  takes the user  64  to Print Invoice Screen  269 , where the user  64  can select a patient from Patient List  270  and print account statements. Selecting Update All Patient Charges Menu Choice  255  adds all charges for the procedures done to the patients file in database  56 ,  68  for billing purposes. 
     Insurance claim forms with the ICD 9 and CPT medical codes reflecting diagnosis and treatment are generated by system  50 , which are submitted to the insurance provider. As explained earlier, medical ICD 9 and CPT codes are used so that although the steps being performed are done by a dentist, the claims may be submitted under the patient&#39;s medical insurance for coverage. This process is fully described in the Administration subroutines section detailed below (step  110 ). The patient is scheduled for the Second Appointment (step  111 ). 
       FIGS. 1 ,  5 ,  6 C,  7 C,  8 ,  9 A,  13  and  14  detail the sequence of steps for the Second Appointment. The Doctor meets with the patient and discusses the findings and conclusions of the Initial Cranio-Mandibular Exam (step  112 ). From Screen  191 , the system  50  allows the user  64  to select Menu Choice  187  to go to Screen  239 . Selecting Menu Choice  241  causes the system  50  to access Screen  198 . The user  64  is permitted to select the desired patient name from List  199 . Selecting Button  220  links to Screen  244 . By selecting Radiological Evaluation Menu Choice  250 , the user  64  is taken to Diagnostic Test and X-Ray Screen  273  by system  50  where the Doctor can review the findings with the patient. Selecting “Done” from Screen  244  accesses Screen  239 . Clicking done on Screen  239  brings up Screen  228 . The user  64  is allowed to select Button  229  by system  50  to accept the charges, which updates the database  56 ,  68  regarding the information entered and amounts charged. This user  64  is brought back to Screen  239  by system  50 . 
     Next, the patient meets with an employee of the Office who reviews the patients insurance coverage and informs the patient on costs, coverage, co-payments, deductibles and arrangements for paying the patient&#39;s out of pocket expenses (step  113 ). At the conclusion of the Second Appointment, the patient schedules a date and time for the Third Appointment (step  114 ). 
       FIGS. 1 ,  5 ,  6 A,  7 C,  8 ,  9 C,  11 A,  14 ,  15 ,  16 A- 16 D,  17 A- 17 C,  18 A- 18 D,  19 A- 19 B illustrate the sequence of steps and show examples of system user interface screens for the Third Appointment, which includes accessing the system, tests and evaluations to be performed, entering diagnostic results, prescribing treatment and documenting the information obtained in the Third Appointment. 
     In the Third Appointment, the patient undergoes the Comprehensive Cranio-Mandibular Exam (CME II) (step  115 ), which is comprised of a comprehensive battery of tests and the patient being fitted for an orthotic device. System  50  displays Screen  191  to the user  64 , from which selecting Menu Choice  187  brings up Screen  239 . From Screen  239 , the user  64  is permitted to select the Comprehensive Cranio-Mandibular Exam (CME II) Menu Choice  242 , which takes the user  64  to Screen  198 . The system  50  allows the user  64  to select the desired patient name from List  199 . Selecting Button  220  accesses the CME II Comprehensive Examination Screen  274 . By selecting Clinical Evaluation Menu Choice  275 , the user  64  is taken to a series of screens, beginning with the Summary of Subjective Complaints Screen  280 , where subjective complaints can be entered (step  123 ). Completion of data entry on this Screen brings the user  64  to Screen  253 , where the system  50  permits the results of the Doppler examination to be entered (step  201 ). Following is the Joint Sounds Screen  281 , where the system  50  allows joint sound findings to be entered (step  124 ). Next the system  50  brings up the Neurological Screening Screen  282 , where results of the neurological testing are entered (step  125 ). This is followed by the Myo Testing Screen  283  for entry of Myo testing results (step  126 ), the Mandibular ROM Screen  284  for Mandibular Range of Motion findings (step  127 ), the Head and Neck ROM Screen  285  for head and neck range of motion data (step  128 ), and the Postural Observation Screen  286  for postural observation result entry (step  129 ). Completion of Screen  286  causes the system  50  to take the user  64  back to Screen  274 . 
     From Screen  274 , the system  50  allows the user  64  to choose Radiological Evaluation Menu Choice  276 , which will access and allow entry or updating of the data for Screen  273  (step  108 ). 
     From Screen  274 , the user  64  is permitted by system  50  to choose Sonographic/Joint Vibration Imaging Menu Choice  277 , which brings up Sonographic Imaging Screen  287 . From Screen  287 , the user  64  can select from various menu selections. Selecting Baseline Menu Choice  289  records to database  56 ,  68  that a pre-diagnostic therapy starting profile of patient&#39;s jaw sounds has been performed. Selecting Diagnostic Therapy Followup Menu Choice  290  records to database  56 ,  68  that post-diagnostic therapy followup imaging of the patients jaw sounds has been performed. The selection of Orthodontic/Orthopedic Followup Menu Choice  291  records to database  56 ,  68  the performance of an in-progress or post diagnostic therapy joint sounds record. Selecting Surgical Followup Menu Choice  292  records to database  56 ,  68  that a post-surgical joint sounds record has been made. 
     The selection of JVA/Sonogram Interpretation Menu Choice  293  causes the system  50  to access Screen  198 . By selecting a patient from List  199  and selecting Button  220 , New Sono Interpretation Screen  295  is displayed by system  50 . By selecting “Yes” from Screen  295 , the user  64  is taken to Digital Sonogram and Frequency Interpretation/Interpretation of Joint Vibration Analysis Screen  296 , where sonogram and joint vibration analysis data can be entered. 
     The selection of IME/IMR Medical Evaluation Menu Choice  294  accesses Screen  198  by system  50 . By selecting a patient from List  199  and selecting Button  220 , New Medical Necessity Report Screen  297  is displayed by system  50 . By selecting “Yes” from Screen  297 , the user  64  is taken to Medical Necessity Screen  298 , where data relating to the medical necessity of procedures can be entered. 
     Selecting “Done” on any of the menu choices on Screen  287  returns the user  64  by system  50  to Screen  287 . Selecting “Done” on Screen  287  returns the user  64  to Screen  274 . 
     Upon completion of the other subroutines accessed from the menu choices on the Screen  274 , the user  64  is permitted by system  50  to select Diagnostic Impressions Menu Choice  278  in order to access Diagnostic Impressions Screen  288 , where the user  64  can select various diagnostic findings (step  130 ). Selecting “Done” from Screen  274  accesses Screen  228 . Clicking Button  229  causes system  50  to accept the charges, which updates database  56 ,  68  regarding the information entered and amounts charged. The system  50  brings the user  64  back to Screen  239 . 
     Following the diagnostic findings (step  130 ) an orthotic device is prepared by taking maxillary and mandibular impressions (step  116 ), occlusal registration (step  117 ) and face bow record (step  118 ). A prescription for the orthotic is prepared from the measurements and is sent to a laboratory for creation of the device (step  119 ), followed by the receipt of the device when completed (step  120 ). 
     The Fourth Appointment is scheduled (step  121 ). From Screen  274 , system  50  permits the selection of Letters and Reports Menu Choice  279 , taking the user  64  to Screen  254 . The process for generating and printing relevant documents and reports containing information retrieved from database  56 ,  68  (step  122 ) is fully described in step  109  above. 
     Insurance claim forms with the ICD 9 and CPT medical codes reflecting diagnosis and treatment are generated by system  50 , which are submitted to the insurance provider (step  131 ). As explained earlier, medical ICD 9 and CPT codes are used so that although the steps being performed are done by a dentist, the claims may be submitted under the patient&#39;s medical insurance for coverage. This process is fully described in the Administration subroutines section detailed below. 
       FIGS. 1 ,  5 ,  6 B- 6 C,  8 ,  11 A  20 ,  21 A- 21 D,  22 A- 22 D,  23 A illustrate the sequence of steps and shows examples of system user interface screens for the Fourth Appointment, which involves fitting the orthotic device, beginning orthotic therapy, tests and evaluations, entering diagnostic results, prescribing treatment and documenting the information obtained in the Fourth Appointment. The user  64  is permitted by system  50  to access Screen  191  and select the TMD Treatment Therapy Module Menu Choice  188  (alternatively, the user  64  can choose Menu Choice  242  from Screen  239 ). System  50  takes the user  64  to Diagnostic Therapy Module Screen  300 . From this screen, the user  64  can select the Existing Patient Information Menu Choice  301 , which takes the user  64  to Screen  197  from which previously entered patient information can be modified, if necessary. To begin orthotic therapy (step  132 ), the selecting of Orthotic Therapy Menu Choice  302  from Screen  300  accesses Screen  198  by system  50 . From Screen  198 , the user  64  is permitted by system  50  to select the desired patient name from List  199 . Selecting Button  220  brings up Diagnostic Orthotic Therapy Screen  304 . The Doctor fits and adjusts the orthotic device to the patient. The user  64  selects Seat Orthotic Menu Choice  305 , which accesses Orthotic Adjustment Screen  312 , where adjustments to the orthotic device are recorded (step  133 ). When done with this menu choice and the remaining menu choices of Screen  304 , the user  64  is returned by system  50  to Screen  304 . 
     Selecting Orthotic Evaluation Menu Choice  306  accesses Orthotic Evaluation Screen  313 , where entry of data relating to the functionality of the orthotic device is performed (step  134 ). Selecting Orthotic Adjustment Menu Choice  307  brings the user  64  to Orthotic Adjustment Screen  314 , where adjustments to the orthotic device are recorded (step  208 ). Selecting ROM Evaluation Menu Choice  308  takes the user  64  to ROM Evaluation Screen  315 , where range of motion test results can be entered (step  135 ). Selecting Myo Testing Menu Choice  309  accesses Myo Testing Screen  316 , where data entry for muscle testing can be entered by the user  64  (step  136 ). Doppler Menu Choice  320  links to Doppler Examination Screen  317 , where the findings of Doppler auscultation testing can be recorded (step  202 ). Selecting Doctor Prescription Menu Choice  310  allows the user  64  to enter various prescription drugs and therapies into the system  50  through Doctor Prescriptions Screen  318  (step  137 ). When the user  64  selects Done, they are returned to Screen  300 . From Screen  300 , Letters and Reports Menu Choice  303  can be selected, taking the user  64  to Screen  254 . All entries are recorded by system  50  to database  56 ,  68 . The process for generating and printing relevant documents and reports containing information retrieved from database  56 ,  68  (step  138 ) is fully described in step  109  above. 
     Insurance claim forms with the ICD 9 and CPT medical codes reflecting diagnosis and treatment are generated, which are submitted to the insurance provider (step  139 ). As explained earlier, medical ICD 9 and CPT codes are used so that although the steps being performed are done by a dentist, the claims may be submitted under the patient&#39;s medical insurance for coverage. This process is fully described in the Administration subroutines section detailed below. 
       FIGS. 1 ,  5 ,  6 B,  8 ,  11 A,  21 A,  21 B,  21 D,  22 A- 22 D,  23 A,  24  illustrate the sequence of steps and examples of system user interface screens for the Fifth through Eighth Appointments, which involves continuing orthotic therapy, tests and evaluations, entering diagnostic results, prescribing treatment and documenting the information obtained in the Fifth through Eighth Appointments. System  50  permits the user  64  to enter this information by accessing Screen  191  and allowing user  64  to select the Menu Choice  188  (alternatively, the user  64  can choose Menu Choice  242  from Screen  239 ). System  50  allows the user  64  to view Screen  300 . From this screen, the user  64  can select the Menu Choice  301 , which takes the user  64  to Screen  197  from which previously entered patient information can be modified, if necessary. To continue orthotic therapy (step  140 ), the user  64  is permitted to select Menu Choice  302  from Screen  300 , bringing up Screen  304 . Selecting Menu Choice  306  accesses Screen  313 , where entry of data relating to the functionality of the orthotic device is performed (step  141 ). Selecting Menu Choice  307  brings the user  64  to Screen  314 , where adjustments to the orthotic device are recorded (step  209 ), either as a direct seat where the orthotic device is fitted directly in the patients mouth, or an indirect seat, where the device is fitted to a model and then placed in the patient&#39;s mouth. This is recorded by selecting “direct” or “indirect” in Selection Box  321 . Selecting Menu Choice  308  takes the user  64  to Screen  315 , where range of motion test results can be entered (step  142 ). Selecting Menu Choice  309  accesses Screen  316 , where data entry for muscle testing can be entered by the user  64  (step  143 ). Doppler Menu Choice  320  links to Screen  317 , where the findings of Doppler auscultation testing can be recorded (step  203 ). Selecting Menu Choice  310  allows the user  64  to enter various prescription drugs and therapies into system  50  through Screen  318  (step  144 ). System  50  allows the user  64  to select “Done” and is returned to Screen  300 . All entries are recorded to database  56 ,  68  by system  50 . From Screen  300 , Menu Choice  303  can be selected, taking the user  64  Screen  254 . The process for generating and printing relevant documents and reports containing information retrieved from database  56 ,  68  (step  145 ) is fully described in step  109  above. 
     Insurance claim forms with the ICD 9 and CPT medical codes reflecting diagnosis and treatment are generated by system  50 , which are submitted to the insurance provider (step  146 ). As explained earlier, medical ICD 9 and CPT codes are used so that although the steps being performed are done by a dentist, the claims may be submitted under the patient&#39;s medical insurance for coverage. This process is fully described in the Administration subroutines section detailed below. 
       FIGS. 1 ,  5 ,  6 B,  8 ,  11 A,  21 A,  21 B,  21 D,  22 A- 22 D,  23 A- 23 B,  25  illustrate the sequence of steps and examples of system user interface screens for the Ninth Appointment, which involves continuing orthotic therapy, tests and evaluations, entering diagnostic results, prescribing treatment and documenting the information obtained in the Ninth Appointment. System  50  permits the user  64  to enter this information into the system  50  by accessing Screen  191  and selecting the Menu Choice  188  (alternatively, the user  64  can choose Menu Choice  242  from Screen  239 ). This takes the user  64  to Screen  300 . From this screen, the user  64  is permitted to select the Menu Choice  301 , which takes the user  64  to Screen  197  from which previously entered patient information can be modified, if necessary. To continue orthotic therapy (step  147 ), the user  64  selects Menu Choice  302  from Screen  300 , bringing up Screen  304 . Selecting Menu Choice  306  accesses Screen  313 , where entry of data relating to the functionality of the orthotic device is performed (step  148 ). Selecting Menu Choice  307  brings the user  64  to Screen  314 , where adjustments to the orthotic device are recorded (step  210 ). Selecting Menu Choice  308  takes the user  64  to Screen  315 , where range of motion test results can be entered (step  149 ). Selecting Menu Choice  309  accesses Screen  316 , where data entry for muscle testing can be entered by the user  64  (step  150 ). Doppler Menu Choice  320  links to Screen  317 , where the findings of Doppler auscultation testing can be recorded (step  204 ). Selecting Menu Choice  310  allows the user  64  to enter various prescription drugs and therapies into system  50  through Screen  318  (step  151 ). Selecting Progress Report Menu Choice  311  accesses Progress Report Screen  319 , where the Doctor can enter findings that detail the progress of the therapy and treatment (step  152 ). System  50  allows the user  64  to select “Done” and is returned to Screen  300 . All entries are recorded to database  56 ,  68  by system  50 . From Screen  300 , Letters and Reports Menu Choice  303  can be selected, taking the user  64  to Screen  254 . The process for generating and printing relevant documents and reports containing information retrieved from database  56 ,  68  (step  153 ) is fully described in step  109  above. 
     Insurance claim forms with the ICD 9 and CPT medical codes reflecting diagnosis and treatment are generated by system  50 , which are submitted to the insurance provider (step  154 ). As explained earlier, medical ICD 9 and CPT codes are used so that although the steps being performed are done by a dentist, the claims may be submitted under the patient&#39;s medical insurance for coverage. This process is fully described in the Administration subroutines section detailed below. 
       FIGS. 1 ,  5 ,  6 B,  8 ,  11 A,  21 A,  21 B,  21 D,  22 A- 22 D,  23 A,  26  illustrate the sequence of steps and examples of system user interface screens for the Tenth through Thirteenth Appointments, which involves continuing orthotic therapy, tests and evaluations, entering diagnostic results, prescribing treatment and documenting the information obtained in the Tenth through Thirteenth Appointments. System  50  permits the user  64  to enter this information into system  50  by accessing Screen  191  and selecting Menu Choice  188  (alternatively, the user  64  can choose Menu Choice  242  from Screen  239 ). This takes the user  64  to Screen  300 . From this screen, the user  64  can select the Menu Choice  301 , which takes the user  64  to Screen  197  from which previously entered patient information can be modified, if necessary. To continue orthotic therapy (step  155 ), the user  64  is permitted to select Menu Choice  302  from Screen  300 , bringing up Screen  304 . Selecting Menu Choice  306  accesses Screen  313 , where entry of data relating to the functionality of the orthotic device is performed (step  156 ). Selecting Menu Choice  307  brings the user  64  to Screen  314 , where adjustments to the orthotic device are recorded (step  211 ). Selecting Menu Choice  308  takes the user  64  to Screen  315 , where range of motion test results can be entered (step  157 ). Selecting Menu Choice  309  accesses Screen  316 , where data entry for muscle testing can be entered by the user  64  (step  158 ). Selecting Menu Choice  310  allows the user  64  to enter various prescription drugs and therapies into system  50  through Screen  318  (step  159 ). Doppler Menu Choice  320  links to Screen  253 , where the findings of Doppler auscultation testing can be recorded (step  205 ). System  50  allows the user  64  to select “Done” and is returned to Screen  300 . All entries are recorded to database  56 ,  68  by system  50 . From Screen  300 , Menu Choice  303  can be selected, taking the user  64  to Screen  254 . The process for generating and printing relevant documents and reports containing information retrieved from database  56 ,  68  (step  160 ) is fully described in step  109  above. 
     Insurance claim forms with the ICD 9 and CPT medical codes reflecting diagnosis and treatment are generated by system  50 , which are submitted to the insurance provider (step  161 ). As explained earlier, medical ICD 9 and CPT codes are used so that although the steps being performed are done by a dentist, the claims may be submitted under the patient&#39;s medical insurance for coverage. This process is fully described in the Administration subroutines section detailed below. 
       FIGS. 1 ,  5 ,  6 B,  8 ,  11 A,  21 A,  21 B,  21 D,  22 A- 22 D,  23 A- 23 B,  27  illustrate the sequence of steps and examples of system user interface screens for Appointment  14 , which involves continuing orthotic therapy, tests and evaluations, entering diagnostic results, prescribing treatment and documenting the information obtained in the Appointment  14 . System  50  permits the user  64  to enter this information by accessing Screen  191  and selecting the Menu Choice  188  (alternatively, the user  64  can choose Menu Choice  242  from Screen  239 ). This takes the user  64  to Screen  300 . From this screen, the user  64  can select the Menu Choice  301 , which takes the user  64  to Screen  197  from which previously entered patient information can be modified, if necessary. To continue orthotic therapy (step  162 ), the user  64  is permitted to select Menu Choice  302  from Screen  300 , bringing up Screen  304 . Selecting Menu Choice  306  accesses Screen  313 , where entry of data relating to the functionality of the orthotic device is performed (step  163 ). Selecting Menu Choice  307  brings the user  64  to Screen  314 , where adjustments to the orthotic device are recorded (step  212 ). Selecting Menu Choice  308  takes the user  64  to Screen  315 , where range of motion test results can be entered (step  164 ). Selecting Menu Choice  309  accesses Screen  316 , where data entry for muscle testing can be entered by the user  64  (step  165 ). Doppler Menu Choice  320  links to Screen  317 , where the findings of Doppler auscultation testing can be recorded (step  206 ). Selecting Menu Choice  310  allows the user  64  to enter various prescription drugs and therapies into system  50  through Screen  318  (step  166 ). Selecting Menu Choice  311  accesses Screen  319 , where the Doctor can enter findings that detail the progress of the therapy and treatment (step  167 ). System  50  allows the user  64  to select “Done” and is returned to Diagnostic Screen  300 . All entries are recorded to database  56 ,  68  by system  50 . From Screen  300 , Menu Choice  303  can be selected, taking the user  64  to Screen  254 . The process for generating and printing relevant documents and reports containing information retrieved from database  56 ,  68  (step  168 ) is fully described in step  109  above. 
     Insurance claim forms with the ICD 9 and CPT medical codes reflecting diagnosis and treatment are generated by system  50 , which are submitted to the insurance provider (step  169 ). As explained earlier, medical ICD 9 and CPT codes are used so that although the steps being performed are done by a dentist, the claims may be submitted under the patient&#39;s medical insurance for coverage. This process is fully described in the Administration subroutines section detailed below. 
       FIGS. 1 ,  5 ,  6 B,  8 ,  11 A,  21 A,  21 B,  21 D,  22 A- 22 D,  23 A,  28  illustrate the sequence of steps and examples of system user interface screens for the Fifteenth Appointment and beyond, which involves continuing orthotic therapy, tests and evaluations, entering diagnostic results, prescribing treatment and documenting the information obtained in the Fifteenth Appointment and beyond. System  50  permits the user  64  to this information into the system  50  by accessing Screen  191  and selecting the Menu Choice  188  (alternatively, the user  64  can choose Menu Choice  242  from Screen  239 ). This takes the user  64  to Screen  300 . From this screen, the user  64  can select the Menu Choice  301 , which takes the user  64  to Screen  197  from which previously entered patient information can be modified, if necessary. To continue orthotic therapy (step  170 ), the user  64  is permitted to select Menu Choice  302  from Screen  300 , bringing up Screen  304 . Selecting Menu Choice  306  accesses Screen  313 , where entry of data relating to the functionality of the orthotic device is performed (step  171 ). Selecting Menu Choice  307  brings the user  64  to Screen  314 , where adjustments to the orthotic device are recorded (step  213 ). Selecting Menu Choice  308  takes the user  64  to Screen  315 , where range of motion test results can be entered (step  172 ). Selecting Menu Choice  309  accesses Screen  316 , where data entry for muscle testing can be entered by the user  64  (step  173 ). Doppler Menu Choice  320  links to Screen  317 , where the findings of Doppler auscultation testing can be recorded (step  207 ). Selecting Menu Choice  310  allows the user  64  to enter various prescription drugs and therapies into system  50  through Screen  318  (step  174 ). The user  64  selects “Done” and is returned to Screen Module  300 . All entries are recorded to database  56 ,  68  by system  50 . From Screen  300 , Menu Choice  303  can be selected, taking the user  64  to Screen  254 . The process for generating and printing relevant documents and reports containing information retrieved from database  56 ,  68  (step  160 ) is fully described in step  109  above. 
     Insurance claim forms with the ICD 9 and CPT medical codes reflecting diagnosis and treatment are generated by system  50 , which are submitted to the insurance provider (step  176 ). As explained earlier, medical ICD 9 and CPT codes are used so that although the steps being performed are done by a dentist, the claims may be submitted under the patient&#39;s medical insurance for coverage. This process is fully described in the Administration subroutines section detailed below. 
       FIGS. 1 ,  4 - 5 ,  29 ,  30 A- 30 D,  31 A- 31 C,  32 A- 32 D,  33 ,  34 A- 34 C illustrate the sequence of steps and system user interface screens within the System Setup and Administrative subroutines. 
     From Screen  191 , system  50  allows the user  64  to select Administration Menu Choice  189 , which links to Administration Screen  330 . For any of the Menu Choices, selecting “Done” will cause system  50  to take the user  64  back to Screen  330 . Selecting Add New Patient Menu Choice  331  accesses Patient Information Screen  345 , where new patient information can be added or existing patient information can be modified, as in step  103 . Selecting Add/Edit Insurance and Attorney Contact Information Menu Choice  332  brings up Contact Info Screen  346 , where attorney and insurance company information can be added or modified. Selecting Add Memos/Notes Menu Choice  333  allows the user  64  to view Insurance Information Screen  347 , where insurance company information such as group numbers and claim numbers can be entered. Choosing Add/Edit ICD 9 Codes Menu Choice  334  brings up Doctor Information Screen  348 , where ICD 9 diagnosis codes can be manually added or edited. The Add/Edit Doctor Information Menu Choice  335  accesses the Providers Screen  349 , where additional Doctors providing services using the system  50  can be added or existing Doctor information can be modified. Selecting Edit CPT Fees Menu Choice  336  brings up the Chargeable Services Screen  350 , where the fees charged for services can be changed based on its CPT code. Selecting Record Payments Menu Choice  337  links to Paid Invoices Screen  351 , where the user  64  can enter amounts paid by the patient or the patient&#39;s insurance company. Selecting Add Charges Menu Choice  338  causes the system  50  to update all current charges not already entered into the database  56 ,  68 , bringing accounts current for all services provided. Selecting the Print Insurance Menu Choice  339  accesses the Insurance Screen  360 , which contains the Setup Insurance-Add Charges Menu Choice  361  and Print Insurance Forms Menu Choice  362 . Selecting Setup Insurance-Add Charges Menu Choice  361  takes the user  64  to Insurance Information Screen  363 , where information relating to the insurance provider can be entered or amended. Selecting Done from Screen  363  take the user  64  to Insurance Setup Finish Screen  364 , where the user  64  acknowledges completion of the entry of the insurance information, which returns the user  64  to Screen  360  All entries are recorded to database  56 ,  68  by system  50 . 
     Selecting Menu Choice  362  allows the user  64  to access Print Insurance Screen  365 . From Patient List  366 , the user  64  can select a patient and display Insurance Form Display Screen  367 . From here, the user  64  may print medical health insurance forms with ICD 9 diagnosis codes and CPT treatment codes that have been automatically entered based on services performed by the Doctor and entered into the system  50 . Selecting “Done” takes the user  64  back to Screen  360 . 
     From Screen  176 , the user  64  is permitted by system  50  to select either Menu Choice  177  or Menu Choice  178 . By selecting Menu Choice  178 , the user  64  is taken to Startup Wizard Screen  179 , where system  50  configuration may be performed. From Screen  179 , the user may add the names and information for Doctors providing services using the system  50 . From Screen  179  and subsequent screens accessed from Menu Choice  178 , the user  64  can continue forward to the next user interface screen by selecting Menu Choice Next  181 , go back to the previous user interface screen by selecting Menu Choice Back  182  or exit back to Screen  176  by selecting Menu Choice Finish  183 . Selecting Menu Choice  181  from Screen  179  takes the user  64  to CPT Code Screen  184 , where the user  64  can customize CPT treatment codes. Selecting Menu Choice  181  on Screen  184  takes the user  64  to Location Configuration Screen  185 , where the user  64  can set the location of the server and the application. By selecting Menu Choice  183 , the user  64  is taken to Screen  191 . All entries from this subroutine are recorded to database  56 ,  68  by system  50 . 
     The invention can be practiced with additional steps for processing or paying insurance claims or for communicating the status of submitted claims to health care providers and patients by system  50 . For instance, when a claim has been submitted and approved, an explanation of benefits can be automatically created and sent to the provider, the patient, and/or to an employer of the patient. Electronic funds transfer can be used to execute payment from insurers to health care providers for approved claims by system  50 . 
     The present invention may be embodied in other specific forms without departing from its spirit or essential characteristics. The described embodiments are to be considered in all respects only as illustrative and not restrictive. The scope of the invention is, therefore, indicated by the appended claims rather than by the foregoing description. All changes which come within the meaning and range of equivalency of the claims are to be embraced within their scope. Although the present invention has been described in terms of the foregoing preferred embodiments, such description has been for exemplary purposes only and, as will be apparent to those of ordinary skill in the art, many alternatives, equivalents, and variations of varying degrees will fall within the scope of the present invention. That scope, accordingly, is not to be limited in any respect by the foregoing detailed description; rather, it is defined only by the claims that follow.