Good charting software has many features. One of the most important is that it eliminates all paper. That means the software must accommodate all the bits of paper data that accumulate in a chart and it must have a method of importing virtually anything either with a scanner or file import function. If some bit of paper possibly a lab slip or patient letter must be stored in a folder then you have lost one of the primary benefits of an electronic chart.Continue Reading
Paper charts don’t just appear in the office for free. The paper folder and all the other papers cost about $2.50 each. If you have 2500 charts they cost you at least $6,250 to create and every time a new patient walks in it’s another two-fifty; cha-ching.
Other chart contents, like X-Rays and photographs can be even more costly. A set of bitewings with film, processing and mounts can be a dollar or two. A photo printed from the intraoral camera is $1.50 or more. It is reasonable to add at least another $2.00 to the cost of each chart for these contents adding another $5,000 to the cost.
Storing the records isn’t free either. A typical office with 2500 charts will need three or four full size lateral files to hold them all. Depending on how nice the files are they will cost about $4,000 and could be a lot more. They will take up office space costing another $550 per year. Plus all the “inactive” charts stashed away somewhere else?
So far our inexpensive paper files are costing us $15,800, but that’s not the total cost. There is the human effort to make the chart, type the label, arrange the contents, file new bits when they arrive in the mail, write the notes, pull the charts every day and then re-file them. And of course there is the daily ritual of the lost chart, which no one can find only to have it turn up days later either misfiled or hiding in a stack on the doctor’s desk. The human cost is at least $11,520 per year.
What we have is a paper chart system that is really quite expensive costing $15,800 to create and $11,520 per year to maintain for a total of $27,320.
Insurance CDT codes are set up by procedure and are designed primarily to track fees. However, in real life in the dental office we work on appointments not just codes. Many procedures require multiple appointments to complete. For example a traditional crown (not CAD CAM) includes a preparation and then a delivery. A denture requires impressions then a bite, a try in and then a delivery. Root canals are often multiple appointments. Then there are follow up appointments that have no fee and no code such as suture removal, bite adjustments and such.
Set up additional appointment based procedure codes, just for your practice, to accommodate all the extra appointments that do not have an assigned CDT code. The most obvious being the delivery of a crown. Doing this makes using the software much more efficient; you can create procedure notes for each extra code. You can assign a default appointment time and you can treatment plan it.
Once you have set up the formal CDT procedures and created your own appointment based codes you can create digital procedure or progress notes for each one. These are the notes you used to scribble in the chart after every appointment. When you write your digital notes start with what you usually hand write in the chart but keep in mind that you can now add detail that it is impractical to include in manual notes.