#20– Scheduling Concepts | Dental Practice Coaching

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#20– Scheduling Concepts

A. Verbal Skills:  a. Terminology    b. Basic Insurance    c. Basic Ledger   d. People skills
B. How to fill the schedule
C. Primetime List
D. Welfare
E. Dental Options patients
F. Broken appointments
G. Creatively Filling the Schedule
H. Military patients

A. Verbal Skills

a. Terminology

TEETH TERMINOLOGY: What you need to know before you start scheduling!

Primary Teeth – The first 20 teeth of life (also called deciduous or baby teeth) which will be replaced by the 32 permanent teeth
Anterior Teeth – Those teeth located in the front of the mouth. The central incisors, lateral incisors and canines – 6 center upper and lowers.
Posterior Teeth – Those teeth locate toward the back of the mouth. The premolars and molars.
Maxillary Arch – The upper teeth.
Mandibular Arch – The lower teeth.
Quadrants – The imaginary division of the mouth into four parts.
Incisors – Those teeth with a thin, sharp cutting edge which are used for cutting and biting. There is a central and a lateral incisor in each quadrant.
Canine – The heavy tooth designed to cut and tear those things that are too tough for the incisors to cut. The canine, which is sometimes called the cuspid, is located at the corner of the dental arch and there is one canine per quadrant.
Premolars – Those teeth which are like the canines in that they have pointed cusps for grasping and tearing; however, they also have a somewhat broader surface for grinding and chewing food. They are also referred to as bicuspids. There are two premolars in each quadrant of the permanent dentition and no premolars in the primary dentition.
Molars – The posterior teeth with a broad working surface which is grinding of the more solid pieces of food which require the use of heavy forces. There are two molars in each quadrant of the primary dentition used for the grinding of food.

Amalgam – An alloy containing silver and other metals that is mixed with mercury to form dental restorations.
Composite – A plastic based tooth colored restorative material Crown – That part of the tooth which is covered with enamel and which is normally visible in the mouth. A crown is also a preformed restoration, usually gold or of a tooth colored material, that covers the entire crown of the tooth.

Bridge – A fixed appliance used to replace one or more adjacent teeth.
Pontic – A dummy tooth used to replace a missing tooth in a fixed bridge.
Abutment – A tooth that supports a fixed bridge or a removable partial.
Denture – A removable appliance used to replace all of the teeth in an edentulous (toothless) arch. C/= upper complete denture /C= lower complete denture.
Immediate Dentures – A denture that is placed immediately following the extraction of remaining teeth, rather than waiting for 4-6 weeks for healing and then placement.
Partial Denture – A removable appliance used to replace some but not all teeth in the same arch; made of metal. P/= upper partial /P= lower partial
Plastic Partial Denture – A removable appliance used to replace some but not all teeth in the same arch; made of plastic.
Crown – A crown is also a preformed restoration, usually gold or a tooth colored material, that covers the entire crown of the tooth.
SSC – Stainless Steel Crown – generic fit, usually for a temporary use.
FMC – Full Metal Crown.
PVC – Porcelain fused to gold crown.
FG – Full Gold crown
PC – Porcelain Crown – A glass like crown for front teeth.
Inlay – A cast restoration, most often made of gold, that is fabricated outside of the mouth and cemented into the tooth.
Onlay – A cast restoration, that restores the entire occlusal surface, and some of the proximal surfaces, of the tooth.
Root Canal – Removal of the nerve in the pulp chamber of the root of a tooth. Anterior teeth (front middle 6) have one canal each.
Canines – one or 2 canals.
Molars – 3-4 canals.

Surfaces of the teeth:
M – Mesial – toward midline of mouth
D – Distal – away from midline
I – Incisal – biting edge – front teeth (anterior)
O – Occlusal – chewing side of bicuspids and molars (posterior).
B – Buccal – cheek surface and facial also
L – Lingual – tongue surface
F – Facial – surface that is towards face or cheek

When you schedule a new client, be sure to offer for them to go online to our website & they can print their forms at home & fill them out before they arrive for their appointment. This is a really nice feature that most people appreciate – plus, it saves us time when they are here because we do not have to wait for them to finish filling out the health histories.

Tell your client your website address and then walk them through exactly what to click on so they can choose the health history form that best matches them – Adults, children, ortho or Dentures.

b. Basic Insurance

Dentrix & EagleSoft insert an insurance estimate into every patient’s treatment plan automatically. This estimate is based on that patient’s insurance information.

There are 2 types of Dentrix insurance estimates:
1. We feel confident it’s correct – If we have had another patient with the same insurance plan and employer and they have the exact same dental code, then the computer tracks the amount that insurance paid. It will insert this amount for any other patients who are planning to have this treatment done.
2. Total guess – If no other patients in their plan have had this procedure done, then Dentrix looks back to the general insurance guidelines and assigns the average insurance coverage percent. This estimate is a total guess and we have no confidence that this will be accurate at all.

To check to see which type of insurance estimate you are getting:
1. Go to the family file for your patient
2. double click on the Primary Insurance box
3. Click on the Payment Table button – now scroll down and look for the procedure codes that match the procedure your patient is planning. If you see your procedure code, then you can feel that this is Type 1 – and you can tell your client that you feel confident of this insurance estimate. However, this is still not a guarantee of insurance coverage.
4. If you do not see your procedure code, then you know that it is calculating a percentage (type 2). Click ok in the Payment Table box to close it and then click the Coverage Table box to see the percentages, deductibles and maximums that we have entered for this insurance plan.
5. Our default for new insurance plans is $750 maximum/year with a $50 deductible – if you see this, then you know that we need to call their insurance plan to confirm their maximum, deductible and percentages.

Your job in level 1 is to have a basic insurance estimate conversation with your client at check out. It might go like this:
Sec: Here’s your treatment plan that shows the handful of fillings Dr. Smith has recommended. You can see that the total fee will be $500 and that we estimate insurance to cover $380, that leaves your portion at $120.
Client: So, that’s what my insurance will pay?
Sec: This is just an estimate from our computer. Since I do not see a previous payment on these same codes from your insurance, this is just calculated based on your insurance saying they will cover at 80%. However, since we don’t know what their top fee is, I cannot guarantee what your insurance will pay.
Client: So, how do we find out?
Sec: You have a couple choices. If you would like, I can send a Pre-Treatment Estimate to your insurance asking them to review this treatment plan and send us a report back showing the dollar amounts they plan to pay. Again, this isn’t a guarantee of insurance payment, but it’s pretty good. The only problem is that it usually takes about 3-4 weeks for them to return this report. Your other option is to go ahead and we can work with this computer estimate – today I would only ask you to pay your portion of $120 and then if your insurance pays less than we estimated, then you would get a statement, if they pay more, then you would get a refund. Which sounds better to you?

Certain items are not covered by insurance, including:
a. Anything cosmetic such as whitening
b. Electric toothbrushes – we sell Sonicare
c. Most 9000 codes

Insurance Estimates:
a. STM – You need to change the insurance estimate in the computer to 50% for all STM’s.
b. Generally Insurance will not pay for more than one cleaning (prophy) every six months.
c. Crowns, bridges, partials, dentures – all at 50% generally
d. Extractions – as of Oct. 2008 – must change to 50% as well
e. Other items are covered at 80% – this covers most restorative care such as fillings

Some items are covered at 100% – for cleanings and exams – however, remember, 100% of the insurance company UCR (usual, customary & reasonable) fee – NOT OUR FEE – there can still be a few dollars left over after insurance depending on the difference between the insurance company UCR fee and our fee for a cleaning.

When a patient presents new insurance plan (to our computer system) we must reduce estimates of coverage by 30% and explain to them that we are unfamiliar with their plan and will see how pay this time. (You do not have to tell them that you’re adjusting their coverage, but explain, if they ask, that because their plan is new we will be a bit more conservative.)

Insurance coverage – What is and what isn’t? Discuss whitening, Sonicare, veneers, STM, etc.

C. Ledger/Account
How to read the ledger/account – review insurance links, other family members, previous balances
For this section, meet with a secretary and have her quiz you on some family accounts – you need to be able to explain what the insurance did and did not cover for each family member and give reasons for each.

Quiz on ledger
What do the colors mean?
Check a couple completed treatments to explain what insurance cover and what the balance is from.

____________________      _________________
Team Leader                                     Date

D. People skills
The words you use are the “mirror to your soul.” When talking with a client, use words and phrases that professionals use. How you say what you say makes all the difference.
Avoid                                                                  Better
Cancellation                                                     Change in schedule
Emergency time                                              Dr can relieve your discomfort at ____
What is your phone number?                      Where can we reach you during the day?
I have an appointment at ..                          Dr ___ can see your at ____ or ____
Case presentation                                          Consultation or treatment discussion
Remind                                                            Confirm or reconfirm
Call list                                                             Take your name
Can I help you?                                               How may I help you?
Dr. is busy                                                        Dr is with a patient
Check up                                                           Thorough examination
Long appointments                                       Well planned appointments
Running late                                                   Interrupted schedule
Pain                                                                  Discomfort
Filling                                                              Restoration
Pull, extract                                                    Remove
Cap                                                                   Crown
Drill                                                                 Handpiece
Caries                                                              Decay
Shot                                                                 Injections
Work                                                               Treatment
Study models                                                 Impressions
Full mouth x rays                                         Complete series x rays, or necessary x-rays Plates                                                               Dentures
Partials                                                            Partial dentures
Operatory                                                       Treatment room
Recall                                                              Re examine or re evaluate
Grind the tooth                                             Reshape the tooth
Old or defective filling                                 Restoration has outlived its usefulness
Suggest                                                            Recommend
Baby teeth                                                       Primary teeth
Rehabilitation or reconstruction               Comprehensive dentistry
Waiting room                                                 Reception room
Dr. doesn’t work Sundays                            Dr’s hours are …
Would you like to come in?                          Dr. ___ is ready to see you now.
Thank you for calling.                                   Thank you for calling, Mrs. Smith.
Dr. can’t speak with you now.                      Is this in regard to your account, or an appointment?
Have you seen the Dr before?                     When was the last time you saw the Dr?
Do you understand?                                      How do you feel about this?

When serving a client, avoid “no” statements that upset anyone.
Our policy is
You’ll have to call back because
That’s not my responsibility
We’ve never done it that way
You must be mistaken
Most of our patients like it done that way
I don’t see why that’s a problem for you

Watch out that you don’t lose control and just “hand the appointment book” to the client. Statements that allow you to lose control are:

1. Would next Thursday at 9:00 be ok?
2. What time is best for you?

These are questions that can be answered “no”. You must lead the client with positives.

Always offer two times.
Mrs. Jones, would this Wed. at 9:00 AM or Friday at 2:00 be more convenient?

These are 2 times that you want filled. If neither of these times are convenient, offer two more, but don’t let the client tell you what to do. Try to offer 1 morning and 1 afternoon time for variety.

Never use the negative “I’m sorry.” You don’t have anything to apologize for. Tell them what we do have for them. For example:
not “I’m sorry, that time is taken.”
rather “I have 9:30 Wed. AM or 2:30 Fri. PM”
not “I’m sorry doctor is with a patient.”
rather “Doctor is with a patient. How may I help?”

Now. let’s look at specific situations.

Young child needs filling mornings are best time for youngsters, Mom doesn’t want child to miss school.
Receptionist. children are happier and their appointments go more smoothly early in the day. John will be able to concentrate on his classes better if he’s not worrying all day about his appointment.
We can see John Monday at 9:30 or Wed. at 1:30. Which one would you prefer?
Parent I don’t like for Susie to miss school. Can I get a later appointment?
Receptionist. Of course. We just want John to have the best possible appointment. Are you sure you wouldn’t like her treated while she is rested and fresh? (then do whatever Parent says)

Parent “I’m scared to death of the dentist and I don’t want Jill to be that way” or “Jill is very frightened of doctors.” or “Is the doctor good with children? I don’t want Jill to be afraid.”
Recep. “I’ll tell Teresa (RDH) to be especially careful. I’m sure you’ll be very pleased. Most of our children really enjoy coming to see us!”

Parent (who is our client) When is a good age to bring Craig in? He’s never been to the dentist before.
Recep. “Usually 2 years of age is a good time to begin. Most of the baby teeth are in by then. Why don’t you bring Craig with you at your next appointment (as long as the appointment is not more that an hour)? We’ll show him around the office.

Welcoming New Patients
When a new patient comes into the practice stand up, look them in the eye, and greet them. “Welcome to HealthPark.” Offer them a packet of new patient health history to fill out and also a packet of new patient brochures. Make sure they realize the health history information is 3 pages long.

The greeting should sound like, “Welcome to HealthPark. Here is some paperwork to fill out. I have also included a packet of information about our practice. Feel free to look over it. If you would like to have a seat and fill out your paperwork the Dr. will see you in a few minutes.” (Include my name is _____).

Open brochures and explain them. “Just let me know if there is anything else I can do for you.” New patient packets include – cover, specialist brochure, Healthpark brochure, a business card, and a newsletter.

_____________________    ________________
Office manager                                   Date

Care To Share Cards:

  • If you have been happy with the care we’ve provided and know someone that needs a caring and experienced dentist please pass on this card and we promise to take great care of them.
  • Mrs. Jones we just love having you as our patient. We wish all our patients were as nice as you!! If you have any friends, family or colleagues that are as nice as you that need a dentist we would love to take care of them.
  • Always plant the seed with every patient that we are accepting NEW patients!

Explaining the care cards is important. They should not be stuffed into the goody bags, hoping the client figures them out on their own. Be sure you put an expiration date on the card

Controlling the Schedule for Success

There is more to scheduling appointments than just filling in times. If that’s all there was to it, we’d leave the appointment book the reception room and let our clients fill in their own times. That may sound silly but you will find that it takes months for you to get used to controlling the flow of the day through proper scheduling.

The producer tracking columns and symbol notations make it possible for you to gain control. Now you’ll be able to see open times, avoid double scheduling, and know why and what is going on. Now it’s time to put this information together to organize each doctor/team’s day. Here are the results you can achieve:
Clients seen on time.
No staff members “running around in shock.”
High level production.
Smooth, efficient function leads to high quality.

Now you can begin to understand why you are the hub of a successful dental practice. Let’s look at the appointment schedule in detail now.

1. Always enter the correct client’s name, verify phone number, enter the proper procedure and time sequence (see sample). Mark if there is hygiene check time allowed and when. This should be entered for every appointment in the computer.

2. A – anesthetic. In a busy practice, the dentist will inject the client and then go to another client. All lower teeth and upper back teeth need 5 10 minutes to “get numb.” Rather than waste this time, 15 minutes is set aside for the “anesthetic.” During this time:
a. Client is seated.
b. Room is set up by the chairside.
c. Client is offered headphones and/or nitrous oxide. If client declines, s/he is offered a magazine.
d. Chairside places topical anesthetic.
e. Dentist excuses from client “X”
f. Dentist injects client “Y”
g. Dentist returns to client “X” and completes treatment.
h. Chairside monitors client “Y” for anesthetic and nitrous oxide.

3. Multiple procedures
Your goal is to schedule each client with the fewest appointments necessary to complete the treatment. Each separate appointment requires a number of steps that are duplicated at every appointment.
a. Discussion to set up appointment.
b. Call to confirm
c. Client arranging his/her schedule.
d. Client drive to office
e. Chairside setting up tray and cleaning room
f. Chairside greet, seat, prepare client (topical anesthetic, nitrous oxide, etc.)
g. When treatment completed, allow client to rinse, clean up.
h. Escort client to front desk.

These steps must be repeated at every visit. They are a major waste of time – time that the team could have used more productively in treating clients.

Our goal – LONG, WELL PLANNED APPOINTMENTS. Burn this into your memory. This is essential to our success. To make this possible, the dentist will combine various kinds of procedures (amalgams, crowns, and root canals). A dentist/team may spend one whole half day with a client, alternating between “producers.” This may sound terrible for the client, but it’s not!! Everyone is busy nowadays. You save the clients lots of driving time, appointment arrangements, and “hassle” by using these long well planned appointments.

4.Finding the right amount of time is easy if you follow these steps:
a .Find the right amount of doctor’s time.
b. Next find the support staff (EFDA, Chairside) time. Be creative. If there isn’t quite enough doctor or staff time, ask your doctor if the time available could accommodate the procedures.

5. Always offer your client two time slots. This gives your client the feeling that s/he is in control. At the same time, you are offering two times that are most convenient to us. Offer the first opening you have and then a second time in a different part of the day. For example: “Mr. Duncan, Dr ________ could see you at 9:00 this Thursday morning or 4:00 next Tuesday afternoon. Which would you prefer?” This is better than just “I have a time at ______.” It’s much harder for the client to refuse the DOCTOR than you!

6. Hygienist client examination time by the dentist. The dentist must excuse himself from the clients he is treating in order to examine the client who has just been seen by the hygienist. This is disruptive and time consuming. It is also a state law and essential to the best treatment of that client.
If the dentist is only examining one hygienist, s/he will break away, run the exam, and return to his/her original client in about 5 minutes. This doesn’t require any special scheduling. However, if the dentist is checking two hygienists, 15 minutes is blocked out of each hour so s/he won’t get behind. When you are scheduling a doctor for this type of half day, the schedule will look like the sample on the next page. This example shows that you schedule through these 15 minute blocks as though they didn’t exist.

7. Only schedule the doctor’s time 3 weeks in advance. Booking too far into the future robs us of our flexibility. When we reach a point that you are scheduling a full 3 weeks out, tell your doctor.

8. Hygiene can be scheduled 3 weeks in advance. Each day you will open a new day. Be sure to call the clients on your waiting list before offering these times to clients who only requested them that day. By standing firm on these times, you will find that often clients will accept a harder to fill time rather than go on the call list.

9. Don’t fill the middle of the day first. When you put short appointments in the middle, you chop up the day and make long well planned appointments impossible.

10. Avoid holes in the doctors’ schedules. These will occur two ways.
a. Leaving spaces between doctors’ times.
b. Not starting the scheduled appointments early and late in each half day.

11. Don’t feel bad to adjust a client’s appointment up or down by 1/2 hour. If you have two small holes, move the other appointments to create one larger hole. This can be filled more productively.

12. Keep the computer screen out of the client’s view. Don’t let them see it, or they may want to give you ideas on when to schedule them!

13. When a client will need several appointments, schedule 2. Think about what happens if you only schedule only one appointment. The client makes the first appointment – and then waits a week or so for the appointment. Then the client comes in and completes the first appointment. Now you schedule the second – and there is another 1 2 week wait. This really spreads out treatment and the client may not get convenient times.
By scheduling the second appointment – and always staying one appointment ahead (always have 2 appointments scheduled), you will avoid spreading out treatment and give your client convenient times.

14. When a whole family wants recall appointments, try to appoint them when we have two hygienists. This will make their stay in the office as brief as possible. The only exception to this is when a parent is bringing young children for preventive care appointments. The mother or father should be in the preventive care room with the children. The parent needs to see how the children are doing.

15. If this is the first time a client is making an appointment with us, be sure to follow these steps:
a. Reinforce the importance of the appointment
“I’m glad Dr. _______ will be able to start your (root canal, crown, etc.) quickly. You’ll feel (look) better soon.”
b .Confirm the day and time of the appointment while handing an appointment card to the client.
c. If the appointment is more than 2 days away, tell the client the appointment will be confirmed.
d. Ask “Is there anything else I can do for you today?”

Your job is to smooth out the schedule. Avoid staff stress. Keep the clients from waiting. Here’s how:

1. Know what’s going on!! Pay attention to your schedule. When you see a producer dropping behind, find out what’s going on. When you talk with the producer, you’re going to be told either
a. I’ll be caught up and back on schedule quickly.
b. I’m in trouble and I expect to be ______ minutes behind schedule.

Here’s your action plan for each situation:
a. Go to the reception room. Tell the next client how much longer it will be. Apologize. Offer to reschedule if we are more than 15 minutes behind. If the client chooses to wait, ask the producer if you could reduce the fee $20 to thank them for sticking with us during the inconvenience.

b. Same as “a” plus call the next scheduled client that isn’t there. Reschedule then if the appointment is 45 minutes or less. If the appointment is longer, ask the producer what should be done.

2. A client doesn’t show up. Wait for 5 minutes past the appointment time. Call the client. If the appointment is 45 minutes or less, place the client on the call list. Never reappoint! If the client ruins our schedule once, we ask them to heal it (from the call list) the next time.

If the appointment is longer than 45 minutes, place the client on hold. Quickly ask the producer what the latest the client can be and still make the appointment.

3. A client calls to cancel a same day appointment.

a Recep. Oh Mr. ______. I’m sorry you won’t be able to make your appointment. I know Dr. Smith was concerned that we get that (crown filling, root canal, etc.) done before it gave you any more problems. Are you sure there’s no way you can be here? If “no”- Ok Mr. ____ All our available appointments are filled, I can place on our call list until something opens up, it will probably be 2-3 weeks. Will you be okay until we can arrange that appointment?

Don’t be obnoxious, but try to help clients understand how valuable their appointments are! Make a note on the yellow treatment sheet that the client cancelled on short notice, why, and whether s/he was placed on a call list.

b. Okay, let’s say you couldn’t talk them into coming in. Go to your call lists. Use the list “ASAP List” first. This group (if there are any) consists of clients who want to speed up their treatment.

c. The second list is your “Day of Only” list. Don’t beat people over the head with the fact that they failed an earlier appointment and now are being punished. Your conversation could begin, “Hi Mr. Green! This is Lynn from Dr. ________’s office. We had a change in our schedule and I thought of you. Would you like to come in at 2:00 this afternoon to get __________ done?”

If your client says “no,” but wants to schedule another time, say, “I’m sorry Mr. Green, our appointment book is full. However, as soon as we get another opening I’ll give you a call!” Make a note in the yellow treatment section of Mr. Green’s chart that he refused the appointment. Also make a note in the “Day of Only” list, so no one else will call the same day.

These notes in the clients’ treatment folders are very important. If two months from now, the client says, “Why haven’t I been seen for my appointment?” It’s great to be able to read off three or four dates that attempts were made to bring the client in and why the client chose not to come in.

d. Check the lab. Have any cases come back early? These clients often like to come in early. You can say, “Hi Mrs. Ritter! This is Jenny from Dr. ________’s office. We had a change in our schedule and the lab finished your crown (denture, etc.) early. Would you like it seated today?”

1. The client shows up more than 10 minutes late. “Mr. Fellers, I’m so glad you’re ok. I called your house and office. No one knew where you were (or “thought you would be coming”). I was worried about you. Let me check with Dr. _____________ to see if we still have enough time for your appointment.”

5. Your doctor will need to keep several things in mind.
Is there enough time remaining to complete all planned treatment?
Can part of the treatment be completed and the rest reappointed?
Can other treatment be done today in the time remaining?
Can more time be arranged by moving back the next client’s appointment?
Can the client be seen, but later in the day?

If your doctor will treat the client, you’re all set. Keep an eye on the schedule to make sure the next client is seen on time.

If your doctor doesn’t have enough time, place the client on a call list. “Mr. Jones, I know you realize that you are 20 minutes late for your ________ minute appointment. We just don’t have enough time to provide this service today. Our schedule is filed, but I can place your name on our call list. I’ll do everything I can to get you in as soon as possible. These clients are routinely scheduled 15 minutes early for their appointments.

6. If the client acknowledges that s/he is late but says they have had to wait for us before and thinks s/he should be seen today. Remember another people rule: Never argue or defend. Try saying this, “Mr. Jones, you’re right. There have been times in the past when we’ve kept people waiting. Some times an emergency occurs and nothing can be done, but often we’ve tried to accommodate a client who was late and see them anyway. This made a doctor late for every client after that. Dr. _______ realizes that wasn’t fair to anyone, including his staff who had to work late. I’m sorry you weren’t able to be here on time, but I hope you understand why we cannot see you.”

7. Now you can see how important it is for clients to be on time. One basic people rule is to thank people for doing what you want them to. This encourages them to repeat this behavior. “Hello Barbara, it’s good to see you. Thank you for being on time. Dr. _______ is on schedule and you shouldn’t have more than a few minutes wait. Why don’t you have a seat, relax and I’ll let Dr. _____ know you’re ________ minutes early. We have you scheduled at _______. Dr. ______ is on time. I’ll let him know you’re here. Thanks for getting here early.”

The producer is more than 10 minutes behind schedule, but feels will be able to catch up after the next client. Try to call this next client to let him/her know approximately when the client can expect the appointment to begin. “Hi, Mrs. Gabel! We’ve had an unexpected emergency and Dr. __________ asked me to call to let you know that your appointment won’t begin until _____________. Is this ________ minute delay going to be a problem for you?

8. The client calls with an emergency, fill out the blue emergency form. Schedule ½ hour with a chairside assistant or hygienist (hygienists should have priority in keeping their schedules filled, then EFDA’s and then chairside assistants).
No emergency should be put off more than 2 hours – unless the client requests more convenient time.
The client determines the seriousness of an emergency – not you.

How to document the initial Emergency questions in the tooth chart:
1. Open tooth chart
2. Go to progress notes and select “Administrative”
3. Double click on “Sec. Emergency” at the bottom of the list
4. The “Chief Complaint” (1st box to pop up) needs to be exactly what the patient claims is bothering them. Hit “okay”
5. Answer all of the questions.
6. After the appointment is made change the provider to the correct doctor the patient is scheduled to see in the progress notes.
7. DO NOT SIGN!!! The doctors may need to edit this information. Do not use the pen icon and sign.

 

9. How to explain a thorough exam: “Your dentist will begin with a conference to review your past medical and dental treatment. He’ll be interested in your concerns and what you expect of us. Next we’ll get a set of dental records including a complete set of x-rays. Have you had a complete set in the last 5 years? This is 16-18 x-rays to give us a view of every tooth. We also use this for a reference if anything should happen in the future. Once the records are complete, your dentist will do a thorough exam and then discuss his findings with you. Do you have any questions?”

_________________           ___________
Initials (level 3 and up)               Date

B. How to Fill the Schedule

Making Appointments Introduction

Nothing creates more frustration in a dental office than mismanaged appointments. Staff sitting with nothing to do, clients coming in late or on the wrong day. You get the picture! Client management is second only to client treatment in the success of our practice.

Our scheduling goals are:
Fill the available time slots
Match client’s needs with the staff that can best meet them.
Minimize the risk of no-shows, last-minute cancellations, and reschedules.
Minimize in-office rescheduling.

Dentists generally agree that the most tiring days occur when they spend the day:
Running to catch up with the schedule.
Have to cut treatment short to stay on schedule.
Many short appointments (rather than long, well planned ones) treating more than 8 clients in a day.
A series of unplanned interruptions.

How do we avoid these problems?
Have our secretaries trained to schedule effectively.
Don’t let anyone but secretaries (definitely not doctors) make appointments.

Lists to use to fill the schedule
You may want to pull this page out & save it where you can refer to it regularly.
Here are the lists we use to fill the schedules:

  • ASAP list (Level 1+ can work this list)
  • Broken appointment list (Level 1+ can work this list)
  • Unscheduled treatment plans list (Level 3+ can work this list – or lev2+ after being checked off on the language of dentistry)
  • Monthly recall list (Level 1+ can work this list)
  • Yearly recall list (Level 2+ can work this list)
  • Primetime list (Level 1+ can work this list)
  • Quickfill List (in EagleSoft)
  • Credit balances

To Print lists:

ASAP List in Dentrix: To put someone on the list
Office manager Must schedule them an appt in future
Reports In appointment at Schedule box choose ASAP
Lists
ASAP
Select provider and dates
Print

Unscheduled appointment list in Dentrix:

Any time you break an appointment your patient goes on this list, make sure you put any notes in the appointment (day of, tues only)

Reports
Lists
Unsched. Appt List
Select provider and date
Print

Unscheduled Treatment Plans in Dentrix

Anyone who has a TX plan is automatically on this list
Office manager
Reports
Lists
Unsched. Tx Plans
Select provider and date
Print

The QuickFill List in EagleSoft

To use this list to fill schedules:

  1. In the schedule, choose the QuickFill list icon (red Q) to bring up the list
  2. Click the dropdown menu in the Search Criteria to search for a specific type of appointment that will fill the schedule. You can search by Classification (Quickfill, Sooner if possible, Failed, Cancelled or neither) and/or you can search by Appointment Type. Then click apply.
  3. Once you have your list of patients, click on a patient name – then you can see the number of times that person failed, cancelled or neither. The initials SIP in the type column stand for Sooner if Possible. Here’s where you can call each patient to try to fill the schedule – and add a note if you left a message or talked with a patient and they didn’t come in. You can also delete patients from this list.

To add a patient to the Quickfill list:

  1. Double click in the schedule, enter the patient name
  2. Go above the patient name and select from the dropdown menu Schedule Entry – choose Quickfill appt.
  3. This opens a new window – enter the provider, appointment type & duration and any notes.

To add a patient to the Sooner if Possible list – Double click on an existing appointment & checkmark the Sooner if possible button (right under the appointment date).

To print the appointment queue and unscheduled appointments list:

  1. Go to the home desk screen
  2. Select reports in the top task bar – click All and Find appointments, then click Process
  3. This brings up a new window where you can select date range and checkmark unscheduled appointments.

Monthly Recall List
_______________prints
Yearly Recall list
_____________prints
Prime Time List
In excel Used especially for 4 and after and Saturday prophies

Expectations
The doctors expect that our schedules are completely full 2 weeks out. There should be some holes in the third week out and plenty of flex time in the 4th week out. We confirm that schedules are full 3 patient days ahead for every provider as part of the ideal day. Your job is to make sure that the doctor’s schedules are full – this takes priority over all other secretary team projects.

You are expected to keep an eye on the schedules – every page – throughout the day. You should be watching the schedule regularly to be aware of when each providers next opening is – this helps you to more easily fill the earliest openings first.

The secretary that runs Dr’s huddle will report on what effort has been put into filling schedules if they are not 100% full for 3 days out. Dr expects to hear that the secretary team is aware of the openings in the schedules and has worked every call list and done everything they can think of to fill the schedule.

2 Levels of Filling the Schedules
1 – Ahead of the game – This means that everyone on the team works their call lists regularly and schedules stay full to the doctor’s expectations (2-3 weeks out is full).
2 –Under the gun – This means that there are holes in the first week, even within the next few days. The team has to scramble to fill the schedule and “prove” to the doctors that they’ve done everything they can.
Which level would you rather work in?

To stay in Level 1 – Ahead of the Game –
The team must work together to work their call lists. There are goals for every call list – doctors expect that secretaries should schedule 40% – 50% of their Monthly recall list, you should schedule 10%-15% of your Yearly recall list, you should schedule 45% – 50% of your Unscheduled treatment list.
When the team receives each list on the first of the month, then they should make a plan – every evening the team should finish one page of a call list.

So – in the first 8 business days of the month the first calls should be completed for both these call lists. If you have all call lists done in the first 2 weeks of the month, then you can give the clients week 3 to hopefully return your calls & schedule and during week 4 you can send them an email or letter to try to motivate them one more time.

We also run a weekly unscheduled treatment list – these calls should be made in the evening also, generally there are about 15-20 clients to call each week – and these clients have just been in, so it should be easier to catch them.

You also should work your Broken appointment list every day – its on the Ideal day to make sure this gets done. Your job is to reschedule each and every patient that is on this list – at first, your job is to help them to heal our schedule, since they caused us a problem another day, but if you cannot get them to schedule within 24 hours after a few tries, then your job is just to get them scheduled!

To send Text messages in DemandForce
If you get a patient that cancels an appointment at least an hour from now, you can use DemandForce to send a text message to other clients.
Instructions to send a text message in DemandForce:

Click on the Patients tab – find the patient you want & click on their name.
Click on Text – this brings up a window to write the content. Then click submit.
For example, you could write:
“Change in our schedule – can offer you 20% discount off your portion to come in today at 3pm for your cleaning. Call 667-2417 if interested.”

When you fall into Level 2 – Under the gun –
So, how much work is enough to fill the schedule? How many calls are “enough”?
If your team is behind the schedule described above, then you should call a team meeting and get everyone back on track. If your team is on track with call lists, then you may be wondering, well, what else can we do?

For hygiene openings:
1. Confirm that every call has been made to every patient on monthly recall.
2. Confirm that every call has been made to every patient on yearly recall.
3. Confirm that every call has been made to every patient on broken appointment list.
4. Move emergency appointments up as early as possible (this will help fill schedule possible tx same day)
5. Check the ASAP list to see if anyone wants to move their appointment up.
6. Walk around the building and let all your providers know that your hygienists have an opening so if any of their clients would like to get a cleaning, now is the time!
7. Look at the patients scheduled for treatment that day – is there anyone due for a cleaning?
8. Don’t forget to check Specialists schedules for clients due for cleanings – maybe a child is with Dr. Mason whose Mom is overdue for her cleaning?
9. Is there anyone on staff who needs a cleaning? Anyone in their families that can come in?
10. Check the current month’s unscheduled treatment lists (there is a list for each week) – do you see any sealants or STMs that you can call?
11. Get the commitment notebooks from all the hygienists – who can you call from these lists?
12. Check your schedule 3+ weeks out and call any clients to offer them to move up their appointment.
13. Primetime
14. Is there anyone with a pending appointment on DemandForce that can be called?

For doctor openings:
1. Confirm that every call has been made to the current week’s unscheduled treatment list.
2. Confirm that the day box notes (usually patient follow up) have been contacted.
3. Confirm that all patient follow up folders have been contacted.
4. Confirm that every call has been made to the PTE list folks.
5. Confirm that every call has been made to the Case Acceptance folks (check each one to make sure they have a next appointment).
6. Check previous weeks unscheduled treatment lists – keep going back to each previous week, call each patient to try again to motivate them.
7. Walk around the building and let all your hygienists know that your doctor has an opening so if any of their clients would like treatment same day, now is the time!
8. Check your schedule 3+ weeks out and call any clients to offer them to move up their appointment.
9. Five year review recall lists
10. Emergency to recall lists – check for treatment, prophies, CMS/Comp exams
11. Print the Care Credit application list- anyone need scheduled?

12. Print a list of patients with Credit Balances – check to see if they have a treatment plan or are overdue for a cleaning and would like to use their credit.

 

What if you cannot fill the schedule?

The plan for Dentist schedules not filled:
4 days out – Fill anything more than 3 hours with prophies
2 days out – Fill anything more than 2 hours with prophies
1 day out – Fill all open time with prophies

The plan for Hygiene schedules not filled:
7 days out – If all hygiene schedules are open, then cut each by ½ day and put blocks in to fill top down or bottom up. Review with the secretary team to make sure everyone follows this.
1 day out – Hygienists come in late or leave early based on their schedules

Periodically, there will not be enough clients to fill either the hygiene or the general dentist’s schedule. When you see this, get with your office manager and dentist so they can decide what to do.

The plan for Hygiene schedules not filled:
1. 1 week in advance – all hygiene schedules open for 8 hours/hygienist. We will ask each hygienist to reduce her schedule by ½ day. This will stay in effect until hygiene schedules are almost full for the next 8 working days.
2. Schedule 8 hour days from the bottom up. Avoid holes in the middle of the day.
3. Schedule 4 hour days from the top down.
4. The day before, tighten up the hygiene schedule. It is okay to move clients by 1-3 or 4 units and they usually won’t feel inconvenienced.
a. You have 1 unit open, then a 3 unit appointment, then 2 units open – move the 3 unit appointment up 1 unit and now you have 3 units that can be used for an adult prophy.
b. The hygienist has 2u (or more open first thing in the morning) – ask the hygienist to come in later.
c. There is 1u open at 11:45 and 2u open at 1:00 – have the hygienist start her lunch 1u early and start her afternoon at 12:45pm – enough time to add an adult prophy.

__________________     _____________
Office Manager                              Date

C. PRIMETIME LIST – for Prophies in the evening/weekend hours
No new patients are to be put on the primetime list for their first cleaning – you can go ahead and schedule them right away. However, explain to them the list does exist and in the future they will be put on the list for evening and weekend appointments.

Anyone requesting an after 4:00 pm or Saturday appointment will be placed on our “primetime” waiting list in Microsoft Excel. To open this list:
1. Open Excel
2. Click file, open
3. When adding patients to the Primetime list, please also see if they are able to be added to the Hotlist in DemandForce. If they have email or text opted in through DemandForce, please follow the instruction to add these patients to that list, and make sure they are deleted from DemandForce Hotlist as they are scheduled or removed from the Primetime list.

We have more than 25 evening and Saturday appointments every week, but due to the popularity of these hours we have established a waiting list. Right now there are approximately _#_ people ahead of you for those times. We do have ___ or ____ times during the day available this week if either of those times would be convenient otherwise I can add your name to the list.
If yes, verify phone # and desired times.
Use daily as new time opens up
Note date appropriate message below when contact was made
Left message answering machine
Spoke with member of family
Spoke with person to be scheduled
No answer
Delete person from list when appointment has been made
NO CLIENT IS EVER TO BE GIVEN A PRIME TIME APPOINTMENT AHEAD OF ANYONE ON THIS LIST UNLESS SPECIFICALLY OKAYED BY A DENTIST.

To manage the Primetime list:
We want to schedule every patient from this list.
Our goal is to not have more than a 4-5 week wait for folks on this list. Since we open a new month in Dentrix every month we should be able to accomplish this.
Once a week you should contact the patients who have been waiting the longest and schedule their appointments. You should call them 3 times – generally try to call them at work. If you leave messages, then send an email and send a snail mail note letting them know you would like to schedule their appointment off of our list.
You are responsible to make sure that all these patients get scheduled since they are “playing by the rules”.

_____________________      ______________
Initials (Level 3+)                                Date

D. WELFARE GUIDELINES

1. We accept Medicaid for _________________ cardholders only.
2. Our scheduling guidelines are: We only schedule 24 hours into the future & if the patient no shows they get one opportunity to heal our schedule and if they no show again, then will be dismissed from HealthPark. When patients call, we will put them on a list. Then, at 5pm each afternoon we will call to fill any openings for the next day only. When you schedule a patient off the list, delete their name from the list.
3. Treatment we can do under Medicaid:
a. Prophy/exam – schedule 2u with hygienist & use adult code for age 14+; can only have 1 every 6 months (even one day less they will not pay)
b. Emergency exam – schedule 2u in the 2nd column
c. Amalgam fillings on back teeth & Composite fillings on front teeth – schedule 1 anes, 2u doc
d. Simple extractions (cannot bill as surgical)
e. Root canals by Dr. only if he wants to – ask him before you schedule
f. For xrays, CMX and Pano – only 1 every 5 years and cannot be done at the same time as pa’s or bite-wings
g. Fluoride toothpaste is permitted for anyone under the age of 21 years
h. Sealants are permitted for anyone under the age of 18 years
i. Complete dentures, partials, crowns & post/core, diagnostic casts with PTE only

4. Scheduling treatment for Medicaid: Always schedule 1 unit for anesthetic and 2 units with the doctor for all treatment (for both adults and children) – no matter how much treatment is needed. We will do as much treatment as possible in this appointment and depending on our schedule, probably continue treatment if other patients cancel or no show.

5. We will try to limit the treatment we provide each year to $300 or less. We understand that means we will be leaving some decay. The goal is to keep the costs low for the Medicaid program, treat the worst first for the patients and keep them out of pain, and provide them a motivation to take care of their teeth. If a patient is obviously not brushing, then he will not be scheduled for restorative treatment – only extractions when he is in pain. If patients are caring for their teeth, then they will receive a cleaning/exam and this also earns them another $300 in restorative treatment.

New Medicaid Patient (internal form)

Do you have ____________insurance?

Name _________________________________ Date ______________
Do you have some specific problem you are most concerned about? (If in pain – then schedule, if not add to list)
_____________________________________________________________________

_____________________________________________________________________

If in pain – use the blue emergency form along with this page.
Can I get some information from you to help smooth out your first visit with us? (Address, phone only)

What is your Medicaid card number? (9 digits) ___________________________________
Go to www.______________.com to confirm the card is current

Do you know where we are located?

How can we reach you? ________________________________________________________

If not in pain – “All of our appointments are currently taken, but I can place your name on our call list and we will call you as appointments become available. I would expect you will be seen within 3 weeks.”

Internal Information below
Attitude: frightened shy hostile very pleasant time concerns

Scheduling Guidelines:
 We schedule 24 hours in advance only from our call list
 2u for prophy; 2u emerg exam, 3u for new client prophy

Go online to www._____________.com to confirm that their card is current.

This person is eligible for Medicaid until: ___________________________

Secretary check off list
 Patient information entered ALL CAPS  Referral source – Insurance directory, Medicaid
 Billing type 6  First Visit date changed
 Apt. date_________ time_________  Receptionist_________________
 Chart Made (blue chart)  Fee schedule 3
 Set provider in family file
 Set ins to Medicaid of Ohio & type Medical card # into Subscriber ID (If multiple family members, set for each to use each billing #) only if we submit to Medicaid.

Handout to give to Medicaid patients when they arrive:

Welcome to HealthPark Dentistry
We accept Medicaid coverage for _______________. In this program, we provide cleanings, exams, fillings, extractions and other select treatment for those who sign up.

We’ll help you
Our goal is to help as many people as possible to have healthy teeth and gums. Our unique, health-oriented approach to dentistry has won many state awards and even national recognition. We can help you learn all the new ways to control decay and gum disease. We will help you become dentally healthy so that when you don’t have Medicaid, you will be able to afford to continue your dental care. Once you stop your decay and gum disease, the cost of an annual cleaning and exam – and no need for expensive repairs – makes the cost of dentistry so low that it will fit into your budget!

You’ll help us
Since the state welfare department’s fee schedule (about 45% of our standard fees) doesn’t even cover our costs, we’ll need your help to allow us to take care of as many Medicaid patients as possible. Here’s how you can help.
1. Your name will be added to our next day call list. When your name hits the top of the list, we’ll call you for your cleaning appointment on the next day. We’ll give you 3 calls for appointments. If none of these are convenient, you’ll go to the bottom of this list to move up again..
2. Saturday and late afternoon/evening appointments are reserved for clients that would otherwise miss work to see us. However, we will offer you these opportunities if they become available on short notice.
3. We will do our best to work you in, but a minimum 2-3 week wait is normal.
4. Be on time (or 5 minutes early) for every appointment. If you miss or are more than 5 minutes late for your appointment, we won’t be able to treat you that day. We will place you on our missed appointment call list to fill in for someone else that failed their appointment. Since these failures don’t occur often, it may be a month or more before you work your way to the top of this call list.
5. For your continued good dental health once you have received your $300 of care, we will place your name in our recall preventive care system 6 months from your last cleaning.
6. When you return for your recall cleaning appointment and your mouth is healthy, we will provide another $300 worth of dental treatment. If your gums are not healthy at this cleaning, we will only provide emergency extractions as needed for the next 6 months. Then, you can have another cleaning appointment. You may go to any other Medicaid provider who will see you, if you want, at any time.

By following these steps, you can learn to be dentally healthy and we can partner together for a lifetime. We are looking forward to helping you become healthy so that you can stop dental problems now and when you no longer need Medicaid, you’ll be able to stay healthy and continue to see us for continued cleanings and exams so you can avoid the heavy expenses of continual extractions and repair dentistry.

Sincerely,

To add new Medicaid or Limited Service Program patients into the computer

1. Family file – Double click name section, select patient, click New Family
Type name in all caps
Enter fee schedule #3 for Welfare

2. Double click insurance – add insurance only for patients we are submitting to Medicaid
a. Clear carrier box, type 1st 2 letters to find:
Welfare Medicaid of Ohio Type in subscriber #
a. Check release & assignments boxes
b. Make sure the current patient is the subscriber.

3. Go to head of household (select at bottom or may need to add) – then double click billing type: Billing type # 6 (Welfare)

4. Check family members – especially Guarantor
Is the guarantor a patient?
Does the guarantor have private insurance? If so, we don’t submit to welfare.

Welfare Guidelines for Treatment
• Greeter to give welfare client the Welcome sheet that discusses our guidelines for welfare treatment in the office.
• Clinical staff to establish treatment plan – do any fillings, extractions same day if possible, or have the dentist note the time needed and put them back on the bottom of the list.
• Hygienist to discuss option with client that needs STM that they can choose to pay full fee for additional appointments if they want.
• Secretary team to let the patient know we will put their name on our list & schedule them one day out. There is no copay to collect for Medicaid. If the patient wants to pre-schedule, then they can choose to pay our full fees and become a regular patient or they can go to another Medicaid practice that allows prebooking. Occasionally, we may offer treatment that is not covered by Medicaid and you will review FAs with them (they must pay in advance to schedule).

Options for Treatment:
1 – Pay full fee & become regular patient
2 – Go to another welfare dentist that submits to Medicaid & allows prescheduling
3 – Follow our one day out scheduling policy for treatment at welfare fees here

Special situations:
Welfare client needs STM – Choices:
1. Have one cleaning (30 mins) at welfare rates
2. Client pay full fee for additional cleanings

Hard Times Program (Instead of submitting to Medicaid)

We established this program to offer an option to families who need dental care yet cannot afford our regular services – and they do not belong to the Medicaid plan we accept.

1. Who is eligibile:
a. Patients who have a current Medicaid card for our county are eligible.
b. Our Dentists can decide to place a family on this program based on an in-depth conversation regarding their financial situation.
c. People who have attended a free lunch program or other financial assistance program are eligible.

2. Description of the program – We offer cleanings, emergencies or fillings/simple extractions at the Medicaid fee schedule (about 40% of our normal fees). To receive these discounted fees, the clients can only schedule 24 hours into the future & if the patient no shows they will be dismissed.

3. Treatment we can do under this program:
a. Prophy/exam – schedule 2u with hygienist
b. Emergency exam – schedule 2u with 2nd column
c. Amalgam fillings on back teeth & Composite fillings on front teeth – schedule 1 anes, 2u doc and with an EFDA
d. Simple extractions only (no surgical)

4. Scheduling treatment for this program: Always schedule 1 unit for anesthetic and 2 units with the doctor for all treatment (for both adults and children) – no matter how much treatment is needed. We will do as much treatment as possible in this appointment and depending on our schedule, probably continue treatment if other patients cancel or no show.

5. When patients call, we will put them on a call list. Then, at 5pm each afternoon, we will call to fill any openings for the next day only. When you schedule a patient off the list, delete their name from the list. Use DemandForce text messaging to contact the list of clients waiting when you have an opening.

6. Greeter to give welfare client the Welcome green sheet that discusses our guidelines for welfare treatment in the office.

7. Clinical staff to establish treatment plan. Hygienist to discuss option with client that needs STM that they can choose to pay full fee for additional appointments if they want.

8. Secretary team to discuss scheduling guidelines and financial arrangements. Explain you can only schedule 1 day out and let them know what the amount due is. If the patient is upset that they cannot preschedule, then they can go to another dentist.

9. Special situations – Welfare client needs STM – Choices:
a. Have one cleaning (30 mins) at welfare rates
b. Client pay full fee for additional cleanings ($64 for 45 mins or $84 for 1 hr) instead of the full STM fee

10. Options for Treatment:
a. Pay full fee & become regular patient
b. Go to another welfare dentist that submits to Medicaid & allows prescheduling
c. For extractions & fillings only, we can do treatment at welfare fees but then can only schedule 1 day out.

Hard Times Program
For People who are NOT on Medicaid

To qualify the patient must show financial need in some way (for example, that their children participate in the school free lunch program). If you believe the family qualifies then add their name to our list & ask them to bring some evidence to us that shows their economic need.

Name __________________________ Date ________________

Cell phone _____________________ Email ________________________

Do you have some specific problem we should know about?
____________________________________________________________________________________________

____________________________________________________________________________________________

Secretary check off list – for emergency patients
 Patient information entered ALL CAPS  Referral source
 Billing type 6  First Visit date changed
 Chart Made  Fee schedule 3
 Set provider in family file  Receptionist_________________

Secretary check off list – for future appts
 Patient on list
____________________________________________________________________________________________

Office records only
3. Emergency pain- see quickly, add to Dentrix
2.All other care place the patient on the waiting list – go to: F:SecretariesSecretarial administrationPatient ListsCall ListsWelfare clients.xls ( this is on desk top )

Financial need program_________________________________________________________________________

Dillard Dental Services Medicare/Medicaid patients

Medicaid – There are 2 different dental Medicaid programs for children  TennDent and CoverKids.

TennDent – kids under age 21 are covered 100%

CoverKids – kids under age 21 are also covered 100% but they have a $1000 annual maximum and a $15 copay – so we need to explain this to parents.

Medicare (for seniors)  – HealthSpring is  Medicare Part D Supplement that seniors can sign up for that costs nothing and provides preventive dental services for member dentists. Seniors can choose to pay an additional premium to increase coverage for dental treatment as well.

E. Dental Options Clients

Dental Options is a program run through the Ohio Dental Association. People having financial problems in need of dental care can call the Options program and they will be screened. The Options program will take turns calling the dentists in that client’s geographical area so that each dentist sees a handful of these low income clients each year. We are not providing free care to these clients, but they are paying on the Options Fee Schedule (we get copies of this). All our GP dentists participate in this program. We also have the Options program on our list for people that come to us and are having significant financial problems.

Here’s how the system works:

1. Doctor receives a letter from Options that describes the patient’s situation and he should give it to a secretary. The docs will expect the secretary to manage this patient.
2. When secretary gets the letter – read it, sometimes the letter will tell you what the patient wants – i.e. full dentures. In the letter it will request a specific fee schedule be used. The fee schedules are A – E. Fee schedule A is the least amount discounted while fee schedule E asks us to provide virtually free dentistry. If they do not include the fee schedule with the letter, then you have to call Options and request the fee schedule.
3. If the letter references fee schedule A, then we will automatically see the patient. If the letter requests any other fee schedule, then you must take the letter & the fee schedule to the doctor to ask if he wants to see the patient.
4. If the doctor says he will see the patient, then you will call Options to tell them yes and ask the patient to call and ask for you directly. You should keep the letter & fee schedule until this patient calls.
5. The client will call back to schedule. You will schedule this just like an emergency exam – 2 units in the doctor’s second column. Make the chart & put the letter & fee schedule in it. Also write on the top of the paperwork “Dental Options Client – $ a problem” and create an alert as well. Also schedule an FAs appointment after this exam so that you (or a top level secretary) can sit down with the client to review the treatment plan and set up the financial arrangements.
6. At the exam appointment: Doc will create a treatment plan that works for the client’s financial situation-focus on the client’s chief concern not thorough treatment. For example: Not STM but 2 step cleaning; No PVCs –Stainless Steel Crowns. After the treatment plan is discussed with the patient, then the secretary will do Fas (financial arrangements). These FAs should NEVER be done at the front desk. Always move this person to the consult room for privacy.
7. The secretary’s job is to follow our normal financial policy using the reduced fee schedule. If the patient can work out FAs then go ahead & schedule. Usually, they will not make any decision that day, so we will give them the brochures associated with the treatment they want and a written plan for the total cost and the acceptable financials. Secretary to make notes in the chart & the computer so that if the client calls back to schedule, that patient will be directed to talk with the secretary that has been handling the case.

F. Broken Appointments (never reappoint them same day!)

Recep. Oh Mr. ______. I’m sorry you won’t be able to make your appointment. I know Dr. Smith was concerned that we get that (crown filling, root canal, etc.) done before it gave you any more problems. Are you sure there’s no way you can be here? If “no”- Ok Mr. ____ All our available appointments are filled, I can place on our call list until something opens up, it will probably be 2-3 weeks. Will you be okay until we can arrange that appointment?.

Calling a client to fill a space on short notice.
Recep. “Hello Mrs. _________. This is Nina from Dr. Smith’s office. We have had a change in our schedule and I knew you’d want to complete your treatment as soon as possible. Would you like the 2:30 time?”

Client wants to come in earlier than there is an opening.
Recep. Right now that time’s all been reserved. If there is a change in schedule (do not say cancellation), I’ll call you. In the meantime, let me reserve a time for you on _________.

You want to change a client’s time. This can happen when Dr. will be attending a course on short notice or you are trying to work in another client.
Recep. Hello Mrs. _____. This is ______ from Dr. Smith’s office. We have a patient in pain and Dr. wondered if you would allow him to use the time we reserved for you today.
or
“… Dr. Smith will be attending a continuing education seminar next week. This came up on very short notice. I’ll need to reschedule your appointment. I hope this won’t inconvenience you.”

You want to move the client’s appointment up one half hour. “Mrs. West, we need you to come in at 2:00 rather than 2:30 so we can smooth out our schedule. Can you help us?

______________________           ______________
Initials (Level 3+)                                         Date

G. Creatively Filling a Schedule

The primary responsibility you have as a secretary in a dental office is to fill the schedules. Filling the schedule takes priority over any other project. To make sure you can fill the schedule, write down 3 examples of situations where you creatively filled the schedule and turn in to your office manager.

Can fill the schedule:
_________________________________ ___________________
Signature Date

H. Military patients

Active duty military patients have dental insurance through the government. The government will give the patient an approval number for each appointment and the dentist is to submit a “Readiness number” for each visit. This Readiness number is a rating of the dental health of the patient to make sure they are ready for action. The dentist chooses from:

1 – No dental issues

2 – Minor issues

3 – Dental emergency

The dentist needs to document this readiness number and then add it into the Remarks section of the claim – if you do not submit this Readiness number, the claim will not be paid. (If you miss doing this, call your patient to get the best phone number to call and submit this number over the phone.)

Signatures For Each Section:

Estimates/Ledger/Terminology

______________________________________ _______________
Signature Date

Welcome New Patients

_____________________________________ ________________
Signature Date

Controlling the Schedule

_____________________________________ _________________
Signature Date

Filling the Schedule

_____________________________________ _________________
Signature Date

Primetime List

____________________________________ __________________
Signature Date

Welfare and Dental Options Clients and Broken List

________________________      ______________
Signature                                                        Date