Dental Referral Process

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Dental Referral Process

  1. 1. New Mexico Land of Enchantment
  2. 2. New Mexico Wildlife
  3. 3. Albuquerque Balloon Festival
  4. 4. DENTAL REFERRAL PROCESS Lindsie Beard, RDH La Casa Family Health Center Portales, NM (505) 359-3806
  5. 5. <ul><li>Location: Portales, New Mexico </li></ul><ul><li>Population Served: 4,664 </li></ul><ul><li>Total Population: 18,018 </li></ul><ul><li>Four Clinic Sites: Portales, Clovis, Roswell and Hondo, New Mexico </li></ul><ul><li>Cardiovascular And Diabetic Population: </li></ul><ul><ul><li>Includes migrant, homeless, rural, urban, and dental </li></ul></ul>
  6. 6. Hondo LA CASA LOCATIONS
  7. 7. <ul><li>THEN </li></ul><ul><ul><li>Two-bedroom house located in Portales, New Mexico </li></ul></ul><ul><ul><li>One family practice physician </li></ul></ul><ul><ul><li>Five employees administering the clinic </li></ul></ul><ul><ul><li>1,000 patients seen in the first year </li></ul></ul><ul><ul><li>Patients were seen on a first come first serve basis </li></ul></ul><ul><li>NOW </li></ul><ul><ul><li>Four clinics located in Roosevelt, Curry, Chavez, and Lincoln county </li></ul></ul><ul><ul><li>16 providers specializing in various medical fields </li></ul></ul><ul><ul><li>Dental clinic added at two sites </li></ul></ul><ul><ul><li>Approximately 100 employees </li></ul></ul><ul><ul><li>Generate over 65,000 patient visits annually </li></ul></ul>
  8. 8. 1976 La Casa de Buena Salud The House of Good Health
  9. 9. La Casa Portales Clinic
  10. 10. La Casa Clovis Clinic
  11. 12. DENTAL CLINIC
  12. 13. DENTAL CLINIC
  13. 14. MEDICAL DIABETIC CONSULTATION APPOINTMENT REFERRAL TO DENTAL PHYSICIAN’S PATIENT ADVOCATE CALLS DENTAL CLINIC TO SCHEDULE APPOINTMENT FOR DENTAL CONSULTATION AT DENTAL CONSULTATION… ASSESSMENT OF ORAL HEALTH, TENTATIVE TREATMENT PLAN, PATIENT EDUCATION RE-APPOINT PATIENT FOR FURTHER TREATMENT AT NEXT DENTAL VISIT… (USUALLY CLEANING APPOINTMENT) RADIOGRAPHS, COMPREHENSIVE EXAM, TREATMENT PLAN, ORAL HYGIENE INSTRUCTION AND PERIODONTAL PROBING DATA ENTERED INTO PECS SYSTEM COPY OF REFERRAL IS SENT BACK TO REFERRING PHYSICIAN REFERRAL PROCESS TO DENTAL
  14. 15. MEDICAL DIABETIC CONSULTATION <ul><li>PHYSICIAN DISCUSSES IMPORTANCE OF DENTAL CHECK-UP WITH DIABETIC PATIENT </li></ul><ul><ul><li>PHYSICIAN INFORMS PATIENT THAT DENTAL CONSULTATION IS FREE OF CHARGE </li></ul></ul><ul><ul><ul><li>THIS INCREASES PATIENT COMPLIANCE </li></ul></ul></ul><ul><li>PHYSICIAN FILLS OUT DENTAL REFERRAL SHEET </li></ul><ul><ul><li>REFERRAL SHEETS ARE PRINTED ON GREEN PAPER </li></ul></ul><ul><ul><li>PHYSICIAN’S PATIENT ADVOCATE CALLS DENTAL CLINIC TO SCHEDULE APPOINTMENT </li></ul></ul><ul><ul><ul><li>DENTAL CLINIC WILL SEE THESE PATIENTS AS WALK-INS </li></ul></ul></ul><ul><ul><ul><li>APPOINTMENT DATE AND TIME WRITTEN ON REFERRAL </li></ul></ul></ul><ul><ul><ul><li>PATIENT IS INSTRUCTED TO TAKE REFERRAL SHEET TO DENTAL VISIT </li></ul></ul></ul><ul><ul><li>REFERRAL IS RECORDED IN PHYSICIAN’S LOG </li></ul></ul><ul><ul><li>PATIENT IS HANDED REFERRAL </li></ul></ul>
  15. 16. Patient Name:________________________ _____________________________ Date of Birth:_______________________________________________________ Do you have a dentist? Y E S N O Have you seen a dentist in the last year? Y E S N O For routine exam and cleaning? Y E S N O For emergency care or pain relief? Y E S N O Do you have loose or painful teeth? Y E S N O Do your gums bleed when you brush or floss? Y E S N O Do you have bad breath? Y E S N O Type Diabetes: 1 2 (circle one) Medical Allergies:____________________________________________________ ___________________________________________________________________ Remarks: __________________________________________________________ ___________________________________________________________________ Referring Physician:______________________________ Date:______________ Dental Diabetes Referral Appointment Date:_________________ Appointment Time:_________________ Chart No.:_________________ LA CASA FAMILY HEALTH CENTER Last First REFERRAL TO DENTAL
  16. 17. DENTAL DIABETIC CONSULTATION (RECEPTION AREA) <ul><li>DENTAL CONSULTATION IS FREE OF CHARGE </li></ul><ul><li>AT THE FRONT DESK </li></ul><ul><ul><li>PATIENT CHECKS IN WITH RECEPTIONIST AND IS GIVEN APPROPRIATE MEDICAL HISTORY AND CONSENT FORMS TO FILL OUT </li></ul></ul><ul><ul><li>A DENTAL CHART IS BUILT SEPARATE FROM MEDICAL CHART </li></ul></ul>
  17. 18. DENTAL DIABETIC CONSULTATION (WITH THE DENTIST) <ul><li>PATIENT IS TAKEN BACK TO TREATMENT AREA </li></ul><ul><li>PATIENT RECEIVES </li></ul><ul><ul><li>ASSESSMENT OF OVERALL ORAL HEALTH </li></ul></ul><ul><ul><li>TENATIVE TREATMENT PLAN </li></ul></ul><ul><ul><li>IN SOME CASES, DEPENDING ON INSURANCE STATUS, APPROPRIATE RADIOGRAPHS ARE TAKEN </li></ul></ul><ul><ul><li>PATIENT EDUCATION </li></ul></ul><ul><li>COLORED REFERRAL SHEET IS KEPT IN DENTAL CHART </li></ul><ul><ul><li>COPY OF REFERRAL IS SENT TO PECS DATA ENTRY PERSON </li></ul></ul>
  18. 19. RE-APPOINT FOR TREATMENT <ul><li>PATIENT MAKES FURTHER APPOINTMENTS FOR TREATMENT </li></ul><ul><ul><li>NEXT APPOINTMENT IS GENERALLY FOR PROPHY WITH HYGIENIST </li></ul></ul><ul><ul><li>PATIENT IS INFORMED AT THIS TIME OF PRICES FOR TREATMENT AND WHERE THEY FALL ON OUR SLIDING SCALE FEE </li></ul></ul>
  19. 20. DATA ENTERED INTO PECS SYSTEM <ul><li>INFORMATION IS ENTERED INTO PECS SYSTEM </li></ul><ul><ul><li>INCLUDES DATE OF REFERRAL </li></ul></ul><ul><ul><li>DATE OF SERVICE </li></ul></ul><ul><ul><li>DECLINE DATES </li></ul></ul>
  20. 21. PROPHY APPOINTMENT <ul><li>AT CLEANING APPOINTMENT </li></ul><ul><ul><li>RADIOGRAPHS TAKEN </li></ul></ul><ul><ul><li>COMPREHENSIVE EXAM </li></ul></ul><ul><ul><li>TREATMENT PLAN </li></ul></ul><ul><ul><li>PERIODONTAL PROBING </li></ul></ul><ul><ul><li>DIAGNOSIS </li></ul></ul><ul><ul><li>EXTENSIVE PATIENT EDUCATION </li></ul></ul><ul><ul><ul><li>HYGIENIST USES X-RAYS AND PROBE READINGS TO TEACH PATIENT ABOUT CORRELATION BETWEEN DIABETES AND PERIODONTAL DISEASE </li></ul></ul></ul><ul><ul><ul><li>HYGIENIST ALSO TEACHES ORAL HYGIENE INSTRUCTION AND PREVENTION METHODS </li></ul></ul></ul><ul><ul><li>APPOINTMENTS ARE MADE FOR ANY ADDITIONAL TREATMENT AT THIS TIME </li></ul></ul><ul><ul><ul><li>EXTRACTIONS, FILLINGS, ETC. </li></ul></ul></ul>
  21. 22. COMPLETING THE CIRCLE <ul><li>COPY OF ORIGINAL REFERRAL </li></ul><ul><ul><li>DATE PATIENT WAS SEEN BY THE DENTIST IS PRINTED ON COPY </li></ul></ul><ul><li>COPIES SENT BACK TO RESPECTIVE PHYSICIAN </li></ul><ul><ul><li>ONE TIME PER MONTH COPIES ARE GATHERED AND SENT BACK TO PHYSICIAN AND/OR TEAM MEMBER </li></ul></ul><ul><ul><li>PHYSICIAN CAN THEN UPDATE REFERRAL LOG BOOKS </li></ul></ul>
  22. 23. SPECIAL CIRCUMSTANCES <ul><li>IF PATIENT REFUSES DENTAL VISIT </li></ul><ul><ul><li>CHECK BOX IN THE PECS DATA ENTRY SCREEN LABLED “DECLINED” </li></ul></ul><ul><li>IF PATIENT HAS FULL DENTURES </li></ul><ul><ul><li>PATIENT CAN STILL BE REFERRED FOR DENTAL CONSULTATION </li></ul></ul><ul><ul><li>AT CONSULTATION,DENTIST WILL EVALUATE DENTURE FIT AND SCREEN FOR SIGNS OF FUNGAL INFECTION </li></ul></ul><ul><li>IF PATIENT USES PRIVATE DENTIST </li></ul><ul><ul><li>PATIENT IS REFERRED TO THEIR PRIVATE DENTIST </li></ul></ul><ul><ul><li>PHYSICIAN’S ADVOCATE CALLS TO MAKE APPOINTMENT FOR PATIENT </li></ul></ul><ul><ul><li>REFERRAL IS NOTED IN REFERRAL LOG BOOK </li></ul></ul><ul><ul><li>ADVOCATE CALLS PRIVATE DENTIST TO CONFIRM WHETHER PATIENT PRESENTED FOR APPOINTMENT </li></ul></ul><ul><ul><li>SAME DATA CAN THEN BE ENTERED INTO PECS SYSTEM </li></ul></ul>
  23. 24. <ul><li>D9310 DENTAL CONSULTATION </li></ul><ul><li>D0150 COMPREHENSIVE EXAM </li></ul><ul><li>D0274 4 BITEWING RADIOGRAPHS </li></ul><ul><li>D0330 PANORAMIC RADIOGRAPH </li></ul><ul><li>D1110 ADULT PROPHYLAXIS </li></ul><ul><li>D4341 PERIODONTAL SCRP </li></ul><ul><li>D1330 ORAL HYGIENE </li></ul><ul><li>INSTRUCTION </li></ul><ul><li>D7140 EXTRACTION SINGLE </li></ul><ul><li>TOOTH </li></ul><ul><li>520.0 ANODONTIA </li></ul><ul><li>521.0 DENTAL CARIES </li></ul><ul><li>873.63 BROKEN TOOTH </li></ul><ul><li>523.0 ACUTE GINGIVITIS </li></ul><ul><li>523.1 CHRONIC GINGIVITIS </li></ul><ul><li>523.3 ACUTE PERIODONTITIS </li></ul><ul><li>523.4 CHRONIC PERIODONTITIS </li></ul><ul><li>112.0 ORAL CANDIDIASIS </li></ul>COMMON TREATMENT AND DIAGNOSIS CODES
  24. 25. BEST PRACTICES <ul><li>Buy-in of providers, support staff, CEO, and Board of Directors </li></ul><ul><li>Having dental person on collaborative core team </li></ul><ul><li>Cooperation of dentist and dental Staff </li></ul><ul><li>Flexibility of dental staff to see walk-ins </li></ul><ul><li>Utilizing internal incentive plans for providers to meet collaborative goals </li></ul><ul><li>Providing PECS registry and summary reports to all providers and Board of Directors on a monthly basis </li></ul><ul><li>Information presented at quarterly QA (quality assurance) meetings and monthly Board of Directors meetings </li></ul>
  25. 26. MEDICAL DIABETIC CONSULTATION APPOINTMENT REFERRAL TO DENTAL PHYSICIAN’S PATIENT ADVOCATE CALLS DENTAL CLINIC TO SCHEDULE APPOINTMENT FOR DENTAL CONSULTATION AT DENTAL CONSULTATION… ASSESSMENT OF ORAL HEALTH, TENTATIVE TREATMENT PLAN, PATIENT EDUCATION RE-APPOINT PATIENT FOR FURTHER TREATMENT AT NEXT DENTAL VISIT… (USUALLY CLEANING APPOINTMENT) RADIOGRAPHS, COMPREHENSIVE EXAM, TREATMENT PLAN, ORAL HYGIENE INSTRUCTION AND PERIODONTAL PROBING DATA ENTERED INTO PECS SYSTEM COPY OF REFERRAL IS SENT BACK TO REFERRING PHYSICIAN REFERRAL PROCESS TO DENTAL D9310 DENTAL CONSULTATION D0150 COMPREHENSIVE EXAM D0274 4 BITEWING RADIOGRAPHS D0330 PANORAMIC RADIOGRAPH D1110 ADULT PROPHYLAXIS D4341 PERIODONTAL SCRP D1330 ORAL HYGIENE INSTRUCTION D7140 EXTRACTION SINGLE TOOTH 520.0 ANODONTIA 521.0 DENTAL CARIES 873.63 BROKEN TOOTH 523.0 ACUTE GINGIVITIS 523.1 CHRONIC GINGIVITIS 523.3 ACUTE PERIODONTITIS 523.4 CHRONIC PERIODONTITIS 112.0 ORAL CANDIDIASIS COMMON TREATMENT AND DIAGNOSIS CODES
  26. 27. QUESTIONS

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