How long is six months?

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JLM
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How long is six months?

Post by JLM » Mon Mar 16, 2015 4:04 pm

Seemed like an obvious question until I started writing some computer code for office use.
Some dental plans allow a cleaning every six months. If I see a patient on 3/31/15, what is the soonest I can see them again?

9/30/15? Then the next cleaning after that is 3/30/16 which is three cleanings in one year.
10/1/15? Then the next cleaning is 4/1/16 which is more than a year after the original cleaning.

or worse: 8/31/15 -> 2/28/16, 2/29/16, 3/1/16, 3/2/16 or 3/3/16?? If you choose the March dates, no one will be scheduled for recall on 8/30 or 8/31 of 2017.

How do insurance companies calculate six months from 3/31 or 5/31 or 8/29-8/31 or 10/31 or 12/31?

How about 183 days from 3/31/15? That would be 9/30/2015 which is obviously(?) less than six months.

The safe choice is 184 days later but some patients object to their appointments sliding year after year. Teachers especially as they want their appointments during summer break and winter break.

So, how long is six months? I don't want to produce values that result in unpaid claims...


Jim Margarit

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dgraffeo
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Re: How long is six months?

Post by dgraffeo » Mon Mar 16, 2015 4:44 pm

I don't know how insurance companies do it, but in my mind there are two ways of doing it. The simple way is going back to the first of the month, adding 6 to the month value, then adding the current day value - 1 to the day. So let's take today 3/16 as an example. We go to 3/1, add 6, which would be 9/1, then add 15, which would be 9/16. Then if we did it again it'd give us 9/1 + 6 months = 6/1, then + 15 days = 6/16.

So for your instance let's start with 3/31/15. That would be 3/1/15, + 6 months would be 9/1/15 then + 30 would be 10/1/15 since September only has 30 days in the month. It's "technically" 7 months if you looked at it that way but for count of days it's 6 months. The next one would be 3/31/15 then because there is no 0 day (you add 6 to 10, which is 3 for the month, then subtract 1 from 1 for the day, so it'd go back to the 31st).

The popular opinion I've seen online is to add 183 days as it has no ill effects in general, but six months is at best an approximation of time and entirely up to your interpretation. Rolling back the day segment, adding 6 to the month segment, then adding the days again rolling into a new month if necessary is what most programming languages do under the hood.
"To understand what recursion is, you must first understand recursion."

David Graffeo
Open Dental Software
http://www.opendental.com

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jsalmon
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Re: How long is six months?

Post by jsalmon » Mon Mar 16, 2015 4:58 pm

I'll give you my programmatic perspective. Keep in mind that I don't deal with claims or insurance companies every day so this might not be that helpful.

I've never added "months" to a date and considered the days portion (e.g. the 183 days mentioned previously). The only time I consider the days portion of a date is after adding a month and getting an invalid date back (E.g. 1/31 + one month = 02/31 invalid). At which point you would subtract days from the resulting date until you get to a valid date for that month (keeping leap years in mind).
Here is an example of how 12/31/2015 should be treated in my opinion and how adding months would affect it:
12/31/2015
1/31/2016
2/29/2016
3/31/2016
4/30/2016
5/31/2016
6/30/2016
7/31/2016
8/31/2016
9/30/2016
10/31/2016
11/30/2016
12/31/2016
1/31/2017
2/28/2017
3/31/2017

Source of example with code: https://msdn.microsoft.com/en-us/librar ... .110).aspx
The best thing about a boolean is even if you are wrong, you are only off by a bit.

Jason Salmon
Open Dental Software
http://www.opendental.com

KevinRossen
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Re: How long is six months?

Post by KevinRossen » Mon Mar 16, 2015 5:39 pm

Most insurance plans seem to allow cleanings/exams twice per plan year now, but there are some that are literal one time per 6 months, or worse two times per 12 months. To play it safe, we set our recall interval at 6 months + 2 weeks for two reasons. First, it steers far and away from the insurance cutoff line. But also, it allows us to call patients scheduled the next two weeks out to fill in gaps in the current week's schedule. Simple trick, but it has many benefits.

From a programming perspective, if you're doing a MySQL query you could use something like:

Code: Select all

WHERE Date(AptDateTime)=CURDATE()+INTERVAL 6 MONTH+INTERVAL 2 WEEK
That would give you plenty of room for error. Again, if you're writing MySQL you don't need to calculate it by days. It has the +INTERVAL feature as an option, which could be the answer you're looking for.
Kevin Rossen
Office Manager, Rossen Dental
Founder, DivergentDental.com
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JLM
Posts: 128
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Re: How long is six months?

Post by JLM » Tue Mar 17, 2015 10:04 am

Thanks for your replies. We have always just done a "six months plus a day". I never paid attention to how my staff has handled the border cases. I wasn't sure how insurance companies handle these cases and priority one is not getting denied claims back. So, it's the golden rule: the one who has the gold makes the rules.

I guess could make my receptionist sit on hold for hours until they find someone at Delta Dental who can tell them what rule they use.


Jim Margarit

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