Talking with the Toothcop

Let's face it; you never can be too careful when it comes to writing prescriptions and taking into account all the details of your patient's medical history. Are the processes and procedures at your dental office up to date?

On this episode, you'll hear from Andrea and I as we discuss codes of conduct, firewall, and antivirus protection, reviewing medical history, and much more. If you want to make sure your practice is operating at the top of dental compliance, you've come to the right place! Have pen and paper ready; you don't want to miss a minute of this helpful and informative episode.

Don't skimp on network security.

While technology and computer networks might not be in your wheelhouse, when it comes to protecting patient data, you can't skimp. Time and time again, I hear that staying in compliance is a difficult thing to do, and I get it, but you've got to prioritize certain aspects like network security. Don't try to get by with a "Free" version of anti-virus software or a less than stellar firewall. Take the time to do your research and protect your patient's data, trust me, it's worth it!

What is the Prescription Data Monitoring Program (PMP)?

A few years back I noticed that Arizona had adopted a strict policy that required all dentists in the state to check their patient's consumption history for controlled substances before writing a new script. Fast-forward to today and almost every state in the country has adopted a similar requirement often referred to as the Prescription Data Monitoring Program (PMP).

The PMP is an excellent tool that allows dental offices like yours to make sure they are taking their patient's full medical history into account. You can learn more about the PMP by listening to this detailed episode!

Why you need to have an up to date record of your patient's medical history.

How often does your dental office update your patient's medical history? Do you do it annually? How did you determine how often you'd request an update? I highly recommend getting an updated medical history of your patients every year. Why risk it when it's just a little extra paperwork? Don't just squeak by with the bare minimum requirements, I've found that the dental offices that set themselves apart from their competition are the ones that go the extra mile to ensure patient safety.

Make sure to get a custom fit for your office.

Whether it's network security, the Prescription Data Monitoring Program, updating your patient's medical history, or something in-between, find what works for your office. There is no one size fits all solution when it comes to these complicated and challenging topics. Put in the time to do your research and customize a solution that is tailor made for your specific practice. I've seen way too many offices grab some template from the internet or the cheapest anti-virus software only to find that they regretted the choice when it was too late. Don't let that happen to you!

Outline of This Episode

• [0:22] Andrea and I introduce today's topics, codes of conduct, firewall and antivirus protection, medical dental history, and the notice of privacy practices.
• [3:30] Why you need to make sure your computer network is secure.
• [6:00] How a cryptovirus can impact your practice.
• [9:40] What is the Prescription Data Monitoring Program (PMP)?
• [14:50] I share a story about looking up a patient's history on the PMP.
• [16:30] Why it's helpful to get a detailed medical history on your patients.
• [20:00] Make sure your notice of privacy practice is specific to your office.
• [24:20] Where to get a template for notice of privacy practice.
• [26:00] Closing thoughts.

Resources & People Mentioned

• Model Notices of Privacy Practices

Connect With Duane

• https://www.dentalcompliance.com/
• toothcop(at)dentalcompliance.com
• On Facebook
• On Twitter
• On LinkedIn
• On Youtube

We've got a whole line up of super sexy topics to cover, from safety data sheets and safe injection practices to radiology infection control and more! While these may not be the most exciting topics, you know that proper attention to important subjects like these is what differentiates an excellent dental office from an average one. What are you waiting for? Have pen and paper ready for this detailed and informative episode of Talking with the Toothcop, you don't want to miss it!

Safety Data Sheets

What are safety data sheets and when are you required to use them? If you've been unsure of how to utilize and safety data sheets or why they are a tool you need to have available in your office, this is the episode for you! A safety data sheet, material safety data sheet, or product safety data sheet is a document that lists information relating to occupational safety and health for the use of various substances and products. As a shorthand, think of it this way, you need to fill out a safety data sheet for anything you purchase from your specialty dental supplier. For additional information on safety data sheets and why you need them in your dental office, make sure to listen to this episode!

Safe injection practices

Did you know that one of the best ways to safeguard your staff from getting accidentally stuck with a dirty instrument is to recap it break it down yourself? While that may sound like a no-brainer, you'd be surprised at how many dental offices don't make this simple adjustment to their procedures. It almost goes without saying but I'll add it here anyway, make sure to NEVER reuse needles and ALWAYS use a Sharps Disposal Container for proper disposal. Don't open yourself up to unnecessary risk, review your process and make sure you have all of your bases covered. To hear more helpful guidelines and best practices, listen to this episode!

Low-speed handpiece motors

Do you really have to sterilize your low-speed handpiece motors or is that just an extra step that some dental offices take unnecessarily? According to CDC guidelines for infection prevention and control, the answer is yes, you do need to sterilize your low-speed handpiece motors.

The CDC guidelines state that "...between patients, dental health care personnel (DHCP) should clean and heat-sterilize handpieces and other intraoral instruments that can be removed from the air and waterlines of dental units. This recommendation is based on studies that have shown that the internal components of air-driven dental handpieces (both low-speed and high-speed devices) can become contaminated with patient material during use, and this material can then be expelled into the mouth of other patients during subsequent uses."

Make sure your processes aren't violating Federal law! For an in-depth explanation of this critical topic, make sure to listen to this episode of Talking with the Toothcop.

Join my 10-day challenge!

Did this conversation give something to think about? Are you in good shape when it comes to safety data sheets, safe injection practices, low-speed handpiece motors, and the rest? Even if you think your office is completely up to snuff, I'd like you to consider taking my ten-day challenge. I challenge you, each day for the next ten business days at some point in the day to rifle through your drawer of sterile instruments and look for anything that might not be sterile. My guess is, you'll find at least one unsterilized item a day. Are you up for the challenge? Let me know how it goes!

Outline of This Episode

• [0:22] I introduce today's topics, safety data sheets, safe injection practices, low-speed handpiece motors, and radiology infection control.
• [9:40] What you need to know about safe injection practices.
• [11:45] Why you have to sterilize your low-speed handpiece motors.
• [16:30] How to protect your patients from radiology infection.
• [22:20] My 10-day challenge for you.

Resources & People Mentioned

• Centers for Disease Control and Prevention

Connect With Duane

• https://www.dentalcompliance.com/
• toothcop(at)dentalcompliance.com
• On Facebook
• On Twitter
• On LinkedIn
• On Youtube

When was the last time you addressed dental waterline maintenance at your office? Are you aware of the increased challenges that many dental offices are facing when it comes to waterline maintenance? On this episode, you'll hear from Mike Rust and Monica Boldt from ProEdge Dental Water Labs.

ProEdge serves dedicated dental professionals by offering assurance with highly trusted waterline testing, expert consultation, and product solutions for your dental practice. They've been testing dental water for over fifteen years with over 160,000 tests, but more importantly, their dental water experts have helped thousands of practices achieve safe water.

In our conversation, Mike and Monica talk about why testing water lines are so important, how R2A helps make water safe, what causes biofilm to grow, upcoming changes to state regulations, how to order a waterline test, and much more. Don't miss a minute of this helpful and informative episode!

Why dental waterline maintenance is so important.

Everyone gets why water testing our drinking water is so important, but if that water is treated and tested regularly, why do we need additional dental waterline maintenance? According to the Centers for Disease Control and Prevention (CDC), safe water should contain less than 500 Colony Forming Units (CFU) per milliliter. Unfortunately, on average three out of ten dental waterlines tested have over 500 CFUs per milliliter. Dental offices that want to stay ahead of the curve need to make sure that they have a plan in place that will keep their patients safe.

Stay ahead of the curve and keep your patients safe!

Even for those dental offices that put a plan in place, dangers still lurk in the water. The team at ProEdge has identified two reasons that lead to failed waterline tests.

• Not all products are easily implemented
• Some products are not as effective as advertised

Is your plan fool-proof? Could you be missing critical factors that will leave your practice open to liability? ProEdge has over fifteen years in the dental waterline maintenance industry, and they've completed over 165,000 waterline tests. To learn more about the amazing solutions they've created for dental offices like yours, make sure to check out the link to their website located in the resources section at the end of this post.

What to expect when you get your waterline tested.

If you are ready to update your dental waterline maintenance program or put a plan on paper for the first time, you've come to the right place! On this episode, Mike Rust and Monica Boldt explain what dental offices like yours can expect when you decide to get your waterline tested. When you order ProEdge's standard kit, you'll receive one mailer kit, lab service, and one sample vial. Once you have the kit, you'll proceed to collect water samples from each dental unit in separate test vials and place it in the provided mailer; the samples are then received and processed immediately. Once the testing has been completed, a full test results report is faxed or emailed to you after the samples are processed (7 Days). For a full breakdown on the waterline testing process and more details on this subject, make sure to listen to this episode!

Outline of This Episode

• [0:22] I introduce my guests, Mike Rust and Monica Boldt.
• [2:20] Mike talks about testing water lines.
• [6:45] How does R2A work?
• [9:45] What is biofilm and how does it impact our drinking water?
• [14:00] Why it is important to take care of your water sources.
• [19:30] Washington and California will soon have regulations regarding water testing.
• [23:00] How to order a water test and what to expect.
• [27:15] Closing thoughts.

Resources & People Mentioned

• ProEdge
• ProEdge on Twitter
• ProEdge on Facebook

Connect With Duane

• https://www.dentalcompliance.com/
• toothcop(at)dentalcompliance.com
• On Facebook
• On Twitter
• On LinkedIn
• On Youtube

Have you ever been tempted to respond to patients who had a negative experience and have taken to the internet to tarnish your business reputation? Did you give in to the temptation? What is the best approach in these type of situations? On this episode, you'll hear about how to respond to negative feedback online, when to use patient consent forms for pictures, how to best serve patients with disabilities, and much more. If you have struggled with how to respond to less than positive feedback online, you don't want to miss this episode!

Don't let yourself get dragged into an online argument.

If you spend very much time on the internet, you are likely familiar with review sites like Yelp. These type of sites can be helpful but often play to our worst instincts to blast others and complain without fear of facing the consequences. What should you do when you see negative public reviews or comments about your business? Should you engage and counter their argument or just let it roll off of your back?

Unfortunately, many of you won't like my answer. While you can engage, I strongly caution against getting dragged into an argument!

The best course of action when dealing with negative feedback that attacks your business reputation is to acknowledge the response and thank the patient for providing valuable feedback. It is best to keep your response brief, professional, and positive or at least neutral. Remember, people on these sites are watching how you respond and they are judging your business accordingly.

Are patient consent forms for photo use really necessary?

I'll admit it, I've had to stop following many of my clients online because I cringe when I see them post pictures for promotional use that show their patient's information or image. In this day and age, you've got to be extra careful about displaying the image of your patient for marketing or any other outside use. If you are going to post a picture to social media or in some other promotional use featuring a patient, it's best to make sure you have a patient consent form filled out. You don't have to make this step difficult, there are a ton of resources out there with generic forms you can use to make sure you and your business reputation are covered. For more information on this vital topic, make sure to catch this episode!

Serving patients with disabilities.

Is your office prepared to serve your patients who have a disability? While most offices are prepared for those who have limited mobility or those who are blind, you might not be as prepared for other individuals with disabilities as you might think.

I recently received a call from a dentist who is trying to figure out how to best serve his patient who is deaf. The patient usually has their spouse accompany them to appointments to serve as their interpreter but they were unable to attend this upcoming appointment. In that situation, would you know what to do? Does your office have a plan in place?

While most offices won't face this scenario, it is wise to have a plan written out and ready should the occasion arise. You need to know that you are required to accommodate all disabled patients and in this situation, that would mean that you have to provide an interpreter and you can not pass that cost on your patient.

To hear more about serving patients with disabilities while maintaining a positive business reputation, listen to this episode of Talking With The Tooth Cop!

Outline of This Episode

• [0:20] Are you paying attention to your business reputation?
• [3:45] How you should respond to patient reviews online.
• [5:10] Why you need consent forms when using pictures of patients for outside purposes.
• [7:10] Do you need to provide an interpreter for deaf patients?
• [12:40] Remember, there are riches in niches!

Resources & People Mentioned

• National Association of the Deaf

Connect With Duane

• https://www.dentalcompliance.com/
• toothcop(at)dentalcompliance.com
• On Facebook
• On Twitter
• On LinkedIn
• On Youtube

Every year fines are levied against well-meaning, hard-working individuals in dental practices all across the country. Nobody wants to do things that put their staff members or patients at risk, yet these safety infractions keep happening. Why? It's not because rules and regulations change, it's because the practices that ensure safety in the dental office slip over time. It's an issue of not effectively creating a safety culture.

On this episode, I'm chatting with Andrea about the most recent years of OSHA violations, going item by item through the violations to point out how and why they happened. We wrap up with some tips and strategies about how you can create something bigger than a commitment to enforcing the rules - you can and should create a safety culture among your team. It's way more powerful.

There's not a Dentist alive who wants to put people at risk

Nobody would even suggest that Dentists are overlooking safety issues because they don't care. Every Dentist I know cares deeply about their patients and their staff. So what is it that causes offices across the country to be fined for safety violations? It's a lack of consistent attention to the policies and procedures that keep people safe.

Listen to hear what causes the average Dentist's commitment to safety to slip in practical ways, hear our suggestions about what needs to be done to keep things on the up and up, and to understand how you can protect yourself and your office from being the next to be cited for violations.

Some of the dental safety violations we see are simply paperwork

There are true safety concerns among the things we note in this episode, but many of them are simply a failure to document the safety steps that have been taken in the practice. I'll give you some examples. In many of the cases where OSHA has cited practices in the past 3 to 4 years, there were:

• No written blood-borne pathogen plans
• No proof of Hep B vaccinations
• No hazard communication plans
• No Safety Data Sheets in the workplace

Do you see what I mean? In most cases, these are one-time administrative tasks that simply need to be created and made available. It's not hard, just time consuming and tedious. The worst part is that by NOT doing something so simple, hundreds or even thousands of dollars worth of fines are being levied, and patients and team members are being put at risk.

A clear example of why a culture of safety is the answer

In some of the instances where dental practices were cited, the infraction was a fairly simple, easy to do task that simply wasn't being done consistently. For example, it's still the case that many of those serving in the office are not wearing the proper eye protection for the task they are performing. Still, others are not using other forms of PPE.

This is not a rule problem - it's a culture problem. It's sometimes harder to fix safety issues of a cultural nature but when you do, the slips tend to go away. Listen to find out how we suggest you go about creating a culture of safety in your practice.

A culture of safety begins with the leader

I'm convinced that every Dentist wants their team and their patients to be safe from blood or body fluid-borne pathogens. The same holds true when it comes to exposure to hazardous materials or radiation in the dental office. If that's true, then the primary motivator for creating a culture of safety is already in place. Dentists simply don't know how to practically apply what they already believe.

Don't think of this as an issue where you need to be the bad guy or bring the hammer down. It's not that at all. What you need to think of is communicating your heart to your team, your desire to see EVERY team member and EVERY patient cared for in a safe manner. That will matter to your team because it demonstrates that you are in it for them. From there, you speak practically about what that concern motivates you to do (follow the prescribed guidelines for safety and ensure your team does too). Your team is smart, they'll make the connection and get on board. Then THEY will be part of your culture of safety.

Then, and only then, you implement your no-toleration policy regarding adherence to the safety rules that have been established. Safety problems don't typically happen because the rules change, they happen because attitudes and diligence change - when they shouldn't. Listen, to learn more.

Outline of This Episode

• [0:22] Creating a culture of safety in your office
• [2:10] How active is OSHA in the dental industry? Not very. It's
• [5:59] What are the violations OSHA Is citing for?
• [10:39] No eye or face protection violations
• [12:55] Not requiring the use of PPE - Doctors don't enjoy using it but they must do it
• [15:56] Healthcare associated infections: a new law in California
• [18:26] The little things that add up
• [22:57] The takeaways: a line has to be drawn in the sand

Resources & People Mentioned

• OCR - HIPAA violations

Connect With Duane

• https://www.dentalcompliance.com/
• toothcop(at)dentalcompliance.com
• On Facebook
• On Twitter
• On LinkedIn
• On Youtube

We like to have fun on these podcast episodes - which you'll hear in this recording - but dental regulatory compliance is not a laughing matter. Tens of thousands of dollars in fines are levied against practices regularly for a variety of infractions and omissions. We thought it would be beneficial to share the most common mistakes we see when we do our compliance consults in client dental offices - so that's what we recording on this episode.

Listen to hear OSHA and HIPAA regulatory requirements and how dental offices around the country are missing vital points of compliance. Much of it is tedious, but it's all the law - and the fines are hefty if you don't comply. Be sure you listen.

A "BAA" - Business Associate Agreement is required in many cases to protect patient information

Every dental office out there works with other service providers. "BAA"s or "Business Associate Agreements" need to be in place for every service provider your office works with.

HIPAA defines a business associate as any organization or person working in association with or providing services to a covered entity who handles or discloses PHI or personal health records (PHR). There's a laundry list of companies or individuals you may work with who fit that description. On this episode, we provide examples and explain what you need to do to ensure your office is compliant with this regulation.

Did you know you need to keep an OSHA medical file for every employee - for 30 years?

Every person who works in your dental office needs to have a handful of documents on file in your office - under lock and key. We commonly refer to these as the Employee's OSHA Medical File. While there are a number of items that could be kept in the file, there are 3 that are must-haves:

1 - Hepatitis B Acceptance or Declination Form

2 - PPE Acknowledgment Form

3 - The Employee Exposure To Termination Form

And the file has to be kept for 30 years. 30 years!??? Yes, 30 years.

That brings up a valid question, "Can these records be kept electronically instead of in hard-copy?" We talk about that question and much more on this episode.

Are you transporting sharp instruments properly inside your office?

One of the most common dental regulatory compliance issues centers around the issue of transporting sharp instruments within the office. Best-practice is to have all instruments in a hard-sided, covered container so that should a slip or fall occur, the instruments are contained and nobody is at risk of being cut or otherwise injured.

But very few dental practices pay attention to this regulation - mainly because it's a bother. That's not a good reason, so we encourage you to think through consistent ways you can train your office staff to comply with best-practices. If you're found out doing this wrong, tens of thousands of dollars in fines could be levied against you.

Employee training has to be more important than the desperation to get the work done

Every busy dental practice knows the struggle it is to find qualified, motivated team members. When you do find someone who fits your team, it's tempting to get them rolling in the actual work of the job right away to relieve some of the pressure and stress within the office. But hold on - don't forget there is a lot of mandatory disclosure and training that must happen before that new employee steps into the role they've been hired for.

Employee training on OSHA and HIPPA issues is vital to ensure that best practices are followed in every step of treatment, record keeping, and patient care. Our team can help you think through your existing systems and put adequate training in place. Or, for now, you can listen to this episode to hear our advice on how to address this important issue.

Outline of This Episode

• [0:55] Is it cactus or cacti? We're afraid to Google it…
• [2:47] Is OSHA a not as scary as The Office For Civil Rights
• [7:01] How these issues come onto the radar in the first place
• [8:42] Top concerns we see in offices regarding OSHA consults
• [19:01] Common trends relating to radiology equipment slip-ups
• [22:55] The beauty of what we do at Dental Compliance
• [23:58] Coming soon to your State (it's happening now in Texas)
• [27:14] Reasons potential employees might be on an exclusion list

Resources & People Mentioned

• Texas regulation 110

Connect With Duane

• https://www.dentalcompliance.com/
• toothcop(at)dentalcompliance.com
• On Facebook
• On Twitter
• On LinkedIn
• On Youtube

On this episode of Talking With the Tooth Cop, I interview Santosh Patel, founder and president of Complete Specialty Solutions, a business dedicated to bringing high-quality dental specialists into your practice with as few logistical nightmares as possible. Throughout this episode, he explains the benefits of bringing in outside dental specialists and how you can leverage their expertise in your community. We discuss how to keep patients safe and protect their privacy while incorporating traveling specialists, as well as why relationship building is key throughout the whole process. It's an episode not to be missed - listen now.

Complete Specialty Solutions offers practical services for independent dental professionals

Many patients are unable to access the specialty care they need, particularly in smaller towns and rural areas. Santosh explains that the idea for CSS came from his background in hospital management, and his desire to inject great healthcare practices and organizational structure into dentistry. CSS provides many resources to dental practices in the Houston/Dallas area such as board-certified specialists, marketing strategies, patient recruitment plans, scheduling services, and many more.

Santosh and his team accomplish all of this through their network of part-time employees that work for their professional limited liability company. The professionals coming into the practices are not independent contractors, so each dental specialist carries their own certificate of specialty, malpractice insurance, etc. Essentially, CSS is a full-scale operations team that can "help be the how-to solution" for small practices looking to expand their services and offerings while still seeking to maintain their autonomy.

Having accurate record-keeping and proper workflow ensures dental specialists can be successful in your practice

Many dentists are hesitant to bring in dental specialists simply because of the perceived logistical nightmare. However, Santosh's team has developed a way to ensure all records, notes, and files are seamlessly kept up to date as a specialist moves from practice to practice. Typically, a GP fills out a referral form, which is then delivered to CSS. They then recommend a specialist to travel to the practice, where he or she provides all of their own personal documentation. The specialist performs the service and completes all necessary patient care. Billing goes through the practice's tax ID number but is filed under the specialist's National Provider Identifier number. The CSS method prevents multiple tech platforms from being used, resulting in a higher level of satisfaction from the GP, the practice's staff, and the patients.

There are steps you can take to prevent liability and malpractice issues when bringing in additional dental professionals

In addition to stellar record keeping, CSS can assist practices with preventing liability and malpractice issues. They encourage the GP to let their insurance carrier know that they're bringing in dental specialists, as well as keep honest and direct lines of communication open. Santosh has also discovered that by using specialists that are local to the practice's area, there are fewer chances of issues arising. If the specialist has a rapport within the broader community, and they fit with the overarching practice culture, it can go a long way towards preventing lawsuits and miscommunications.

Pairing independent practices and third-party dental specialists must be about building solid relationships

Throughout this entire episode, Santosh explains the critical importance of relationship building between dentists, their staff, and dental specialists. Without a healthy rapport between all 3, the process is less likely to be successful and effective. CSS does not seek to have short-term contract work with practices, rather they're striving to build long-term working relationships between specialists and dentists. CSS encourages all specialists to be diligent in follow-up care with patients, working with the practice's staff to ensure their databases are accurate, and speaking honestly with everyone involved in order to make the specialist process as smooth as possible. For more, be sure to give this episode your full attention.

Outline of This Episode

• [0:21] Santosh Patel explains what Complete Specialty Solutions can offer for your practice
• [3:40] All about Complete Specialty Solutions and what they can offer to your practice
• [10:20] The employment and organizational structure of CSS
• [17:22] Auditing, fraud, and ensuring accuracy in your record-keeping processes
• [25:00] Liability issues in the specialty dentistry industry
• [31:20] The top things Santosh looks for when researching potential practice partners for CSS

Resources & People Mentioned

• Connect with Santosh on LinkedIn
• Follow Complete Specialty Solutions on LinkedIn
• CSS website

Connect With Duane

• https://www.dentalcompliance.com/
• toothcop(at)dentalcompliance.com
• On Facebook
• On Twitter
• On LinkedIn
• On Youtube

Successfully keeping dental records goes beyond preventing lawsuits and insurance headaches. It's necessary to provide excellent patient care and operate the best practice for your patients and staff alike. Auditing is required by many regulatory agencies, and having proper audit records could prevent malpractice lawsuits and other issues. On this episode of Talking With the Tooth Cop, I explain 7 main reasons why you must be excellent in the way you're keeping dental records. I also outline 3 main types of audits and explain why YOU, the dentist, must justify every decision you make regarding patient care. It's an episode packed with need-to-know information that can't be missed, so be sure to listen.

7 reasons why you need to evaluate how you're keeping dental records

Keeping accurate dental records is the best way to protect your patients, your practice, and yourself. To comply with regulations, minimize risk, and continually improve on the way you practice dentistry, consider these 7 reasons why keeping great records is essential.

1. To reduce and ultimately prevent improper payments
2. To enhance patient care
3. To speed up and optimize proper claim payments
4. To minimize billing mistakes in our practice
5. To reduce the chances of an external audit
6. To show good faith and due diligence (protect our integrity)
7. To send a message to your staff that everyone should positively contribute to the practice by reporting, correcting, and learning from mistakes

Various types of audits can be used when keeping dental records

Even though it's easy to become complacent in mundane office-keeping tasks, maintaining proper records are essential. You can ensure the quality of your records through regular auditing processes. There are 3 main types of audits that you can implement.

1. Prospective/pre-bill audits
2. Retrospective audits
3. Limited/problem-focused retrospective audit

The first type of audit is done on a daily basis, where your office staff examines end-of-day reports and verifies every pending claim with actual treatments administered. These audits are time-consuming but prevent administrative hassles later on. The second type of audit doesn't look at every claim or chart, but rather a snapshot of a few different types of charts. It holds everyone accountable for consistent processes. Finally, the third type of audit involves pulling 10 records, selecting one evaluation area, and examining those records against the one specific area (i.e. HIPPA form completion). The next time you pull 10 records, select a new evaluation area. This method is faster, although not 100% complete. For the full explanation of different types of audits, don't miss this episode.

Comparing clinical notes with your dental and billing records is a crucial step

Every dental practitioner and their staff should constantly ask themselves, "Do our clinical notes describe every aspect of the billing records?" The balance between clinical notes and billing is immensely valuable when taking preventive action against unnecessary paperwork and insurance issues. It's important to carefully examine the claims you submit to insurance providers and look for red flags that would point towards gaps in information. This episode is full of helpful information that will make your practice and your office run much smoother - you don't want to miss it.

The onus is on YOU, the dentist, to justify which treatments you provide to your patients

As the dentist administering care, the burden of proof for explaining treatment falls on your shoulders. YOU have to justify the need for a treatment and why it was necessary. This is achieved by supporting the necessity with the following pieces of information:

• A clearly stated diagnosis
• Presenting conditions that support the diagnosis
• All risk factors
• Materials used
• How you completed the treatment
• Expected vs. actual outcome

Essentially, you have to tell the whole story, leaving no detail unexplained. If you have a great way of keeping dental records, it will guide you through this documentation process. And even if the treatment was medically necessary, if your dental records don't reflect that, the payees will assume that it was not medically necessary. Transfer all of your knowledge and patient history onto paper, and you'll save yourself from inconveniences in the future. For even more great insights, don't miss this episode of Talking With the Tooth Cop.

Outline of This Episode

• [0:21] 7 reasons why you need to evaluate how you're keeping dental records
• [8:49] Why should you audit these record keeping processes?
• [10:57] You can use these 3 types of audits in your practice
• [19:57] Comparing clinical notes with your dental and billing records is a crucial step
• [30:52] YOU have to justify which treatments you give your patient
• [35:37] The latest info on dental record retention timelines

Resources & People Mentioned

• Eaglesoft dentistry software
• Dentrix software tool

Connect With Duane

• https://www.dentalcompliance.com/
• toothcop(at)dentalcompliance.com
• On Facebook
• On Twitter
• On LinkedIn
• On Youtube

The Texas State Board of Dental Examiners has released new regulations regarding nitrous oxide delivery. These regulations are going to change the way your practice handles routine business, and you need to be aware of them. On this episode of Talking With the Tooth Cop, I outline the new 3 main rules, what requirements have not changed, and why your office needs to take these changes seriously. Note that these rules apply to all levels of nitrous oxide delivery and sedation and they are applicable for patients of all ages. It's a complicated subject with many details, so to get the full story listen to this podcast episode.

These requirements have not changed, even after implementation of the new regulations

Even with the new regulations, a few staples of dental care have not changed. You must employ qualified, trained staff who can identify problems and emergencies in your practice. Evaluating patients prior to sedation, utilizing consultations if necessary, and having written, expressed, and informed consent is still required when using nitrous oxide or any other method of sedation. Equipment checks must be completed thoroughly and regularly and proper patient records kept. You must also ensure all staff members are aware of who can and cannot be involved in delivering sedative drugs. To hear the full list of regulations that are still in place, be sure to listen.

New rule #1 - Preoperative checklists must be completed

This rule applies to sedating any patient via any method. The TSBDE now required offices to "create and maintain in the patient's dental record" a checklist entitled "Preoperative Sedation Anesthesia Checklist." Included in this checklist must be the following:

• Medical history review
• Confirmation of informed consent
• Confirmation of delivery of pre/post procedure instructions
• Physical examination
• Equipment readiness check confirmations
• Any special preoperative considerations
• Documentation for any/all reasons why portions of the checklist were not completed

This checklist may physically or electronically stored and the same checklist should be used by the dentist and anesthesiologist. It may be completed at any time prior to delivery of nitrous, but it must be repeated prior to ALL instances of delivery. For all of the details regarding the new checklist, don't miss this episode.

New rule #2 - Offices must write emergency procedures and hold training sessions

Every office now must have written policy procedures in place detailing how they are to handle emergency situations. Special attention must be given to respiratory crises and how the office will stock, monitor, and restock emergency kits. Staff must be trained regularly on these procedures to ensure everyone knows their responsibility during an emergency. It's important to remember to not assign specific individuals emergency duties, but rather assign it to a position. Annual review sessions should be held as well to revise these procedures as necessary.

New rule #3 - Permit holders must have the proper drugs on site and immediately available

Every dental office must be diligent in the way they keep records on nitrous oxide delivery. Special attention should be given to medicine cabinets and storage units to ensure expired drugs are disposed of and restocked with fresh supplies on a regular basis. Emergency kits with reversal drugs, AEDs with fresh batteries, and other necessary equipment should also be carefully monitored.

These new rules were established to ensure dental patients are receiving the best care possible. To ensure your practice is compliant, be sure to get the full story by listening to this episode of Talking With the Tooth Cop.

Outline of This Episode

• [0:22] New nitrous oxide delivery rules are covered on this episode of Talking With the Tooth Cop.
• [2:33] Existing regulations on nitrous oxide delivery and office equipment
• [7:25] Equipment checks are necessary and IFUs should be present at all times
• [14:40] Preoperative documentation is required in these main areas
• [19:01] The dentist is the sole person responsible for these duties regarding nitrous delivery
• [21:57] Latest information on the AAPD guidelines for nitrous oxide delivery
• [28:35] Post-operative discharge record-keeping requirements
• [35:05] New rule #1 - Preoperative checklist must be completed
• [40:22] Why are these new rules so strict?
• [43:05] New rule #2 - All permit holders for nitrous oxide must create emergency preparedness procedure manuals and hold training sessions for all staff
• [48:14] New rule #3 - Permit holder must have the proper drugs on site and immediately available
• [50:53] These new rules are required for all levels of nitrous administration and sedation
• [54:01] What comes next after these rules?
• [56:00] Where to turn for resources about these new rules

Resources & People Mentioned

• REPORT: "Blue Ribbon Panel on Dental Sedation/Anesthesia Safety of the Texas State Board of Dental Examiners"
• Duane's insider resource: "Medical Emergency Training for Dental Offices"

Connect With Duane

• https://www.dentalcompliance.com/
• toothcop(at)dentalcompliance.com
• On Facebook
• On Twitter
• On LinkedIn
• On Youtube

Keeping data secure is essential for operating an efficient 21st century dental practice. On this episode of Talking With the Tooth Cop I speak with 3 top professionals from CentriServe IT Dental Solutions - Matt Stafford, Jack Wiley, and Jared Galovich. You don't want to miss their insights on the importance of keeping data secure, how to train team members accordingly, and the best way to spend your security budget dollars. Be sure to listen!

Why do dental professionals need to worry about keeping data secure?

Dental professionals need to worry about keeping data secure because practices contain sensitive information that must be kept confidential. You are ultimately responsible for the data you collect on your patients, and you also need to protect your practice and team members. Keeping data secure is accomplished through a variety of steps, all of which are covered in full detail on this episode. Remember, the easiest way to handle a data breach is to prevent it from happening in the first place. Don't miss this episode - your practice will thank you.

What is an audit log, and why do they matter?

The most common type of audit log tracks who logs into your computers, when they logged in, what files they accessed, etc. You can monitor this log for any unusual activity, and it's an important asset in the event of an audit or data breach. Maintaining these logs and keeping them organized are critical in order for them to be useful in your practice. If you have audit logs in place and you do experience a data breach, your monetary fines will be much lower than a practice who does not utilize this technology. We discuss the benefits of audit logs in full detail on this episode, so be sure to listen.

4 main areas dental offices need to focus on in order to keep data secure

When you begin your data security process, you need to focus on these 4 main areas first and foremost:

1. Training staff on security procedures
2. Securely store your physical and digital data
3. Maintain and update firewalls and digital security measurers
4. Limit data access points

These systems can be implemented for a few hundred dollars per month. Preventative measures are much cheaper than crisis fixes, and your practice will benefit from focusing on these areas. Be sure to catch the full details on this episode of Talking With the Tooth Cop.

Invest in THESE top areas to keep your data secure

If you only invest in two areas to keep your data secure, make sure it's in a stellar firewall and secure communications for email and file sharing. Upgrading these 2 areas will place you years ahead of most dental practices, and it'll keep the majority of your data secure. If you combine these two strategies with limiting data access control points and an off-site server backup program, your practice will be better set up for success.

Outline of This Episode

• [0:22] Top professionals from CentriServe IT Dental Solutions are my guests for this episode
• [3:30] Why should you care about data and login tracking?
• [13:39] What is an audit log?
• [19:15] The importance of selecting the correct communication channels
• 32:49 The top data security areas dental offices need to focus on
• [41:00] Invest your security dollars into these top areas
• [47:25] Considerations for antivirus and cryptovirus software solutions

Resources & People Mentioned

• CentriServe website
• Call the CentriServe IT team at: (469) five five one 3144
• Email CentriServe
• Email Jack
• Email Jared

Connect With Duane

• https://www.dentalcompliance.com/
• toothcop(at)dentalcompliance.com
• On Facebook
• On Twitter
• On LinkedIn
• On Youtube