The Insider Threat

Posted November 29, 2016 by Jennifer G

How Well Do You Really Know Your Dental Staff?

computer-screen-with-personIn recent years the trusting relationship between dentists and their staff has come under scrutiny. Questions such as ‘how much control should my staff have?’ or ‘can my staff have access to my prescription pad?’ are questions posed in a dental office on a day-to-day basis, or so we hope.

With 58% of dentists falling victim to prescription fraud, an issue that seems to be hitting dentists is Identity Theft. Not identity theft in the usual sense, but specifically the misuse of a dentist’s DEA number, forged signatures and stolen prescription pads.

The culprit? The Insider Threat comprised of office staff and fellow dentists. As the opioid epidemic kicks into full gear, dental offices are seeing the highest rate of fraud yet with forged prescriptions, specifically for controlled substances, and unfortunately…read the eBook.



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Mission to Serve

Posted November 15, 2016 by Danielle H

Dr. Ross Sanford brings dental care to Guatemala

Tell us about your background before going to Guatemala.

I am a general Dentist, graduating from the University of Louisville in 1980 with a DMD degree. I moved immediately to Las Vegas after passing the board before school was officially “out”. I associated with a dentist for 3 ½ years before opening my own practice in December 1984. I have practiced solo for my whole career. For the first 27 years I was in a space sharing arrangement with another dentist that I met while taking the Nevada Board exam. We built our first office in 1984 and quickly outgrew that facility. In 1994 we moved into our “Taj Mahal” in Las Vegas where we continued in the same arrangement for another 12 years. I sold my practice in Las Vegas in 2006 and moved to Alaska for one year of “R and R”. I obtained a license in Alaska and practiced as an associate there while playing in Alaska. We made a lot of money and spent all of it on playing in Alaska; fishing, hunting bear and moose, helping with the Iditarod Dog Sled Race and many other things. We moved back to Vegas in 2007 to find that the recent law change had destroyed the clinical practice of dentistry in Nevada, so we moved to Oregon. I established a new practice in December 2008; just about the worst time possible to start a new business, but with a lot of effort and care on my part it grew and we flourished. In 2015, I sold that practice to a younger man and my wife and I applied to serve as missionaries for the LDS Church. We were asked to be Dental Specialists assigned to the (only-one-of-its-kind in the world) Guatemala dental clinic.

What kind of work are you doing there?

2-dentist-mission-to-serveOur work here in Guatemala is focused on serving several populations: 500 orphaned boys and girls of the Tio Juan/Mi Casa organization, a municipal school serving about 800 “would be” street kids, La Esperanza which serves about 500 children, and current and future missionaries up to about 300 miles around Guatemala City.

We (there are two dentists here in our clinic) provide general dental services of the most basic nature; including cleaning, basic restorative dentistry, minor periodontal services, endodontic services and extraction of teeth. All services are provided at no cost to any patient. We, as doctors, are not paid at all. We pay our own way (airfare, living expenses, auto expense, food, etc.). We depend on donations for our sustenance of dental supplies in the clinic. Additionally, everything we are used to hiring for; cleaning, repairs and maintenance of dental equipment, and ordering supplies, is all done by us. The good thing is that we don’t have to worry about money!! We don’t charge anything for our services and therefore don’t have to worry about collections. It is amazing how fulfilling dentistry can be when money is removed from the equation!

Share with us what a typical day looks like.

We arrive about 8:30 and setup the clinic. That means getting out all the valuable stuff that we keep locked away at little-girl-mission-to-servenight (laptop computers, Nomad X-Ray machine, operating loupes, etc.), turning on the computers and getting the network up and running, and setting up our operatories. We have a short devotional every day before beginning. Patients arrive about 9 and we start to work. Lunch is from 11:30 to 1:00, then in the afternoon we do the same thing. When we are done, we take down the clinic and put everything away, lock up and go home. We work Monday to Thursday on this schedule. We take off Fridays like most U.S. dentists. Our treatments can be anything from a routine prophylaxis to horizontally impacted third molars. We do not use any sedation; only local anesthetics when required. One challenge is…Read the full story

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4 mistakes that are costing you money

Posted November 7, 2016 by Danielle H

4-mistake-costing-moneyFor many Dentists, the dream of practice ownership is often met with the struggle to start and run a small business. In today’s post, we look at 4 common mistakes that business owners make and how you can overcome these challenges.

1. Not sticking to your budget

For many, the concept of budgeting is easy to understand but difficult to do. You probably know that creating and following a budget is key to building a profitable practice, but if you’re finding yourself stuck in a bad routine, it may be time to push the reset button. Dentists who run their business on a budget are able to keep their goals in perspective and make wiser purchasing decisions. If you’re just getting started, give yourself some grace for the first few months. Remember that no two months are exactly alike and your budget cannot be a template that you copy and paste over and over.

2. Letting your bookkeeping slide

Bookkeeping is a critical component to realizing success in your dental practice. If you’re not reconciling your books monthly, you’re missing an opportunity to correct mistakes sooner, when transactions are fresh on your mind. Left unnoticed, even small mistakes will create additional work for your CPA and result in higher fees.

3. Failure to review practice reportspractice-demographics-report

To take your practice’s daily pulse, you have to check reports daily. It will take you less than a minute to glance at your production, collection, debit and credit values each day. Making it a habit to review this information frequently will ensure there are no surprises when you’re reviewing the numbers over longer periods of time, such as monthly or quarterly. After you have a good handle on the basics, start getting familiar with other metrics such as outstanding insurance claims, new patient analysis, accounts receivables, and practice demographics.

4. Do-It-Yourself technology

Spend a few minutes perusing the Dentaltown forums and it might seem easy to setup and manage your own network. After all, there are many other dentists documenting their trials and successes, right? The average DIY dentist fails when it comes to seeing the big picture, especially as it relates to managing risk, aligning technology with practice goals, and long term planning. Taking time from production to configure practice hardware is not a wise use of your time. This job is best outsourced to a network service provider who can help you manage the technology needs for your practice.

As an independent dental software company, XLDent is dedicated to the preservation of private dentistry and has made it our purpose to help new dentists in practice build successful small businesses.

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How to Get to “Yes” in Case Presentation

Posted October 31, 2016 by Alexa S.

What is your initial thought as you walk into a new patient exam? As your patient begins to share the reason for their visit, where does your mind go? Odds are, you have started formulating a treatment plan before the patient has finished describing their problems; you have a solution in your head and are ready to get right to laying it all out for them. Hold up! Truly listening to your patient and preparing for how you’re going to present your treatment plan is imperative to gaining acceptance.

Time is money. Your time (and your patient’s) is valuable and should not be wasted. But, taking the time to explain the proposed treatment will help improve your case acceptance rate. Find your sweet spot. If you are unable to review the treatment plan chairside (or in a consult room), it is important to schedule a consult visit. Scheduling this time where you can dr-chart-patient-win-surffocus on the procedures and plan ahead will leave the patient feeling that you truly care about their well-being. Treatment Planning is easy with the realistic odontogram and efficient with the point-and-click interface of XLChart. You will have the ability to set multiple plan options if needed, giving you the flexibility to define different approaches to treat the same problem. Each option allows you to set various phases or appointments even going so far as defining time for each appointment to show your patient a clear map of their proposed treatment.

Case presentation should be a two-way street. You should leave time for your patient to address their questions and concerns about the suggested treatment, and don’t forget to ask for their feedback. Remember, this is a conversation, not a presentation in the typical sense, you do not want to overwhelm with too much, or not enough information. Every case should feel as though you’ve reach the solution together.

Dental terminology is Greek to many. Did you always know what an Abutment was, or what surface the Buccal referred to? If your patient needs a dictionary to understand your impressive dental knowledge and terminology, you lose case acceptance likelihood.

Operating on assumptions. While it is widely known that much of the population fears going to the dentist, and often the dental procedures themselves, it is not always a good idea to make these and other common assumptions. “Don’t worry.” Is this something you have ever said to a patient? Two of the most common barriers to case acceptance are phobias and finances. If your patient has concerns, be sure you allow enough time for them to raise these concerns during your case presentation. Don’t assume they are scared, or that finances are the cause of the case acceptance outcome.

Documentation. Have you ever had a patient come into your office, talking about their friend whose dentist let them get XYZ procedure done, and you “just did ABC”, and didn’t provide the same option? What do you think happened here? Did you really only give them one option? xlchart-treatment-plan-with-signatureLikely the answer is no. However, do you have that documented in their file? A common mistake in clinical charting, as well as case presentation, is the lack of documentation in providing options. Often times, when a patient decides on a route of treatment, the other options that were presented get deleted. If your practice management software does not allow you to keep track of “rejected” treatment plans, you should consider how you can go back and reference this. Luckily, with XLDent, you are able to easily access proposed, accepted, and rejected treatment plans all within the tooth chart. Plans can easily be reviewed and signed digitally by the patient using a tablet PC, keeping everything in their electronic chart. You can create alternate options and keep them as a precaution. Remember to have a Standard Operating Process (SOP) for documenting all phases of the treatment plan and retaining them. If it isn’t written down or in their electronic record, it did not happen.

So, what do you do now with all of this information? Keep in mind that having a “yes” attitude gives you the confidence and positive determination to meet your goals. It is important to review with your team, your specific goals and how to achieve them. The beautiful thing about confidence is that it is contagious, you and your team can share this attitude with your patients and it will improve your case acceptance rate. Believe that you and your team are offering the very best care and treatment plan for your patients, and they too will believe it. Often times, patients are looking for validation that they have made the right decision for their treatment plan, their doctor, and their overall care. It is important that you reassure them in their decision from the minute they walk in the door, to when they leave – as a team! Following these ideas and using XLDent Practice Management Software can give you all the tools you need to create treatment plans that get you to “yes”

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SCDI Meetings in Denver

Posted October 19, 2016 by Dawn

The second meeting of the ADA Standards Committee on Dental Informatics this year was held at the Hyatt Regency Hotel in Denver, Colorado. XLDent continues to participate in Working Group 11.1 Standard Architecture and Working Group 11.9 Core Reference Data. This year we were invited to participate as a voting member and happily accepted the invitation.

Our working group Chairman, Dr. Mark Diehl, unexpectedly passed away last April. Dr. Diehl’s most notable accomplishment is the work he had done to produce numerous standards and technical reports related to the architecture, data structure, and open implementation of the electronic health record. Most notable are the following:

  • ANSI/ADA Standard No. 1000,Standard Clinical Data Architecture (2001, revised 2010);
  • ANSI/ADA Standard No. 1027, Implementation Guide for Standard No. 1000 (2010);
  • ANSI/ADA Standard No. 1039, Clinical Conceptual Data Model (2006);
  • ANSI/ADA Standard No. 1067, Electronic Dental Record System Standard Functional Requirements (2013).

He was recognized as an expert in the science of clinical informatics and I was proud to have served with him on WG 11.1, 11.9; and, the recent progress we made on ADA Technical Report No. 1091 for Cloud Computing and Data Storage. Dr. Diehl will be missed and we will do our best to continue the work he started. During the Plenary session today, Dr. Amit Acharya was nominated as Chairman of the Subcommittee on Clinical Informatics and Dr. Terry O’Toole as Vice Chairman.

During our session, WG 11.9, which will define a core set of data to support the Implementation Guide for TR 1067, focused on narrowing the scope of the project because the group was not able to make much progress given the expanse of the undertaking. Dr. Mark Jurkovich proposed that we focus on the exchange of information based on current standards that already exist (i.e. X12 835, 837D, 270, etc.) and are successfully in practice to exchandawn-no-backgroundge objects of data, versus focusing on the monumental scope of interoperability. It was concluded that the working group will take a “bottom-up” approach in that we will start with a focus on establishing a standard core set of data that is typically exchanged during a referral between a general dentist and a specialist, for example. All of this will be done with the ultimate goal of achieving interoperability at some point in the future. Keeping this ultimate goal in our sights means that we will need to decide on the standard document or transport mechanism (i.e. HL7 CCDA format) so that we can begin populating it with this first core dataset.

With these meetings wrapping up, I’m on my way to meet up with Duane at the ADMC meeting….and tomorrow the ADA 2016 Exhibit Hall opens!

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