Tuesday, May 30, 2017

Every patient has unique situations so let's chart them correctly

Every patient is unique and making sure his or her tooth chart accurately represents his or her uniqueness is important when you are transitioning from that paper document to the digital document. Patients have diastemas, missing teeth, unerupted teeth, retained primary teeth and lots of other situations that you want to document on the tooth chart. How do you keep it all straight and chart it as accurately and quickly as possible?

Using the Dentrix conditions is a way that you can chart all those unique features that you find and want to make note of. You can customize the conditions with different paint types, edit the description and add them to your quick buttons for faster charting. In this article, I am going to go through a few of the common conditions and show you some screen shots of what it might look like on the tooth chart.

  • Diastema – The default condition in Dentrix for Diastema is Open Contact. So if you look in your list of Conditions and find open contact, that is the best one to use. If you want to edit the description, you can go to the Office Manager > Maintenance > Practice Setup > Procedure Code Setup > select the Conditions category, select the Open Contact and click on Edit. Then you can edit the description to say Diastema if you want.
  • Missing tooth, closed space – If you have a patient who had a four-bi extraction as a kid and the orthodontist closed the space, you can use the Drifting Mesial condition to show that the space has been closed. This could also be used if a patient lost a tooth and the teeth have moved into the open spot.
  • Unerupted tooth – If your patient has a 3rd molar or another tooth that has not fully erupted yet, you can use the condition Unerupted tooth. I have seen offices either use the U on the tooth to mark it or circle the tooth. You can choose what works best for you. If you want to change how it paints on the tooth chart, go to the Office Manager > Maintenance > Practice Setup > Procedure Code Setup > select the Conditions category, select the Unerupted and click on Edit. Then there is a drop-down menu for Paint Type.

If you have a patient with a retained primary tooth, then you would highlight the tooth and click on the Primary/Permanent icon on the tool bar and click on Change Selected to just change that one tooth. Other options here would be changing all the teeth to primary or all to permanent.

I think having an accurate picture of your patient’s dentition helps with the visual aspect and makes the perio chart more accurate. Now that many offices are using the digital record instead of paper, it is important that you treat the digital chart with as much detail as the paper chart.

Wednesday, May 24, 2017

Avoid the awkward moment of not having the lab case

Joe walks in for his scheduled appointment to deliver his nightguard and your dental assistant escorts Joe to the treatment room, puts his bib on and lets him know she would be right back to deliver his nightguard. Ashley goes back to the lab area to locate Joe’s nightguard only to find that his nightguard is not at the office. She frantically calls the lab to find out where Joe’s nightguard is and the response is, “We can have it to you by tomorrow.” Well, that’s not good enough. You need it today. How did this happen? Where was the breakdown in communication?

This common situation can be avoided with a couple tweaks in your system. Your Dentrix software can help you track both the patient appointment and the lab case.

Any time the patient has an impression for something, there will need to be a delivery or seat appointment scheduled. Either the patient will be scheduled or the patient will wait for your call to schedule when the case comes in. When you create the appointment, make sure to include all the details of the appointment and attach the lab case to the appointment. For all the details of how to use the Lab Case Manager, refer back to my blog called “What is the Status of the Lab Case?”

If the patient is scheduling, you are good to go and you will see an icon with a blue L with a white background on the appointment so you can easily see if the case is in the office or still out. When the lab case is set as received, the icon will turn into a white L with a green background.

Now, if the patient is not scheduling, then I would recommend doing all the above steps … except put the appointment on the Wait/Will Call list so you have a way of tracking the appointment. This will hold the appointment on the Unscheduled List so you have a way of keeping track of it. For more information on the Unscheduled List, please click here.

Good tracking systems will ensure that your patients don’t walk in for an appointment when your team is not prepared and will avoid those awkward moments when you have to let Joe know that he will have to reschedule to another day. 

Wednesday, May 17, 2017

Help your hygienists monitor their own goals

If you listen to a hygiene coach or consultant speak about numbers during a conference presentation, you may hear some industry standards like hygiene production needs to be 30% of practice production or they should be producing three times their salary. You will need to discover what the goals are for your hygiene department and help them reach those goals. Today, I want to help you with some tools inside Dentrix to help your hygienists monitor their goals.

Once you know what each hygienist’s individual monthly goal is, I would recommend entering those goals in the computer so your team can monitor those goals. You can enter the goal for each hygienist from the Office Manager > Analysis > Setup > Goals and select the provider ID to add the monthly goal. I would recommend adding in the goals for the entire year if you have that information available and you know everyone’s vacation schedule.

Now you can start using some of the amazing tools available in Dentrix to monitor the goals. One of my favorite ways is also a favorite for the hygienist because he or she doesn’t have to run a report. This is super easy and really helps to see the goal versus the scheduled versus the actual in a super easy to use view on the appointment book. From the appointment book, click on view at the top of the page then you can click on Add or Edit to change the view. You will need to change two things in order to see the production goal: Select the provider ID and make sure there is a check mark in View Amount. If you only want to show one provider’s goals at a time, then only select one provider for your view. Then when you click on the monthly calendar in the upper left corner of the appointment book, you will see it calculate the goal, scheduled production and actual production for that provider you selected in the view.

The next tool you can use is the Daily Huddle Report. This report will also add up the goal, scheduled production and actual production based on the provider IDs you select in your filters for the report. You can use this report as part of your morning huddle or each provider can look at it on a daily basis to see how he or she is doing for the month.

I strongly believe that the hygiene department is a highly integral part of the practice and should be held to the same accountability for production as the doctor. They just need some helpful tools to help bring awareness to the numbers.

Tuesday, May 9, 2017

Progress Notes vs. Clinical Notes

As you start to use the patient chart more and more, it is important to understand the difference between the Progress Notes tab and the Clinical Notes tab at the bottom of the patient chart module. The reason I feel it is important is because they show different things and sometimes offices get confused with the language. I also want to show you how these two modules work together and how you can make your chart review each day a lot easier.

  • Progress Notes: Progress Notes keeps track of procedure codes and the status of those procedure codes. You will also notice there are columns of information with symbols and things that I will explain. These symbols will help you visually to know if there is more information about that procedure code.
    • The Date, Tooth, Surface, Description and Provider columns are all pretty self-explanatory so I will not go into a lot of detail about these.
    • “N” column = If you see a musical note here, it means there is a note on the procedure code. I love this note box for the diagnosis and the reason why you are treatment planning that procedure. For information about this note box, CLICK HERE.
    •  “R” column = If you see a > in this box, it means this procedure has been referred out to a specialist. So it would be very common to see a musical note for the reason why along with a > for the referral. For more information about referring out treatment, CLICK HERE.
    • “D” column = If you see a D show up in this box, it means that someone has added a diagnostic code to this procedure code. Now this field is not being used very much yet because the dental industry has not yet adopted a universal diagnostic coding system and the insurance companies are not yet requiring it.
    •  “M” column = If you see a triangle in this field, it means that this procedure code has been flagged for medical cross-coding. If you see a solid triangle, it means that this code has been billed to medical. For more about medical billing, you can CLICK HERE.
    • Status = There are four statuses you will see here; EO = existing other, E = existing, TP = treatment plan and C = completed. Any procedure code that has a C in this column will match the ledger.
    • Amount = The amount you are charging the patient for the procedure.
  • Clinical Notes: The clinical notes tab is what happened today. This is where you will write up the materials used, anesthetic, next visit and anything else that happened during the appointment or anything that was discussed during the clinical portion of the visit. The clinical notes can be written using templates and signed with an electronic signature device. To read more about clinical note templates, please CLICK HERE.

One feature I think is really cool is that you can merge the Progress Notes with the Clinical Notes for an easy patient chart review. If you want to read more details on how to do this, please read my blog titled “Read your clinical notes like you used to” by CLICKING HERE.

Thursday, May 4, 2017

Don't get caught with FOMO

I remember when I attended my very first Business of Dentistry conference in 2006.  It was the first year I was a certified Dentrix trainer and I was super excited because my doctor agreed to tag along with me because it happened to be held at his favorite ski resort (so he could bail out if he got bored).  I remember Dr. Gordon Christensen was the keynote speaker that year and my doctor was so impressed with the entire event he never made it to the slopes (at least during class time).

Since 2006 I have never missed a Business of Dentistry Conference  (I would have serious FOMO) and this year will be no different.  This year I am teaching six courses over two days and I am super excited to be such a big part of this amazing event.

CLICK HERE to learn more
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