Misunderstandings concerning treatment and fees can be reduced dramatically between office and patient by notating and having the patient sign the agreed-upon treatment plan in that patient's record.

CDT-2005

There's a new codeset due to become effective 1/1/05. We will update this site as new information comes out including impact on the individual dental office.

Are you on the same page as the specialists you refer to? An interesting situation was presented by one of our subscribers and they wanted to share it with the entire Group. A patient had had a 3 unit bridge (28-29-30) inserted ~ 15 years previously. The patient had disappeared for several years and when he returned, presented with loose bridge caused by a severely broken down unsalvageable #30. The patient was in his late 70's, had average periodontal health and a history of "putting off definitive treatment until it was really necessary". In addition, the patient had subgingival decay around another crowned tooth, #12. It was decided that the tooth requiring the crown lengthening would be addressed first, and then attention would be directed to the the molar abutment and its options. The patient was referred to a periodontist. Two months later the patient returned with a healed crown lengthening on #12 and an implant where #30 had been! The only fee the periodontist had discussed with the patient had been the implant. When the patient found out the cost for a replacement bridge, he hit the ceiling.
The lesson from this is that make sure your specialists understand that they should be co-treatment planning with you. They should not be taking the initiative and possibly misleading the patient. They should discuss treatment options with you before presenting to the patient.

Take a free all-expense-paid tour.... around your own office. Pretend you're a patient and have a seat in the reception room. Can you inadvertently overhear confidential phone or financial conversations that are taking place in the reception area between your front desk personnel and patients. Remember HIPAA? Recline in your treatment chairs. Remember that dead fly in the overhead lighting assembly that your patient mentioned to you a month ago but, since you never look up, forgot to confirm that the cleaning crew removed? Does your staff un bag your instruments in front of the patient (so the patient actually sees that you follow the proper sterilization techniques) or is that done before they are seated, so they're ready for you to use. Remember that perception is reality. Every once in a while, look at your practice from the same perspective as your patient. You'd be surprised at what you see.

This tip can not be repeated enough: Never ever send your original x-rays in to an insurance carrier. They are integral parts of the patient's permanent record, legal documents for your office and are necessary if your treatment is ever challenged by the state board, other insurance companies, etc. Always send duplicates or, better yet, use double film packets..