Assess the situation before you go chartless

Did your office make a New Year’s resolution that this year is the year you would go “Chartless”?  Is this the year you are going to transition from your paper chart to using a digital chart, but not quite sure where to start?   How do you make this transition smoothly and efficiently?

Bringing technology into the dental practice to help achieve your goal of transitioning from paper charts to electronic health records can be exciting for some and scary for others.  I understand your anxiety because I have been there with my office and worked with many office’s through the process of guiding them through the necessary steps and customizing a timeline that meets the needs of the office.  If your office has decided to take on this challenge alone, I have some helpful tips for you that will surely make the transition go more smoothly.

Going chartless is a process that will add another level of complexity and a new set of systems to any size of practice.  It is more than just writing your clinical notes in the computer and taking digital x-rays. With that being said, the first step I want you to do is evaluate your current “core” systems before you decide to travel down the Path to Paperless.  When I talk about “core” systems, I am talking about collections, scheduling, continuing care, treatment planning and patient communications.  Making sure that your core systems are working efficiently and consistently is very important before you start your transition because you will take these systems and incorporate them into your practice management software if it hasn’t been done already.   Let’s ask some questions and break down each system a little farther.

  • Collections
    • Is your collection rate 98% or higher? If not, the office collection system could use a re-assessment.
    • What are you collecting over the counter? Are you able to accurately estimate the patients out of pocket?  Typical over-the-counter collections for a general practice should be between 30-40%.
    • Do you have a protocol for managing patient collections? You should have a phone and letter campaign that is written down and put in your office manual.
    • Is your outstanding insurance claims that are unpaid over 60 days less than 10%?
    • What is your total Accounts Receivable? Does it hover between 1 – 1 ½ months of production?  If it is more than this I would be a little concerned that the collection system needs some attention.
  • Scheduling
    • Does your schedule have an opening for a new patient in within 48 – 72 hours?
    • Are you meeting your production goals or just plugging holes?
    • Is your office performing chart audits on a regular basis?
    • Do you run through lunch consistently?
  • Continuing Care
    • Is your patient retention rate over 95%? Patient retention rate is calculated by dividing the number of patients due for continuing care to the number of patients seen.
    • Do you have a protocol for managing past due patients in the way of a postcard, email or text messaging campaigns? Is it written down and put in your office manual?
    • Do you have a quick call list to move patients ahead when openings happen?
    • What is your protocol for inactivating patients? Is it written down and put in your office manual?
  • Treatment Planning
    • Are you using Fee Schedules and have you added them into your computer software for more accurate treatment plan estimates and patient collections?
    • Does every patient receive a printed estimate of their treatment plan? If they don’t this could add to a higher rate of delinquency and past due accounts receivable.
    • Do you have a report or a way to pull up a list of patients that have unscheduled treatment? How do you manage this list?
  • Patient Communications
    • Do you send out a Welcome packet to New Patients?
    • How do patients read and sign consent forms?
    • Other patient letters; Collection letters, dismissal letters, treatment refusal letters, any other correspondence, does everyone know how to access these letters? How will you store paper if you go chartless?

This is exactly what I do with every office I work with.  So often I get that phone call “Dayna, we are ready to go chartless and we want you to help us!” and the first thing I do with a new office is perform an assessment.  After this assessment it becomes obvious where we need to focus before we even start on entering clinical notes into the computer.  This is what I call Phase I, getting the core systems in check.  The front office is where you want to start, it is the central hub of the office, and everything revolves around the front office and if it is not a well oiled machine the clinical transition will be much more challenging.

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