News — Code of Conduct

Physician practices and hospitals routinely audit for compliance, risk management, revenue cycle and quality of care issues.  They don’t necessarily like it, but they’ve settled into the routine of doing it to minimize their losses in the ever-increasing fight for dollars between providers and payors. Sadly, few dental practices audit patient records. A lot can be learned from auditing including identification of incomplete or inadequate documentation and/or paperwork, missed billing opportunities, issues that can result in recoupments (even criminal prosecution), and a host of other issues.   A dentist’s work is only as good as his records. It is said...

I put out a lot of TOP NOTCH compliance content from this blog to the podcast, "Talking with the ToothCop." I know a lot of you benefit from this content, but some of you might not know what we do....cause let's face it, writing blogs and yakking on a podcast, don't pay the bills. So here's a short synopsis of what we do for our clients and how we keep the lights on here at DCS.  1. Who do we work with at Dental Compliance Specialists? We work with dentists young and old. We work with small solo-dentist practices, dental group...

Daily perspective (pre-bill) audits help identify and minimizes billing errors by ensuring the accuracy of claims before they are submitted. This step alone can help compliance programs pay for themselves. Periodic retrospective audits involve the detailed review of clinical and billing records for compliance with state and federal recordkeeping and billing requirements. Some items to check include verifying the quality and quantity of radiographs, consent for treatment, proper coding, clinical notes to support each claim that was billed, and medical necessity.

My mantra is: “If It Is Not Written, It Did Not Happen!” Record audits must be documented. In the face of a fraud allegation this documentation can help your defense attorney make their case.

Michael Gerber in The ‘E’- Myth (Revisited) illustrates the importance of developing duplicate-able systems. He demonstrates that a business owner’s value is in their system. This makes sense (dollars too, BILLIONS of them!) Look at McDonald's, KFC, Wal-Mart, and EVERY other successful business in America. Every one of those businesses has systems that are duplicate-able, ensure consistency, and, as a result, are worth LOTS of money. Well, every one of those corporations, from KFC’s 11 herbs and spices and their special chicken pressure-fryer to Papa Johns’ fresher ingredients and better pizza, license (franchise) their systems. Those companies make oodles of money...

Let's face it, the day to day operations of working in a dental practice can get crazy! As the dentist, you can be pulled in three (or more) different directions, and your team members try their best to keep you on track! There are times when a patient needs a prescription and you need one of your staff members to help facilitate the process.  Do your employees have delegated duties, such as: 1.   Preparing, for your signature, written prescriptions for controlled substances in those instances where you have expressly directed the employee to do so and where you have specified...