Treatment plans

A treatment plan groups planned procedures from the chart into something the patient is shown, prices and accepts. Presenting freezes the plan as a snapshot; acceptance is a signed copy of that same snapshot. Neither is ever edited afterwards: a change is a new version with its own snapshots, and the earlier ones stay as history.

Drafting

The quickest way to start a plan is to chart: with no open plan, your first click on the chart creates one (see Charting in one click).

To start one yourself, click the round + under the chart and choose New plan (with no open plan, the empty plan panel has a New plan button too). A draft called Treatment plan opens at once, priced from the patient's member price when a membership covers today, else the patient's default price list or the practice's only one, with its first visit, Visit 1, chosen for charting. When none of these decides the price list, a dialog asks for it first. Rename the plan, change its price list or location, and set the date until which the fees are valid and a note to the patient later with Edit.

Fees come from the treatment's location: a location with its own prices for a code charges those, every other location the practice price (see Prices for one site). An NHS price list prices England's scheme, so it is used only at a location in England: a plan, or a treatment recorded, corrected, completed or restored, that pairs it with any other location is refused.

To gather procedures already planned on the chart into a new plan:

Plans are numbered from the practice's own sequence, and each open plan has its own tab under the chart, #number name. A procedure belongs to one plan at a time. Drafts can be edited until they are presented.

Whatever you chart — a click on the chart, Plan procedure or a template — goes into the plan whose tab is open under the chart, in the visit marked Chart here, never into a different plan.

Member price

A patient with a membership is priced on their membership's price list. When you start a plan, plan a procedure or draft a plan from charted items, on the web or in the phone app, the price list starts on the membership's list and says Member price. A membership counts when it is active and covers today: it has started, and it hasn't ended. With no such membership the price list starts on the patient's own list, then on the practice's only one.

When Smileline can't tell which list to use, nothing is chosen for you and the picker says why, so you choose the price list yourself:

• two memberships on different price lists cover today;
• the patient's memberships couldn't be loaded;
• the membership's price list is archived.

A membership list can take a percentage off the fee schedule, as any price list can (see List discount).

Presenting

Click Present in the plan's header. The plan is frozen as a snapshot under the presenter's name, the presentation PDF is rendered and filed on the patient's documents, and the plan moves to Presented. A clinician presents under their professional registration; a treatment coordinator or front-desk member may present an unchanged plan the clinician authored.

If the PDF failed to render (for example while document rendering is not yet configured for your practice), the plan is still presented. Regenerate PDF, in the bar under the visits, files it again from the frozen snapshot, dated the day the plan was presented rather than the day it was regenerated.

Acceptance

The signature is stored as a clinical document, and the accepted snapshot carries the signer's role, name, relationship, the attestation version, the signing time and, for each treatment, whether the patient accepted or declined it — and, for a judged child, the clinician, their registration and when they confirmed their password. The plan's header then shows who signed, for example Signed by Mark Doe (Parent). View signature opens it through a one-minute link. A parent, guardian or attorney who has since been erased reads Signed by Erased patient (Parent), with no View signature.

Without a date of birth on file, or for a child with no parent or guardian on record, the dialog says what to add first and nothing can be signed. The signer is checked before the signature is filed, so a refused acceptance leaves no signature behind.

If the patient declines every treatment, record a decline instead (see Declining): an acceptance needs at least one treatment the patient accepts.

The acceptance is tied to the plan version the dialog showed. If the plan was changed and presented again while the dialog was open — or a procedure it cites was voided, corrected or re-priced — the acceptance is refused; close the dialog and record it again from the current version.

Accepted online

With the patient portal's Online plan signing on, a patient — or a parent, guardian or attorney who may consent for them — can accept a presented plan themselves, deciding per treatment as at the desk. The accepted plan's header then reads, for example, Signed by Sarah Jones · Signed online, and an acceptance certificate (a PDF of the plan as accepted, with the signature and how the signer proved who they are) is filed on the record and shared with them in the portal. A plan past the date it is valid until can't be signed online.

Adding to a plan the patient has seen

A presented, accepted or in-progress plan is what the patient was shown, and perhaps signed. Charting onto it — a new item, a ⇧ change to an item, Place on tooth or a template — asks you first: the plan is reopened as its next version, a draft, which the patient must be shown and sign again. Click Continue to reopen it and add the item in one step, or close the question to leave the plan as it is.

The earlier presentation and signature stay on record as history, but they no longer stand as the patient's consent. If the item cannot be added, nothing changes and the plan stays as the patient saw it.

The question names the version you were looking at. If someone presented or signed the plan elsewhere in the meantime, the plan is refreshed and you are asked again about its current version.

Afterwards

The plan's header carries one button for the next step: Present on a draft, Record acceptance once presented, Start treatment once accepted. Everything else sits in the bar under the visits.

Reopen as new version, Complete treatment plan, Cancel plan and Declined ask you to confirm first: reopening makes a new draft the patient must be shown and sign again, a completed or cancelled plan is closed for good, and declining marks its planned treatments declined. Start treatment stays one click, because it only moves the plan forward.

Cancelling an accepted or in-progress plan asks why, on the web and in the mobile app: choose one of the practice's reasons, kept under Settings → Not-proceeding reasons. The plan records who cancelled it and why.

Declining

Marking a presented plan Declined records that the patient said no to it, under your name. Its planned treatments stay on the chart and on the plan, each with a Declined pill, and none of them can be started or completed until the patient accepts it in a later version: reopen the plan (or put the treatment on another plan), present it, and record an acceptance with the treatment ticked. Correcting, re-pricing or undoing a declined treatment keeps it declined.

Record a signed refusal records the same decline with the patient's signature — an informed refusal. The signer, the attestation and the signature follow the same rules as an acceptance, and you can choose a reason from Settings → Not-proceeding reasons. The decline, its reason and who recorded it stay on record even after the plan is reopened.

A plan with any treatment already started or done cannot be declined as a whole: record an acceptance with the treatments the patient no longer wants unticked, or cancel the plan with a reason. Work already done is never marked declined.

Alternatives

To offer the patient another option for the same need, choose Make an alternative: a new, empty draft at the same location and on the same price list, grouped with the plan. Chart it and present it like any other plan. When the patient accepts one plan of the group, the others are settled in the same step, under your name: a presented alternative with no work done is declined, and a draft — or a presented alternative with work already started — is cancelled. Each settled plan shows Another option accepted beside its status; your practice's not-proceeding reasons are left as they are. A plan cannot be accepted while another of its alternatives is accepted or in progress.

Visits

A plan is split into visits — the appointments the work will take — the way a treatment coordinator books it. Under the plan's header each visit is a grey card: its number, Visit n or the name you type, the practitioner, and on a draft its duration and the Ready to book switch. Once the visit is booked, the card also shows the appointment's date and start and end time (a link to that day of the diary), its status as a coloured pill and the appointment's own note, read-only — change the note on the appointment in the diary. A purple Completed pill appears once every treatment in the visit is done. Treatments that are in no visit yet are listed first, under Not yet in a visit.

Each treatment is a white row: its name (click it to open the treatment's details and notes), the date it was done, the site, the practitioner, a pill for the kind of price list it is priced from, its minutes, its price, a lock once it has been charged, and the completion box. A treatment the patient declined carries a Declined pill and cannot be completed until they accept it. A treatment sent to a lab carries a pill for its latest lab case: the lab's stage for an order sent to a connected lab, otherwise the case's status, such as Sent or Received. A line under the row previews the treatment's newest note with its state, and +n when it has more. Hide n completed treatments folds the finished rows away; the card's foot totals the minutes and the price. A re-priced treatment shows only its current version. A treatment voided by a clinician stays, struck through; one that was removed — with Remove, or Undo on the chart — no longer shows on the plan and stays in the chart's History.

Chart here on a visit card sends what you chart to that visit; the chosen card is outlined in blue and its button is solid blue. Press it on the next card when you move on to the next appointment.

Add visit appends a visit; the cross on a visit removes it, asking first when it holds treatments (they go back to Not yet in a visit).

Two people can work on the same draft. Each change to its visits, its treatments or its details is checked against the version you were looking at. If someone else changed the plan in the meantime, nothing of yours is saved over theirs: the plan reloads to show their change, and the details you typed in Edit draft stay in the form so you can save them again. Saving a draft's details and its treatments is one save: both are kept, or neither.

Visits are part of what the patient signs: the presented snapshot and the PDF list them. So they are edited while the plan is a draft; to change the visits of a presented or accepted plan, Reopen as new version, edit, and present it again.

Moving a treatment to another visit

On a draft, open the row's ⋯ menu, choose Move to visit and pick the visit, or Not yet in a visit. The same menu holds the row's other actions — Start, Refer out, Send to lab, Remove and Void — each shown only when the treatment's state and your role allow it. Refer out asks you to confirm first.

Send to lab is offered in UK and US practices on planned or in-progress treatment the patient has not declined, to anyone who can manage lab cases. It opens a new lab case for the treatment and its plan; choose a connected lab and Continue opens the lab's own order form instead.

Placing a treatment on a tooth

A tooth or surface treatment that has no tooth yet — a crown added by a template, for example — has Place on tooth in its ⋯ menu: choose it, then click the tooth (or its surfaces) on the chart. The treatment keeps its price, duration, invoice wording, practitioner, note and place in the visit. On a plan the patient has seen, you are asked first.

Grouped treatments

A bridge charted across several teeth (see Bridges, dentures and splints) is one row in its visit: the teeth it spans, such as 34–36, its name, a badge such as 3 units, and the units' minutes and prices added up. Open it with the arrow to see each unit as its own row, with its Retainer or Pontic pill, its details and its own completion box.

• Complete each unit on its own row. There is no completion box for the whole bridge: each unit is completed, charged and claimed on its own, and a completion is a clinical record, so it is only ever ticked for a unit you have done.
• Moving moves the whole bridge. Move to visit in the row's ⋯ menu takes every unit to the visit you pick, and Remove asks for a reason and removes every unit in one step, or none if one of them can't go; see Removing a bridge.
• A bridge stays in one plan. New plan from charted items offers it as one tick box, so its units always move together.

The plan's PDF lists each unit with its part, for example 34 (retainer), and a partial denture with the teeth it covers, upper arch: 12, 11, 21. Charge's list names each unit's tooth.

Booking a visit

Book this visit on a visit card — or the calendar icon at the start of the bar under the visits, which books the next unbooked visit — opens the Diary ready to book that visit. A banner across the top names the patient, the visit and how long it takes. Click a free time on the diary, or click Find a time in the banner and the diary looks for free times that fit. Once the appointment is saved, the confirmation offers to take you back to the chart. The record's Appointments tab lists the unbooked visits too, under To book, each with a Book button that does the same and comes back to that tab.

The length is the visit's own duration when you typed one, otherwise the sum of its treatments' durations; either way it is rounded up to the next 5 minutes, because the diary books in 5-minute steps. The appointment it creates is linked to the visit, which shows as Booked. A cancelled or missed appointment hands the visit back, so it reappears in the unbooked visits worklist and can be rebooked. A booked visit cannot be removed from the plan.

Charging and completing

The bar under the visits starts with a joined group of bordered icon buttons — book the next unbooked visit, Regenerate PDF once presented, Edit on a draft, Cancel plan, the signature once accepted, and the menu (decline, reopen) — each greyed out when the plan's state or your role does not allow it. Then the plan's Total and what is Uncharged — completed treatments that have no charge on the ledger yet — in bold. Charge posts the next one; its arrow lists Charge next and every uncharged treatment with its fee, so you can pick which to charge. Ticking a treatment's box completes it (a service date, which starts on today's date at the practice, a location, which starts on the treatment's own, and, for a supervised clinician, the supervising dentist); Complete treatment plan closes the plan once its work is done.

A treatment's details and notes

Click a treatment's name, or the arrow beside it, to open it in place. The left side holds its details; the right side holds its clinical notes.

Save stays greyed out until you change something and saves the details and any new note together; Cancel discards your edits and closes the row. The foot of the details shows when the treatment was last updated; rest the pointer on it for the exact time.

Who can change what

• Price, Price list, Invoice description and Duration need the Adjust treatment prices, invoice wording & durations permission, listed under Compare roles on Settings → Team members. Owners, managers, dentists, hygienists and the front desk hold it; nurses do not.
• Practitioner and Completed on need the right to complete procedures: owners, managers, dentists and hygienists. Completed on can only be changed on a completed treatment.

A field you cannot change is greyed out. Every change is recorded in the activity log against the patient.

Practitioner and Completed by

Practitioner is who the treatment is attributed to: it is shown on the row, it goes on the treatment's charge, and it counts in the income reports. You can change it even after the treatment is completed, as long as the treatment is not locked. Only a clinician who may complete procedures can be chosen, so not a nurse.

Changing the Practitioner or Completed on of a completed treatment corrects it in place: the earlier practitioner and date are kept on record as history, with who made the change and when.

Completed by is the clinician who completed the treatment under their professional registration, and it never changes. When it differs from the practitioner, it is shown under the Practitioner field. An insurance claim always bills the dentist who completed the treatment, not the practitioner it is attributed to.

Changing Completed on does not move a recall that completing the treatment already scheduled; adjust it under Recalls.

Changing the price

A new Price or Price list replaces the treatment with a new version at the same place in the plan. The earlier version stays on the record as history, struck through, and the new one keeps everything else: its completion, who recorded and completed it, and its notes. Choosing another price list prices the treatment from that list, on the date it was done or today, unless you type a price as well. An NHS price list sets its own fees, so you cannot type a price on one.

A treatment priced from a price list's discount keeps how its price was reached: under Price it reads, for example, "10% off £100.00 (Members, priced Mon 12 Oct 26)", and pointing at the treatment's price in the plan shows the same. The plan the patient is shown keeps it too: its document reads "10% off £100.00" under the fee. A typed price carries no such note. A change to the list's discount later never moves the price of treatment already planned, accepted or charged; choosing another price list prices it again from that list.

On a draft plan the new price simply replaces the old one. On a presented, accepted or in-progress plan, Save first asks you to confirm, because the plan goes back to draft as a new version: the patient must be shown the new fee and accept it again. Changing any other field leaves the plan as it is.

Invoice wording and duration

The Invoice description (up to 500 characters) becomes the line on the ledger when the treatment is charged, and so the line on the patient's invoice. The plan's PDF keeps the treatment's own name, which is what the patient was shown.

Duration feeds the visit's length: a visit without a duration of its own books for the sum of its treatments' minutes, rounded up to the next 5 minutes (see Booking a visit).

When a treatment is locked

A treatment's details cannot be changed once:

• it has been charged on the ledger — reversing the charge unlocks it again;
• it is on an open or paid insurance claim, including a rejected claim that can still be resubmitted;
• it is an item on an NHS course of treatment — a bridge on a course is locked as a whole, every unit of it;
• the plan is closed (completed, cancelled or declined).

Treatments synced or imported from other practice software, and treatments that were referred out or voided, are read-only too. The row's lock shows a charged treatment; if a claim or an NHS course holds it, Save tells you so.

Notes on a treatment

The right side lists the treatment's clinical notes — including those written before it was re-priced — newest first. They are ordinary clinical notes of the procedure kind, so they also appear in the Notes tab, and they follow the same path: draft, then complete, then sign. Edit opens a draft in the note editor; Complete, Sign and Add addendum work as in the Notes tab, and an addendum stays on the same treatment.

To write a new note, type in the editor under the list — Insert template in its toolbar adds a note template where the cursor is — and click Save. The note is saved as a draft under your name. A nurse also chooses the supervising dentist, and when the treatment has no location you choose one. Writing a note needs your account to be linked to a practitioner profile; without one, a hint takes the editor's place.

Placed devices

A completed treatment that places an implant or another device shows Placed devices under its details: the devices recorded on it, with Record device, Correct and Entered in error. Scanning the box's barcode fills in the GTIN, lot, serial number and expiry. See Placed devices and lot recalls.

Unsaved edits and failed saves

While a save runs, the fields and the editor are read-only, so nothing you type is lost. If one part fails — the details or the new note — the other part is still saved, and the failed one stays as you left it, marked Not saved. If someone else changed the treatment since you opened it, your values stay in the form: Save again to keep yours, or Cancel to discard them.

Closing a row with unsaved edits asks whether to save or discard them. While a row has unsaved edits, the actions that would move or remove it — its Move to visit, removing its visit, Edit, Cancel plan, Declined and Complete treatment plan — are greyed out until you save or discard. Charting onto that treatment — ⇧-clicking a surface of it on the chart, say — is refused the same way. Switching to another plan's tab, Images or History keeps your edits.

Who can do what

Notes on a treatment follow the clinical notes rules: dentists and hygienists write and sign them, a nurse writes them under a supervising dentist, and the front desk reads them.

Episodes

An episode is a name you give one course of care that runs across plans — "Implant UL6", "Ortho 2026". An implant placed under one plan and restored under another, or a referral sent before any plan, then has one home. An episode has no fixed types or milestones: its timeline shows where the course stands.

What an episode gathers

You link plans, lab cases and referrals to an episode. Everything else follows from those links:

• a linked plan's visits and treatments;
• a treatment's notes, images, placed devices, lab cases and referrals;
• the linked lab cases and referrals themselves.

Recalls aren't shown: Smileline can't tell which course of care a recall came from. A record belongs to one episode at a time; moving it is a removal from one and an add to the other.

Open and link an episode

The patient's active episodes show as chips above the plans on the Chart tab. To start one, click New episode… there, give it a title, the day it opened (not in the future at the site) and the site when the practice has more than one, and click Open episode.

• A plan's header has an Episode chip: link the plan to an active episode, start a New episode… with it, or Remove from episode.
• The lab case and referral dialogs on Documents have an optional Episode select.

Click a chip to open the episode beside the record: its title, status and dates, and one timeline across plans, visits, treatments, notes, images, devices, lab cases and referrals, newest first. Load more shows older entries until you reach the start. Each part of the timeline shows only what your role may read: someone who can't read lab cases sees no lab cases in it.

Closing, reopening and entered in error

• Close first lists what the episode still has open, for example a plan in progress or a lab case awaiting its fit, then offers Close anyway. Closing changes nothing it gathers: unfinished plans, lab cases and referrals stay open in their usual places. Closed episodes are listed under Closed episodes.
• Reopen makes a closed episode active again.
• Entered in error marks an episode opened by mistake, with a reason. It stays as history and shows only under Show entered in error.
• Rename changes the title.

If someone else changed the episode since you opened it, the change is refused and the episode reloads; check it and try again.

Anyone who can write treatment plans opens, links, renames and closes episodes; linking a lab case or a referral also needs permission to manage those. Seeing an episode needs permission to read treatment plans. A patient with an episode can't be merged into another record, and an episode is kept with the patient's other clinical records when they are erased.

Templates

The Plan templates tab of the treatment list beside the chart lists your treatment templates (kept under Settings → Treatment templates). Click one to add its procedures, in one step, to the plan whose tab is open under the chart — priced from the plan's price list at the plan's location and grouped into the template's visits.

• With no open plan, a new Treatment plan draft is created first.
• On a plan the patient has seen, you are asked first, as for any other item.
• A hygienist's or therapist's template carries their supervising dentist.
• Treatments the template adds without a tooth can be put on one with Place on tooth.

Anyone who can chart can apply a template.