Orthodontics
Larkhaven Hollow Orthodontics · Orthodontics · Duluth, MN
Celine Ellsworth is the treatment coordinator at Larkhaven Hollow Orthodontics, a two-doctor orthodontic practice in Duluth, and she bills every adjustment visit after insurance, gets each family's treatment agreement signed and chases the invoices still unpaid.
HealthcareBillingDocuments and e-sign5 tables · 7 views · 2 forms · 1 dimension set · 1 dashboard · 1 digest · 1 document · 1 notification · 1 stage rule set · 1 agent
Use this templateBilling board
InvoicesLH-30428
LH-30448
LH-30470
LH-30404
LH-30412
LH-30422
LH-30436
LH-30446
LH-30424
LH-30466
LH-30502
LH-30416
LH-30440
LH-30452
LH-30472
LH-30490
LH-30406
LH-30410
LH-30418
LH-30430
LH-30434
Tables
Invoices
38 sample rows · 15 columnsEvery adjustment and procedure billed after insurance: what the family owes, what has been paid and what is still open.
| Invoice | Patient | Treatment plan | Procedure | Fee charged | Visit date | Insurance portion |
|---|---|---|---|---|---|---|
| LH-30448 | Thaddeus Ng-Brandvold | Thaddeus Ng: braces, 24 months | Monthly adjustment, braces | $165 | Oct 17, 2026 | $82.50 |
| LH-30428 | Saffron Achebe-Lindgren | Saffron Achebe: braces, 24 months | Monthly adjustment, braces | $165 | Oct 16, 2026 | $82.50 |
| LH-30470 | Calliope Weatherspoon-Ito | Calliope Weatherspoon: braces, 24 months | Monthly adjustment, braces | $165 | Oct 15, 2026 | $82.50 |
| LH-30512 | Ottilie Brightwater | Ottilie Brightwater: braces, 24 months | Monthly adjustment, braces | $165 | Oct 10, 2026 | $82.50 |
| LH-30436 | Evander Rosenquist-Pike | Evander Rosenquist: early treatment, 12 months | Monthly adjustment, braces | $165 | Oct 9, 2026 | $66 |
| LH-30494 | Rosalind Pettigrew | Rosalind Pettigrew: clear aligners, 12 months | Aligner check and new trays | $140 | Oct 8, 2026 | $0 |
| LH-30422 | Cormac Delgado-Nyquist | Cormac Delgado: clear aligners, 14 months | Aligner check and new trays | $140 | Oct 6, 2026 | $56 |
| LH-30446 | Maren Okonjo-Halvorsen | Maren Okonjo: braces, 24 months | Retainer check | $60 | Oct 4, 2026 | $0 |
| LH-30484 | Linus Hargreave-Okafor | Linus Hargreave: clear aligners, 16 months | Aligner check and new trays | $140 | Oct 3, 2026 | $56 |
| LH-30458 | Imogen Valdivia-Strand | Imogen Valdivia: braces, 24 months | Retainer check | $60 | Sep 30, 2026 | $30 |
| LH-30412 | Leocadia Fenwick-Obi | Leocadia Fenwick: braces, 24 months | Monthly adjustment, braces | $165 | Sep 28, 2026 | $82.50 |
| LH-30500 | Desmond Aaltonen-Reyes | Desmond Aaltonen: braces, 20 months | Monthly adjustment, braces | $165 | Sep 26, 2026 | $66 |
Patients
18 sample rows · 9 columnsThe children, teens and adults in treatment, who pays for them and which insurance plan they are on.
| Patient | Date of birth | Responsible party | Phone | Insurance | Member ID | |
|---|---|---|---|---|---|---|
| Ansel Thorvaldsen-Reyes | Apr 9, 2012 | Marguerite Thorvaldsen | (218) 555-0141 | marguerite.thorvaldsen@duluthpostbox.net | LF70412137 | |
| Bastien Oyelowo-Marsh | Oct 11, 2013 | Adaeze Oyelowo | (218) 555-0149 | adaeze.oyelowo@duluthpostbox.net | NP70413233 | |
| Calliope Weatherspoon-Ito | Jan 29, 2011 | Hiroshi Ito | (218) 555-0150 | hiroshi.ito@lakehead-mailbox.net | LF70413370 | |
| Casimir Lindqvist-Tran | Apr 25, 2014 | Mai Tran | (218) 555-0157 | mai.tran@duluthpostbox.net | NP70414329 | |
| Cormac Delgado-Nyquist | Feb 17, 2013 | Ingeborg Nyquist | (218) 555-0143 | ingeborg.nyquist@duluthpostbox.net | NP70412411 | |
| Desmond Aaltonen-Reyes | Oct 8, 1992 | Desmond Aaltonen-Reyes | (218) 555-0155 | desmond.aaltonenreyes@duluthpostbox.net | NP70414055 | |
| Evander Rosenquist-Pike | Sep 30, 2014 | Renata Rosenquist | (218) 555-0145 | renata.rosenquist@duluthpostbox.net | NP70412685 | |
| Imogen Valdivia-Strand | Mar 27, 2010 | Esteban Valdivia | (218) 555-0148 | esteban.valdivia@lakehead-mailbox.net | LF70413096 | |
| Jorund Abernathy-Singh | May 14, 2015 | Priya Singh | (218) 555-0151 | priya.singh@duluthpostbox.net | NP70413507 | |
| Leocadia Fenwick-Obi | Nov 22, 2010 | Tobias Fenwick | (218) 555-0142 | tobias.fenwick@lakehead-mailbox.net | LF70412274 | |
| Linus Hargreave-Okafor | Dec 2, 2012 | Neville Hargreave | (218) 555-0153 | neville.hargreave@duluthpostbox.net | NP70413781 | |
| Maren Okonjo-Halvorsen | Dec 5, 2009 | Chidi Okonjo | (218) 555-0146 | chidi.okonjo@lakehead-mailbox.net | — |
Treatment plans
18 sample rows · 16 columnsEach patient's agreed course of treatment, its price and payment terms, and the agreement the family signs.
| Plan | Patient | Treatment | Doctor | Total fee | Down payment | Months planned |
|---|---|---|---|---|---|---|
| Jorund Abernathy: early treatment, 12 months | Jorund Abernathy-Singh | Ingrid Vasquez-Holm | $2,400 | $400 | 12 | |
| Ottilie Brightwater: braces, 24 months | Ottilie Brightwater | Caspian Linden-Ryu | $5,800 | $800 | 24 | |
| Bastien Oyelowo: clear aligners, 12 months | Bastien Oyelowo-Marsh | Ingrid Vasquez-Holm | $4,700 | $700 | 12 | |
| Saffron Achebe: braces, 24 months | Saffron Achebe-Lindgren | Ingrid Vasquez-Holm | $5,800 | $800 | 24 | |
| Thaddeus Ng: braces, 24 months | Thaddeus Ng-Brandvold | Ingrid Vasquez-Holm | $5,800 | $800 | 24 | |
| Cormac Delgado: clear aligners, 14 months | Cormac Delgado-Nyquist | Ingrid Vasquez-Holm | $4,900 | $700 | 14 | |
| Rosalind Pettigrew: clear aligners, 12 months | Rosalind Pettigrew | Caspian Linden-Ryu | $4,600 | $600 | 12 | |
| Evander Rosenquist: early treatment, 12 months | Evander Rosenquist-Pike | Caspian Linden-Ryu | $2,400 | $400 | 12 | |
| Ansel Thorvaldsen: braces, 24 months | Ansel Thorvaldsen-Reyes | Ingrid Vasquez-Holm | $5,800 | $800 | 24 | |
| Linus Hargreave: clear aligners, 16 months | Linus Hargreave-Okafor | Ingrid Vasquez-Holm | $5,100 | $700 | 16 | |
| Desmond Aaltonen: braces, 20 months | Desmond Aaltonen-Reyes | Ingrid Vasquez-Holm | $5,400 | $700 | 20 | |
| Calliope Weatherspoon: braces, 24 months | Calliope Weatherspoon-Ito | Caspian Linden-Ryu | $5,800 | $800 | 24 |
Fee schedule
12 sample rows · 4 columnsWhat the practice charges for each visit and appliance.
| Procedure | Code | Category | Fee |
|---|---|---|---|
| Records and consultation | LH-110 | $285 | |
| Braces placed, both arches | LH-210 | $395 | |
| Clear aligner delivery | LH-220 | $320 | |
| Monthly adjustment, braces | LH-310 | $165 | |
| Aligner check and new trays | LH-320 | $140 | |
| Elastics and wire change | LH-330 | $95 | |
| Retainers, both arches | LH-410 | $460 | |
| Retainer check | LH-420 | $60 | |
| Broken bracket repair | LH-510 | $85 | |
| Poking wire visit | LH-520 | $55 | |
| Debond and cleanup | LH-610 | $275 | |
| Palatal expander check | LH-620 | $120 |
Also included
- Treatment and payment agreementThe agreement a family signs before treatment starts, with the fee, the down payment and the months planned.
- Billing board
- Monday overdue digest
- Invoice overdueAlerts the coordinator when an invoice slips past its due date so a reminder call can go out.
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