What does Last Treatment mean?

Quick Answer:

Last treatment means the last time a client did any of the following BECAUSE of their condition:

  • Went to the Doctor
  • Took medication
  • Upped their medication dosage
  • Lowered their medication dosage
  • Changed their medication brand
  • Did anything BECAUSE of their medication
  • Took maintenance treatment
  • Had homeopathic or other non-drug therapy (including, but not limited to physical therapy, massage, acupuncturist, chiropractor, etc)

So if your client went to the doctor last week because of their heart attack 3 years ago (their doctor told them to come in, however they wouldn't have had to do that if they didn't have that heart attack), we would consider the date of their last treatment the day of that appointment.


Each carrier treats treatment differently.  Some carriers don't care about maintenance treatment, some carriers do.  Some carriers have different definitions of treatment that don't correspond to other carriers.  Treatment is the hardest thing to nail down.  We decided to go with a logical English-based approach.  We all know what the word means in English, "medical care given to a patient for an illness or injury," however Insurance Companies don't necessarily define it that way.  Some define it as "medical care given to a patient to improve the state of an illness or injury" or as "medical care given to a patient to maintain or improve the state of an illness or injury."  Both are slightly different.  We programmed in solutions into BestPlanPro to compensate for this.  It's better to use the more restrictive definition of treatment across the board so we can have a more systematic approach to medications/conditions.

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