Thanks for Asking

2014-04 PST 1

Kathy Edwards, RDH, Margaret Boyce-Cooley and Dana Morano of the Practice Support Team

Burkhart’s Practice Support Team provides support to doctors by answering hundreds of questions that come in through our toll free number and email. It is our pleasure to provide answers and resources—at no fee—to all of our Burkhart clients! Consider it a value-added service from Burkhart. We’ve compiled the most frequently asked questions and shared some insight on those here:

Q: How can I be sure I am hiring the right employee?
A: Hiring a new team member can be a daunting task, and it is difficult to “see through” that first impression. Fortunately, there are a few steps you can take to gain additional insight into a potential new staff member. Well-structured interview questions that focus on both technical skills and team interaction abilities through open-ended questions and scenarios force the candidate to provide more candid responses. If you find those answers satisfactory, the next step is a thorough reference check that needs to be done by the doctor directly. If the staff member will be handling monies and account information, a simple background check can help prevent disasters. We are happy to provide you with interview and reference check questions—give us a call or email the Practice Support Team.

Q: I am starting a new dental practice. is there any type of checklist you can provide to make sure I’m not missing anything?
A: Yes, there is—in fact, we not only have a checklist for dental start-up practices, but would love to be your resource! We have found that our start-up practice doctors not only appreciate the checklist, but find value in a phone call to discuss their specific concerns.

Q: My case acceptance rate could be higher. Do you have any tips I can pass on to my employees to increase the number of patients accepting treatment?
A: Your case acceptance is reliant on several things working well:
1. The transition from the RDH: Doctor engages the patient and includes a synopsis of the patient’s periodontal and restorative status, as well as aesthetic desires. The doctor’s exam should occur mid-way through the appointment, allowing the front office time to put together the financial part of the treatment plan, and time for the RDH to validate treatment once Doctor leaves the operatory.
2. For larger cases, a ballpark estimate given by the dentist will help the patient understand the type of investment they are making and potentially ask further treatment related questions.
3. The transition from the clinician to the front desk is done in front of the patient, so the next step in treatment is clear.
4. The front desk makes the plan affordable and gets it scheduled. They should be armed with phrases to use when patients don’t schedule, such as, “Are there any challenges I can help you with to get the needed treatment started?” All too often the patient has some type of challenge-usually financial-and they aren’t comfortable bringing up the topic. Knowing they can make a payment, or use an outside funding option, may be all they need. A private area to discuss this in is also highly effective!

Q: What is the difference between the two comprehensive exam codes (D0150 and D0180), and when is it appropriate to use one over the other?
A: Both codes can be used for comprehensive new patient exams. The D0180 includes a periodontal examination and is used for patients showing signs or symptoms of periodontal disease, or who have risk factors for the disease, generally an AAP III or higher case type. D0180 includes evaluation of periodontal conditions, comprehensive probing, and charting, evaluation, and recording of the patient’s dental and medical history. D0180 includes all the elements of a comprehensive restorative and periodontal exam, while the D0150 does not have the periodontal assessment requirement. For general dentistry practices that treat periodontal disease in-house, D0180 is appropriate for that patient base.

Offices should attach a higher fee to D0180 because of the extra time needed to conduct a full-mouth, six-point probing and recording for all teeth, plus charting of recession and mobility. Many third-party payers reflect a higher reimbursement in their schedules for this reason. Some offices alternate between D0120 for a regular preventive appointment and D0180 when a full-mouth periodontal charting is performed once a year. Remember, most third-party payers will cover two exams per year.

One of the frequent questions we hear is whether or not third-party payers will cover D0180. The answer depends on the payer. According to reports from some offices, payers will reimburse D0180 once every 12 or 24 months, some will down-code the D0180 code to D0120 for reimbursement, and a few will reimburse this code only once per lifetime. Insurance companies can set all kinds of restrictions on payment. It is important for practices to use appropriate codes to consistently reflect the work that has been performed, which is dictated by the patient’s needs, regardless of whether or not a patient’s third-party benefits cover the procedure.

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