Patient-Records Tag Archive

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Re-activate Non Responsive Patients; Technology that Pays for Itself

reactivate

Action Run is an online e-service that contacts and re-activates non-responsive patients. This is not a new idea, what is new are the tools that ActionRun has developed and applied to this task.

Early attempts to use digital technology to re-activate patients simply automated the tasks we had sought to do with paper records. That is to look up patients who have not been seen in a couple of years and then send them a notice. A slightly more sophisticated application could scan uncompleted treatment plans and send messages to those people which could even include a motivational note.

However, a car is not merely a faster horse. To truly take advantage of the power of digital technology we can apply tools that were just not possible with paper records; tools that essentially mimic the thought processes of a human mind

Here is a really simple example. The computer examines records and discovers a patient who had a root canal completed on a molar but has no record of ever having a final restoration placed on that tooth. The system knows this is a potential problem; with no intervention from a human operator.  The patient is then contacted and advised to return for treatment.

I am working with this company because I believe that they are using sophisticated digital technology in creative ways. For example with Action Run: Data is retrieved from your dental office computer and is analyzed (mined) by a sophisticated system online (in the cloud). Based on over a million transactions a self learning system (artificial intelligence) identifies a patient needing treatment. Based on his/her need the patient is contacted (data base marketing). All your office staff needs to do is answer the phone when the patient calls to schedule (automated e-service)

Two additional items to note: Early users have had amazing success with an ROI of six or seven to one. That is for every dollar they invest in the system they get six dollars in increased production. Second. These kinds of creative systems can be used in many areas; re-activation is just the beginning.

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REAL Recall – Recall Systems For The Modern Practice

REAL Recall – Matching Advancements in Practice Management and Clinical Dentistry

Dentistry has been practiced since 7,000 BC and “Modern” dentistry began with the establishment of the first dental school, Baltimore College of Dental Surgery, in 1840.  Since that time, now nearly 170 years later, clinical knowledge and technology have advanced considerably.

Today’s dental office is far more effective and efficient than its counterpart from one hundred years ago. Yet, many office’s business systems appear to have never evolved with their clinic. Modern dentistry is performed using drill technology that has advanced light years from its initial implementation. A dentists now also utilize air abrasion and lasers! Clinical dentistry has come “a long way baby….” as Livvie Matthews points out in her great article. And yet, the average business office that supports them still tries to operate out of a shoe box to mail announcements, reminders, and notices to patients (AND will rationalize and justify why this is a “good” thing!).

Does Patient Perception Matter?

Patient perception of how “modern” an office is – while seemingly intangible – is far more valuable than almost any other aspect of marketing and management. It directly impacts case acceptance, appointment compliance, referrals to other friends and family, and overall practice production.  Handing a person a blank card for them to hand-write their own appointment reminder TODAY is the equivalent of inviting them into a dental practice that still uses a stone-aged bow-drill….it does not inspire confidence or provide anything to brag about.

Since the clinical team has the technology chair-side to impress the patient with Jedi skills (which, unfortunately, most patients often fail to notice), should not the main stage also be set with identical capabilities?  Luke Skywalker did not ONLY have a light saber that was rarely used…..he had both C-3PO and R2-D2 beside him providing him with information AND doing a great deal of work autonomously!   Every modern dental office today can and should have the same level of artificial intelligence working in the office – 24 x 7 – 365 days a year

Get Ready, Here Comes the Future of Dental Recall Systems!

Each patient is unique in their dental needs and challenges. While the advertising industry has imprinted everyone with the concept “Visit your dentist twice a year”, we all know that patients may actually require a different visit frequency. This schedule is normally determined and documented in the practice management system (PMS) used by your clinical team.  This key information, along with the date of last cleaning (not to be confused with the date of  last visit) is vital to know when a patient is “due” to visit the office again – for an actual cleaning.  At each patient’s visit, they may choose to commit to a future appointment (that they may or may not keep…) or they may choose to wait to make an appointment until the time gets nearer.   Either decision creates a bunch of “future work” for the office, that either can be handled as best as possible (i.e. inefficiently with all of the normal day to day transactions), or can be given to the artificial intelligence to handle flawlessly.

For the patient that DID make an appointment 6 months from now:

Manual Approach: The current manual challenge is to correctly write up and hand patients a little appointment card (that will be lost somewhere between the front desk and the parking lot…) and then wait.   Hopefully, anywhere between 4 to 6 months from now, a staff member will have the time to generate printed reminder cards (if the office is semi-modern) or alternatively pull hand written cards (of which many no longer are relevant) and get them into the mail with the hope that the patient will arrive at the appointment made 6 months ago.

Automated Approach: If an “artificial intelligence” is given the job, the dedication to detail is far greater and provides the patient with a “wow” factor that they will share with their friends.   As the patient is checking out from the current cleaning appointment, and commits to that time 6 months in the future – they will receive a “Save the Date” email that will meet them when they get to their office / home where it will have a much greater probability of being added to their “official” calendar and remembered. As the actual appointment draws nearer, the computer (with no need for human intervention to run reports, start tasks, etc) will know when to start “reminding” patients that they have an appointment – and will do this using a variety of tools  including e-mail, text-messaging, automated phone call, and yes – even a postcard (you want to have a 100% solution).    On the day of the appointment, the computer can (and will) send reminder text messages to make sure that last minute distractions do not result in an idle chair, a bored hygienist, and a frantic conversation with the patient 10 minutes after their appointment start time.

For the patient that did NOT make an appointment for 6 months from now:

Yes, I am one of those (And yes there are many more like me. How do I know what will happen six months from now?)  who checkout and will “call back” to make an appointment 6 months from now. Better yet, I’ll just “wait for the notice” to arrive in the mail?

Manual approach: The current manual challenge is to keep up with all of these “patients of record – but not on the book” people to try to get them converted back to actual made appointments (which then must be cared for in the same manner above!).  Hopefully with the help of a practice management system – some team member, when they have the time, will run the necessary reports on a regular enough schedule to identify a bunch of patients that need to be “worked on”.  This work would be phone calling or loading cards into a printer to print / stamp / mail. The importance of this task is critical, yet it relies on many faulty components – starting with the practice management system (of which many do NOT accurately identify patients that need to be contacted), the knowledge of the tasks and systems by ever changing staff members, and the actual time available to DO the work.

Automated Approach: When an “artificial intelligence” (Again, think R2D2 and C3PO here) takes on this critical job in real time, it is analyzing every patient and appointment to know WHO is on recall but not currently scheduled for a recall appointment.  The computer will then use all of the tools mentioned above to insure the correct message is sent at the correct time resulting in an appointment being made (and then doing everything mentioned above to make sure the appointment is kept).   If the patient is non-responsive to every “touch” (e-mail, text, postcard, etc.) the computer will NOT allow the patient to fall through the crack and will continue to contact patients that are past-due AND will send notices to the office staff for occasional assistance (so a person can talk to them when it is actually needed).   This will provide the office with the double benefit of KNOWING a critical aspect of the office is covered (no vacations, no sick days, no holidays) and more “found time” is now  available for staff members to focus on items that require a personal touch.

Once the artificial intelligence is turned on in the office and the key tasks are taken care of, there are many other items that can be added to the chore list:

–        Chart Audit / Reactivation (done daily instead whenever….)
–        Morning Huddle Report (review of yesterday, today and tomorrow)
–        Remote Access to office from smart phones and other devices
–        Confirmation calling and texting (what more people are expecting)
–        Statistical analysis and review of office activities and status

Most modern practices today can enable these automated systems for pennies a day. This addition to your practice management system will help your practice be perceived as a  modern, “leading edge” healthcare provider. Just as Luke Skywalker had his choice of robots, you have a variety of choices for automated practice management services.  A dental appointment book and dental patients is very special and has many subtle nuances (like differentiating between a cleaning visit versus a restorative visit or knowing the cleaning interval of each specific patient) that you want to make sure the artificial intelligence you “hire” (they are just a robot applying for a job) is aware of.    Lastly, which ever artificial intelligence you hire should be expected to show up and work each day – with no contract required.   As long as they are meeting your needs, you will continue to use them for everyone’s benefit.   If they cannot perform the job as you expect – or someone better comes along – you should NOT be forced to continue doing business with them because of a contract……unless you are getting the same contractual commitment from your patients?

____________________________________________________________________________________
Allen Jorgensen is a front office manager for his wife’s practice started from scratch in 1994 as an all digital and chartless practice.   Over the years he has applied his 30+ years of commercial data processing experience to automate every aspect of a traditional dental office.    North Gwinnett Dental Care is located in Sugar Hill Georgia and continues to host office tours for anyone interested in seeing how a 15+ year digital office operates.   Allen is also the CFO of Lighthouse Practice Management Group which provides automation solutions to dental offices around the world.   For more information visit www.lpmg360.com or call 888-427-5454 x 88

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Your Secret Weapon…Obnoxiously Detailed Narratives

You’ve experienced it before…the dreaded letter from a patient’s insurance company: We need more information, there is not enough evidence of need, please send us a diagnostic film (after you have initially sent one!). Several things are critical when submitting dental claims on behalf of your patient:

  • Most patients are unaware that employers set the boundaries and limitations on their employee’s dental benefit plan
  • Initially writing a good “obnoxiously detailed” narrative is imperative to resolving your patient’s claim early
  • Diagnostic films are two-dimensional and don’t necessarily tell the whole story. A detailed narrative and/or attaching a photo should always accompany the claim

This article will deal with the challenges dental practices face when attempting to gain dental benefit payment on behalf of their patients. Whether you accept assignment of payment or are completely “insurance free”, it is important to supply enough information for the patient to receive benefits on their claims.

First and foremost, fill out the claim form correctly. Just because you supplied the insurance company with a diagnostic film doesn’t guarantee they will acknowledge receiving the attachment unless you mark the box on the claim form that you supplied the film. The same thing applies for the diagnostic photo. The most recent ADA claim form has a place to check notifying the insurance company that this information has been sent. When a narrative is attached to the claim form, mark directly on the form that you included a detailed narrative. Draw attention to your claim by highlighting any pertinent information. Most often, when a claim has a narrative attached, it must be referred to a live person for review therefore reducing the risk of requesting more information.

There is a wonderful tool available to dental practices now that allows the financial coordinator to send supporting information electronically. An electronic claims attachment service can allow you to send your attachments electronically. Note, not all insurance companies are accepting electronic attachments. However, there are enough insurance companies that will accept electronic attachments which can help to de-stress your environment greatly. Just remember to make full use of the tools available to you and you will have greater success!

Below is a sample narrative which can be uniquely detailed to each patient’s dental condition warranting the need for treatment.

Narrative Sample for insurance claim

Date___________________________
Patient_________________________
Insurance Co.___________________
Group #________________________
ID#___________________________

Dear Dental Consultant:

A ___________________ has been prescribed for restoration of tooth #____ because:

_____1. The _______________________________cusp(s) has/have been destroyed by caries or fracture and require restoration.
_____2. The _______________________________cusp(s) has/have been undermined by caries and/or previous restorations.
_____3. The tooth has a symptomatic crack or fracture on the ________________________________surface(s).
_____4. The tooth has had endodontic treatment.
_____5. There is recurrent decay under the present___________________.
_____6. Other: __________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________

Note: Prosthesis/or restoration is/is not an initial placement.
Date of prior placement ____________________________.
Extraction date ___________________________________.
A Bitewing ______ , or periapical(s) _______ x-ray(s) is /are enclosed.

Sincerely,
_______________________________________________________
Attending Dentist

One stumbling block which dental practices face is creating a narrative claim form that is too generic. The insurance industry calls this “not patient specific”. So, a word of caution…always be sure to design your narrative form in a way which allows the patient’s unique condition to be conveyed on the form.

Make sure that the treatment rendered matches what is listed on the claim form. If a dental benefit plan has an “alternate benefit” clause on the contract, there can be an opportunity to ask for an alternate benefit. For example; a fixed bridge is recommended but, the dental benefit plan has a “missing tooth clause”, which means if the tooth was missing prior to the effective date of coverage then the fixed bridge would not be a covered benefit. An alternate benefit equal to individual crowns on the abutment teeth can be requested. Please remember, it is imperative to bill for the procedure(s) that were actually performed. Therefore, bill for a fixed bridge utilizing the fixed bridge codes and in the detailed narrative, request an alternate benefit for individual crowns on the abutment teeth. A benefit for the pontic will most likely not be available if the tooth was missing prior to the effective date of coverage regardless of the available benefit for individual crown. Never promise the patient that their insurance company will cover an alternate benefit. Let your patient know that you will give it your “best attempt”. Patients want to know you cared enough to try.

Always be prepared to involve your patient in the process. They are your “squeaky wheel” and can always go to their employer to have the decision on their claim reversed and considered for benefit. Have your patient use the information available to them to make them your best weapon in resolving claims issues.

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Lois Banta is CEO, President and Founder of Banta Consulting, Inc., a company that specializes in all aspects of dental practice management. Lois has over 35 years of dental experience and consults and speaks nationally and internationally. She is also the owner of The Speaking Consulting Network. To contact Lois for a personal consultation or to invite Lois to speak to your organization; Office-816/847-2055, Address: 33010 NE Pink Hill Rd, Grain Valley, MO 64029, Email: lois@bantaconsulting.com or check out her website: www.bantaconsulting.com.

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