QUESTION: I work the front desk at a busy dental practice. Lately we’ve had a problem with patients becoming upset when they have to come in for periodontal maintenance after scaling and root planing. When they come to the front desk they ask why they have to pay and say, "I just got a cleaning." That leaves me to explain that it was more than a regular cleaning. How can we prevent this from happening?
Step 1: Create a written protocol for the office staff about how to handle these situations. This way when you welcome a new employee, they know exactly how they’re expected to handle it. Have written guidelines on diagnosing periodontal disease for the hygiene staff, and if the administrative staff doesn’t have clinical experience, they need to be educated on the process.
Step 2: Find out how the hygienists or hygiene assistants are handling the diagnosis of periodontal disease. Listen in on how they explain it to patients and whether or not they explain that this treatment will require close monitoring and patients to come back to the office more often than normal. You shouldn’t have to spend a lot of time at the front desk explaining pocket depths and bone loss.
Step 3: Have the person creating the treatment plan add each visit, even if it’s just a fine scale. Because there isn’t an ADA code for fine scale, create one in your practice management program. Even more importantly, add each perio maintenance visit the patient will need to come back for. For example, if the hygienist wants them to come every three months, add periodontal maintenance to the treatment plan four times. Override the insurance coverage on the treatment plan if you know the patient’s plan will only cover it twice during the benefit year.
(On a side note, if you have only given the patient a treatment plan for the scaling and root planing visit and plan to finish the treatment plan once that is completed, consider waiting to add the perio maintenance at that time so the patient does not become overwhelmed.)
This process should start in the back when the clinical staff has diagnosed periodontal disease. If the clinicians have done a thorough job of discussing the treatment, then teh front desk will just need to go over the financials. Patients do not like surprises, so put as much in the treatment plan as possible.
Not every patient will leave the operatory with a thorough understanding of what they need, nor will they always agree with what they need. And we all know that sometimes patients have selective hearing, so documentation is very important. The hygiene notes need to detail the patient discussion, and the administrative team also needs to notate any discussion, questions, or comments. Good luck!
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