Learn how to quickly create estimates and turn any completed estimate into an organized treatment sheet, all within Instinct!
Table of Contents
🔨 Admin – Creating Estimate Groups
We recommend creating specific Estimate Product Groups (in addition to Treatment Sheet and Invoice Groups) for a few reasons:
- This avoids adding unnecessary items (like non-billable vitals from a Treatment Sheet group) on an Estimate as a $0 line item.
- A Treatment Sheet group may contain multiple billable options that are selected at the time of ordering (5mg Enalapril, 10mg Enalapril, etc.) and if these were added to an Estimate, all options would appear.
- There may be automatic charges associated with Treatment Sheet Product Groups, different hospitalization options, etc.
Estimate-only groups are created in the Admin > Product Groups section in Instinct. A ‘Target Estimate’ amount range is available for internal purposes only and will show up when searching/using groups on the estimate. It’s useful for storing canned estimates such as TPLO or Urethral Obstruction, where you may want to provide a target estimate to help your team make and provide accurate estimates.
Admin users can also manage the Estimate Print Footer in the Admin section to include legal information to all estimate PDFs.
💰 Creating an Estimate
Click ‘Estimates’ at the top of any patient to enter the estimate screen.
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. 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).
➕ Adding Items to an Estimate
Use the search field to add items via Product Name or PIMS ID and use the associate drop down boxes to quickly add Exam, Ward, and Hospitalization charges. You can also add groups to estimates either using existing groups or by creating Estimate-only groups in your Instinct Product Group Admin. Non-billable items can be added to an estimate with a $0 charge and Miscellaneous items can be added to create custom price line items.
Products with a default Frequency and Quantity (set in Admin) will be added to an estimate with the same Frequency.
💲 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.
LOW QTY must be lower than HIGH QTY to avoid an error message. Invalid values will not be accepted and calculated into the total.
When declining a line item with edited QTY LOW/HIGH fields the amounts are preserved.
⏰ 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 Estimate Duration, which is selected via dropdown to the left of the Complete button. This duration button will default to a one-time estimate which is useful for a procedure but if you are making a hospitalization estimate, you can set this for 24 to 48 hours and Instinct will update the math for you.
🏥 Patient Safety Warnings
Dosing calculators, patient safety warnings, and Plumb’s information are available for each 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.
To rearrange the order, click the up/down arrows next to each line item.
Estimate line item labels are editable which allows the user to add a misc. product code to the estimate for procedures or products that are not currently in the system. Renaming the misc. label 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.
Another great use of the editable line item label is for estimating for diagnostics you may or may not need. Simply add a ‘+/-‘ in front of the Product name, change the Low End price to $0, and keep the High End 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 price of a Product is manually changed by a user, the price will no longer automatically update when changing the Frequency or Quantity because this calculation is performed with the default Frequency and Quantity set up in the Admin section. In order for the automatic pricing to calculate, this Product must be removed and re-added to the estimate.
For record-keeping purposes, completed Estimates cannot be deleted. In-progress estimates can be deleted via 3-dot menu only if no line items were added.
⛔ 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.
🧾 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.
You’ll notice 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.
✅ Completing an Estimate
To Complete an Estimate, click the orange ‘Complete’ button towards the bottom right hand corner of the Estimate screen and select ‘Complete’ or ‘Complete and Generate Tx Sheet’.
Complete – Completes the estimate which then becomes available in the treatment sheet search to order as a group.
Complete and Generate Tx Sheet – Completes the estimate and automatically opens the Treatment Sheet Product Group modal to easily add estimate items to the treatment sheet.
Complete and Generate Invoice – Completes the estimate and automatically moves billable items to the invoice.
Once selected, you’ll be directed to the Invoice screen to review which line items you’ll be adding to the patient Invoice.
🚨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.
📓 Please Note: This option does not fill in the Exam, Ward, or Hospitalization dropdowns – these 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.
An Undo feature is available for any completed estimate as long as it was completed within the last 24 hours. Any estimates completed for over 24 hours are not available to undo for security.
✍️ Revision History
Revision history is available at the bottom of the Estimate and includes who Created, Updated, and Completed the Estimate. Please note that the ‘Updated’ revision history is recorded when a new Doctor is selected from the drop down or when toggling ‘Start with Current Invoice Total’.
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, simply click the ‘Save/Print’ dropdown and select ‘Print w/all prices’ or ‘Print w/total only’.
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. Reach out to our team if you’d like advice on this workflow.
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