Going chartless: breaking the process down into bite-sized pieces

Jan. 18, 2012
Consultant Dayna Johnson takes the anxiety away from going chartless by offering a plan to break down the conversion process into doable steps.

By Dayna Johnson

Editor's Note: This is the first in a series of year-long articles from Dayna Johnson, who runs an office manager blog for Dentrix. Throughout 2012, she'll be providing information to you that she has learned through her years of consulting and working at a dental practice in Washington state. I'm very glad to have Dayna as a part of the
DAD team.

Welcome to 2012! Did your office make a New Year’s resolution that this is the year you would go “chartless?” Is this the year you are going to transition from paper charts to digital charts, but you’re 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 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 I have also worked with many other offices guiding them through the necessary steps and customizing timelines that meet their needs. 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 is to 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% and 40%.
  • Do you have a protocol for managing patient collections? You should have a phone and letter campaign that is written down and documented in your office manual.
  • Are your outstanding insurance claims that are unpaid over 60 days less than 10%?
  • What is your total accounts receivable? Does it hover between one and one-and-a-half 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 within 48 to 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 by 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 documented 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 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 his or her 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 who 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 a phone call: “Dayna, we are ready to go chartless and we want you to help us!” 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 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. If it is not a well-oiled machine, the clinical transition will be much more challenging.

Author bio
Dayna Johnson, founder and principal consultant of Rae Dental Management, helps dental offices improve patient care, increase collections, and reduce staff headaches by implementing efficient management systems. With 18 years’ experience in the business and technical side of dental offices, Dayna’s passion for efficient systems is grounded in both personal understanding and professional expertise. She can be reached at [email protected] or visit her website at www.raedentalmanagement.com. If you’re a Dentrix user, you can also check out her blog with front office tips and ideas at http://thedentrixofficemanager.blogspot.com/.