CALENDAR YEAR VS FISCAL YEAR
Solutions
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Description
Please read it and feel free to ask if you have any questions.
December 19, 2022
Before we discuss the calendar year and fiscal year, we must first understand what a year plan is.
A YEAR PLAN is a span of period, which could be the current year or a span of 12 months, by which becomes the basis of many procedures being effective or not. After the year plan of the patient ends, a new year plan would start if the patient continues with the insurance. This means that many of the services would be “replenished” in some sort of way.
For example, a patient is eligible for 2 teeth cleaning sessions (prophylaxis) for one year plan. This means that within that specific year plan, the patient can only have 2 prophylaxis by the insurance. If the patient had used up the two prophylaxis services, then the next time the patient would get another 2 teeth cleaning sessions from the insurance would be the next year's plan.
Many procedures are given a time frame ( one calendar or one fiscal year) where the patients can use them. So what is the difference between the CALENDAR YEAR and the FISCAL YEAR?
CALENDAR YEAR
In this one, the insurance is effective from the current year only.
If the plan starts on January 1, 2022, then that year plan ends on December 31, 2022. The next year's plan would be from January 1, 2023, and this plan would end exactly December 31, 2023.
If the plan starts on March 1, 2022, then that year plan still ends on December 31, 2022. The next year plan would be from January 1, 2023 to December 31, 2023.
Therefore, this is how a calendar year works, if the year plan starts at March 1, 2022.
Calendar year 1 – March 1, 2022 to December 31, 2022
Calendar year 2 – January 1, 2023 to December 31, 2023
Calendar year 3 – January 1, 2024 to December 31, 2024
How do I apply the calendar in procedures?
If the current year is 2023, and the patient has 2 dental exams (D0120) procedures, then those two exams can only be performed for the year 2023. If the patient wants a third dental exam (D0120), then this will not be paid by the insurance. The next paid dental exam will be by next year starting January 1, 2024.
HOW ABOUT FISCAL YEAR?
Another term for FISCAL YEAR is CONTRACT PERIOD.
Fiscal year completes the span of 12 months for every year plan. Unlike the calendar year, which could only be for the current year, fiscal year completes a 12-month count starting from the effective date of the plan.
For example, if the plan of the patient started May 1, 2023, it will end at April 20, 2024.
If the plan started at June 1, 2023, then if will end at May 31, 2024.
Therefore, this is how a fiscal year works if the year plan starts at June 1, 2022.
Fiscal year 1 – June 1, 2023 – May 31, 2024
Fiscal year 2 – June 1, 2024 – May 31, 2025
Fiscal year 3 – June 1, 2025 – Mary 31, 2026
How do I apply fiscal year in procedures?
If a patient under the fiscal year June 1, 2023 – May 31, 2024, has 2 dental exam (D0120) in one fiscal year, then the patient can technically have 2 dental exams from June 1, 2023 up to the next year of May 31, 2024.
Please just keep in mind that in fiscal year or contract period, you must be aware of counting the correct number of months since it is not as straightforward as plans under the calendar year period.
A YEAR PLAN is a span of period, which could be the current year or a span of 12 months, by which becomes the basis of many procedures being effective or not. After the year plan of the patient ends, a new year plan would start if the patient continues with the insurance. This means that many of the services would be “replenished” in some sort of way.
For example, a patient is eligible for 2 teeth cleaning sessions (prophylaxis) for one year plan. This means that within that specific year plan, the patient can only have 2 prophylaxis by the insurance. If the patient had used up the two prophylaxis services, then the next time the patient would get another 2 teeth cleaning sessions from the insurance would be the next year's plan.
Many procedures are given a time frame ( one calendar or one fiscal year) where the patients can use them. So what is the difference between the CALENDAR YEAR and the FISCAL YEAR?
CALENDAR YEAR
In this one, the insurance is effective from the current year only.
If the plan starts on January 1, 2022, then that year plan ends on December 31, 2022. The next year's plan would be from January 1, 2023, and this plan would end exactly December 31, 2023.
If the plan starts on March 1, 2022, then that year plan still ends on December 31, 2022. The next year plan would be from January 1, 2023 to December 31, 2023.
Therefore, this is how a calendar year works, if the year plan starts at March 1, 2022.
Calendar year 1 – March 1, 2022 to December 31, 2022
Calendar year 2 – January 1, 2023 to December 31, 2023
Calendar year 3 – January 1, 2024 to December 31, 2024
How do I apply the calendar in procedures?
If the current year is 2023, and the patient has 2 dental exams (D0120) procedures, then those two exams can only be performed for the year 2023. If the patient wants a third dental exam (D0120), then this will not be paid by the insurance. The next paid dental exam will be by next year starting January 1, 2024.
HOW ABOUT FISCAL YEAR?
Another term for FISCAL YEAR is CONTRACT PERIOD.
Fiscal year completes the span of 12 months for every year plan. Unlike the calendar year, which could only be for the current year, fiscal year completes a 12-month count starting from the effective date of the plan.
For example, if the plan of the patient started May 1, 2023, it will end at April 20, 2024.
If the plan started at June 1, 2023, then if will end at May 31, 2024.
Therefore, this is how a fiscal year works if the year plan starts at June 1, 2022.
Fiscal year 1 – June 1, 2023 – May 31, 2024
Fiscal year 2 – June 1, 2024 – May 31, 2025
Fiscal year 3 – June 1, 2025 – Mary 31, 2026
How do I apply fiscal year in procedures?
If a patient under the fiscal year June 1, 2023 – May 31, 2024, has 2 dental exam (D0120) in one fiscal year, then the patient can technically have 2 dental exams from June 1, 2023 up to the next year of May 31, 2024.
Please just keep in mind that in fiscal year or contract period, you must be aware of counting the correct number of months since it is not as straightforward as plans under the calendar year period.