Tuesday, January 31, 2012

Where do I Make all my Notes . . . part 4 of 4

Whoopee! We’re almost through with our whirlwind tour of notes fields your Front Office can use to keep consistent and accessible documentation of personal, treatment-related, and financial information.  Of course, no Front Office notes guide would be complete without taking a look at the best way to use notes to support a smooth relationship with the insurance company.  So, here we go!
When you are working your Insurance Aging Report do you know where to document your conversation with the insurance company?  Do you know where to insert your clinical narrative for the claim?  Let’s review the three notes boxes on the insurance claim that are designed to capture pertinent information. 
The Claim Status Note is used for keeping track of where the claim is in the process for payment.  If you talk to a claim representative at the insurance company, this is where you would want to document the conversation.  To enter a Claim Status Note, just double click on this box, insert the dateline and document who you talked to and what was said.  The next time you print an Insurance Aging report, these status notes will print on the report.  You can also use the Claim Status note to document if you re-send a claim.  Just click on the re-sent box and enter the date the claim was re-sent.
The Remarks for Unusual Services box is where you’ll type the procedure justification or the detailed narrative.  For example: Type II Perio or mass amal failing, recurrent decay, fx off DB cusps, etc. 
The Insurance Plan Note is kind of a cool one.  This note field pulls information directly from the same insurance note box located in the Family File, in the coverage table section.  Having the same note accessible through both places allows you to enter information here from the insurance claim side without having to open up the Family File and entering it through the insurance edit.
A parting tip on notes – don’t type so much!
Now that you’ve gone chartless and are making all your notes in the Dentrix software, do you ever feel like you are typing too much?  Does it feel like all this note entry is slowing you down?  Well the programmers down at Dentrix headquarters want to make it easier for you.  They’ve added several templates that can be used in many of the notes boxes throughout Dentrix.  You can also make your own templates with your frequently-used phrases or notes.  To create your own templates, go to the Office Manager, click on Maintenance, Practice Setup and scroll down to Custom Notes. There, you can add your own templates; all you have to do is click on the sentence you want to add and it dumps in the text for you without typing. 
Well that wraps up my segment about Where Do I Make My Notes? for the Front Office.  Coming up soon, we’ll focus on clinical side documentation and review where to make your notes pertaining to treatment, procedures, health history and all else clinical.  So, stay tuned for the “Where Do I Make My Notes? Clinical Edition”!

Sunday, January 22, 2012

Where do I Make all my Notes . . . part 3 of 4

You may be noticing that there are many places in Dentrix to make notes!  So far, we’ve looked at the Office Journal, the Patient Note, the Patient Alert, and the Motivational Notes.  My hope is that this information clarifies the options you have for entering notes and allows you to make consistent and informed choices about when to use which type of note.  Now I know this might be a tad overwhelming, but take a deep breath and read on – we’re not done learning yet!  Today, we’ll look at some of the different notes fields within the Patient Ledger
Guarantor Notes and Statement Notes
Within the patient ledger there are two note boxes, the Guarantor Note and the Statement Note -  that are used primarily by the billing department.  The thing to remember about the Guarantor Note box is that it is for information that pertains to a whole family and not just an individual patient.  If you make a note in this box it will show on every family members account.  Some examples of what to enter in here are an alternate mailing address for the statement, billing instructions for divorced parents or a reminder that the family has a credit card on file in your Power Pay system.   NOTE:  The Power Pay credit card processing program meets all the credit card protection laws and is a safe place to store credit card information; the Guarantor Note box is not.
The Statement Note is used to put a note on the bottom of the patient’s billing statement.  You can set a particular statement note to print just once, or you can set  an ending date so it will print for several billing cycles.  If the insurance just paid in full for a family you might write this in the statement note: “Judy, all your insurance has paid, this is your patient portion.”  Your statement notes will show up on the statement whether your office is printing statements in house or sending them through Quickbill.
Transaction Notes
Also in the patient ledger, you will find all your posted treatments, payments and adjustments.  Each of these transactions has a corresponding note box that you access by double clicking on it.  The purpose of these note boxes is to further clarify what the transaction was for.  For example, if you receive a payment from Gramma Sue from North Dakota, you might want to make a note of that in the note box for that payment.  Or if the office has an adjustment code called “Misc Adjustment” you might want to write a note specifically to what that adjustment was for.  This kind of clarifying note is especially important if your doctor reviews his adjustment reports every month  - it is a good idea to provide
Now that wasn’t so bad, was it?  We covered five more types of notes fields and you barely felt a thing.  Tune in next week to learn about three final notes fields that will help you keep your relationship with insurance companies running smoothly.

Monday, January 16, 2012

Where do I Make all my Notes . . . part 2 of 4

Think before you Pop – A controlled approach to using Patient Alerts
I realize that most of you already know how to use the Patient Alerts note box in the Dentrix system, but I am here to say “People please control your pop-ups!”  When used thoughtfully, the Patient Alert can be a very effective way to make sure that your note gets noticed.  However, if you create too many pop-ups, your team members will start to ignore them and even start by-passing them because they are so annoying. 
When you are creating a Patient Alert, pause for a second and ask yourself who really needs to read it.  For example, the Patient Alert is a great way to notify the front office team if a patient has a collection issue.  For this type of note, you might only want it to pop-up when opening the Family File, making a new appointment, opening the ledger and editing an existing appointment.  However, if the Patient Alert is to put the staff on notice that this patient needs to take Pre-med prior to their dental visit, you might want the note to pop-up in the clinical chart as well as for the front office departments because it effects both the front office person who needs to remind the patient to take it and the clinical team member that needs to be reminded to ask the patient if they remembered to take it. 
Using Motivational Notes
In the Family File in the Continuing Care field (where you would go to edit a patients’ cleaning frequency) there is a Motivational Note box.  I’m guessing this type of note will be new to some of you because it is a bit out of the way.  Notes made in this box can be used to track internal issues such as what the patient needs to come in for next, or it can be used to print on the recall cards.  Internal uses might include things like: What hygienist the patient likes to see, a reminder that the patient should bring his nightguard to his next visit, or a note to yourself that the patient is alternating between the periodontist and general dentist.  Just be sure that if you decide to use this note box to add something personal onto the patient post card, you do not insert any personal health information such as diagnosis, test results or treatment plan information as this would violate the HIPAA Privacy Act. 
I hope these articles are helping you to create some consistency for your office with respect to where to document patient information.  Keep reading into next week for more tips on "Where to make all your notes".

Monday, January 9, 2012

Where do I Make all my Notes . . . part 1 of 4

Is your office transitioning from paper charts to electronic health records?  Do you feel like everyone in your office makes notes in totally random places in Dentrix and you can never find anything?  Do you wish there was more consistency in your office?  If you answered “yes” to any of the above, read on for some advice that can help you put your notes in order.
Let’s start with the Front Office . . .
Using the Office Journal for your front office communication can be a very powerful tool for documenting conversations with your patients.  I recommend using the Office Journal for all phone conversations (non-clinical), collection calls, hygiene calls, and treatment follow-up calls, because it is easy to get to (you can get there from any Dentrix module, the Collections Manager Report, the Treatment Manager Report and the Continuing Care List) and it keeps a comprehensive log of patient correspondence. The Office Journal  will also date and time stamp each note automatically so you can see exactly when the conversation happened, which staff member talked to the patient, and what was said..  This can really help when you have different staff members making calls to patients, because your staff can view each other’s notes and avoid duplicating each other’s efforts or making the patient angry with too many phone calls.
While the Office Journal is great for capturing a record of each communication event with a particular patient, it is not the best place to store information about your patient’s personal profile – you know, like who their spouse is, what their kids names are, and what big events are coming up for them.  You don’t want to have to review a whole Journal of notes to get to this information – it is much more useful to have it in one place for quick review.  So, for your patient profile information, I recommend using the Patient Note, located on the Family File. “The Patient Note!” should be your answer when the doctor asks, “Where should I make a note about the Johnson’s vacation to Hawaii?”  Any notes entered here are only viewable on the Family File, however they will print out on the Dentrix route slip and when printing a patient notes report.  (See my blog archive for information on the Patient Route Slip)  As you use the Office Journal, the Patient Note, and the other notes that I’ll cover in upcoming posts, just remember:  CONSISTENCY IS KEY!  These guidelines can be a great starting point for getting everyone on board with one way of using your notes.  You might even begin by printing this and sharing with your entire front office team.  You could also put these suggestions in your office manual to refer back to for future use or new team member training.

Wednesday, January 4, 2012

HELP! How do I run Year End?

Many of you have had time off during the holiday's and now finding yourself trying to get back into the swing of things after the New Year's celebrations.  I know I am. 

One of the things probably on your to-do list for this week or next is running Year End in your Dentrix software.  Since you only run this process once a year you might be asking yourself  "Now, how do I run a Year End again? I know I have those instructions somewhere!"  Well, great news!  Running a Year End is no different than running a Month End so just make sure you have a good backup, everyone is out of Dentrix and go through your regular routine.  If you don't have a month end routine or need some advice about what steps to go through for month end, you can send me an e-mail directly with your questions.  I can be reached at r_d_m@comcast.net.

Dentrix sent out and posted a PDF file to help answer questions for those offices that need help with the Year End Process.  Click Here to dowload and print your copy.  Since they did such a great job creating this info sheet I thought it was best to share it with you all instead of trying to re-invent the wheel. 

Happy New Year!  Bring on 2012.