Faculty Teaching Guide for Health Information Management
Faculty Teaching Guide for Dental Office Management
Module - Clinical and Financial Management
Faculty Teaching Guide for Dental Office Management
Module: Clinical and Financial Management
Module Overview
The dental office manager must properly manage both the human element and the money element in order to ensure that a practice thrives. The learner preparing to go into the field of dental office management must strive to master the people skills necessary to create and maintain a top-notch dental team. He or she also must have the ability to master the details of practice accounting. This module introduces learners to the basic building blocks of practice management and the ethical and legal considerations that must be considered.
The Big Picture
Resources
This module utilizes the following learner resources:
Textbook: Dental Office Management, by Ellen Dietz. Delmar Learning, 1999. ISBN 0-7668-0731-2.
Faculty CD-ROM: The faculty CD-ROM includes this Faculty Guide and PowerPoint Presentation for Dental Office Management.
The Internet: It is strongly recommended that faculty and learners alike have a working knowledge of the Internet.
Note to Instructor:
To make the best use of this module, it is recommended that the instructor make the following preparations:
• Inform learners that they are to read Chapters ____, pgs. ____ in the textbook in preparation for the first class of the module.
• The instructor will provide case histories for all activities that call for them.
• The instructor may also write case histories based on real-life management situations arising in the dental office. However, instructors should be careful not to include identifying information including actual names and locations.
• The instructor also will conduct polls of area dental practices to learn what the dental industry in the region expect of dental assistants and dental office managers. The instructor will use the poll results to focus and streamline class material.
• Collect materials from area dental offices as needed for certain activities. These include mission statements, dental patient chart materials, and marketing materials,
• In any simulations that occur in this course, the instructor will take the following steps: (1) Introduce the theory or concept; (2) Conduct a simulation; (3) Ask learners to evaluate what they have learned about the theory or concept through simulation; (4) Apply the principles learned to actual dental office case histories; (5) Compare learners’ action on the case histories to the actual outcomes; and (6) Have learners critique the simulation/case history experience as a learning tool.
Section 1: Managing Clinical Issues
Section Overview
The dental team is made up of highly trained professionals. Bringing them together into a cohesive unit is a challenge and, if ultimately successful, a joy. Everyone, including the patients, benefit from a well-managed staff. In addition, the office manager must master skills in records management, risk management, and must speak the dental language with proficiency. Last, but not least, the successful office manager realizes that an office travels at the speed of its telephone system, photocopier and fax machine. For this reason, the wise office manager always has a plan for managing office equipment.
Outline of Section 1
Part A: Managing the Dental Team
Part B: Managing the Dental Record
Learning Objectives and Competencies
These learning activities directly address the Learning Objectives and Competencies as stated.
Comprehension
1. Delineate the clinical roles of the dental team.
2. Detail eligibility pathways available to the dental assistant.
3. Summarize legal and ethical concepts in the dental office.
4. Discuss dental office personnel issues from a manager’s point of view.
5. Identify the basics of dental records management.
Application
6. Demonstrate risk management strategies and methods applicable to the dental office.
7. Use team-building techniques in classroom simulations.
8. Exhibit knowledge of dental terminology and anatomy.
9. Simulate charting of the oral cavity including coding.
Analysis
10. Examine dental pharmacy procedures.
Synthesis and Evaluation:
11. Create an office equipment specification sheet based on an operating budget.
12. Contrast the policies and procedures of a local dental office with material presented in this module.
Learning Activities
These learning activities directly address the Learning Objectives and Competencies as stated.
[Insert In-Class Activity icon] Skills Mastery Assessment (Parts A-B, All Objectives)
[Insert In-Class Activity icon] Mission Possible (Part A, Objective 1)
[Insert In-Class Activity icon] Dental Team Match Game (Part A, Objective 1)
[Insert In-Class Activity icon] Who Brought the Donuts: Getting into the Morning Huddle (Part A, Objectives 4
and 7)
[Insert In-Class Activity icon] Personnel Problem-Solving (Part A, Objective 3-4, 6-7)
[Insert In-Class Activity icon] Panel of Experts (Part A, Objectives 1-5)
[Insert Homework Assignments icon] Textbook Assignment (Parts A-B, Objectives 1-12)
[Insert Homework Assignments icon] Oral Charting Flash Cards (Part A, Objective 8)
[Insert In-Class Activity icon] Reality Tooth Identification (Part B, Objective 8)
[Insert In-Class Activity icon] Reality Charting (Part B, Objective 9)
[Insert In-Class Activity icon] Reality versus the Classroom (Part B, Objective 12)
Part A: Teamwork in the Dental Office
Overview
Teamwork is never the accidental result of good intentions. It is the action of constant nurturing and support. The successful office manager understands the training and commitment that each member brings to the dental office. The office manager also is aware of the certification pathways available to the dental assistant and is in the position to encourage DAs to go as far as they can to realize their ambitions.
Initial Questions and Activities
1. If you were to write your own “practice philosophy” or “mission statement” for your dental career, how would it read?
Answers will vary. Encourage learners to brainstorm first, writing down whatever comes into their heads. Remind them that brainstorming means that anything they think of is fair game and is written down. Ask them to return to the brainstorming and to draw up at least three career paths that interest them. Have them locate the common denominator among the three. Help those who may have a harder time finding the common denominator. This consistent career interest will serve as the kernel of each learner’s practice philosophy or mission statement.
2. Do you think there a difference between legal and ethical issues in dentistry? If so, how would you distinguish the two?
Ask learners to remember what they have learned in previous classes. Suggest that they begin by attempting to define each term and then contrast and compare the two terms. Encourage learners to use life and work experience to comment on a comparison of dental law and ethics.
3. Have you ever had to maintain someone’s confidentiality? Was it difficult? Was it worth it in the short run? In the long run?
Have learners discuss this issue while maintaining that someone’s confidentiality. Urge them to remember how many times they almost slipped and what might have pulled them back. Ask them to gauge the difficulty factor in maintaining someone’s confidentiality. Was it easier with some topics than others or easier with some individuals than others? Have learners comment on the value of remaining confidential. One way of measuring this is to have learners relate what they’ve experienced when confidentiality was broken and the ramifications that occurred.
4. Describe your worst experience with any piece of office equipment. Did the experience reveal any strategies
for managing this vital area of a practice?
Everyone who has ever worked in an office has horror stories of the copier going out or the fax machine failing just at the wrong time. Keep the discussion focused on what learners learned about managing equipment breakdown. What specific strategies did they adopt to either eliminate or lessen the impact of an equipment breakdown. If you wish, you can extend this conversation into the breakdown of clinical equipment.
|Key Concepts |References and Activities |Slides |
|Introduction to Module | |Slides 1-2 |
|Introduction to Section | |Slides 3-5 |
|Key Terms |Chapters ____, pp. _____ |Slide 6 |
| |[Insert In(Class Activity icon] Skills Mastery Assessment | |
|Introducing the Dental Team |Chapter ____, pp. ____ |Slides 7-15 |
| |[Insert In-Class Activity icon] Mission Possible | |
| |[Insert Group Activity icon] Dental Team Match Game | |
| |[Insert Group Activity icon] Who Brought the Donuts: Getting into | |
| |the Morning Huddle | |
|Managing Risk |Chapter ____, pp. ____ |Slide 16 |
| |[Insert In(Class Activity icon] Personnel Problem-Solving | |
|Managing Office Equipment |Chapter ____, pp. ____ |Slide 17 |
| |[Insert In(Class Activity icon] Panel of Experts | |
| |[Insert Home Ass icon] Textbook Assignment | |
| |[Insert Home Ass icon] Oral Charting Flashcards | |
[ ] Group Activities [ ] Homework [ ] Individual Activity [ ] Internet Activity [ ] In-Class Discussion [ ] In-Class Act [ ] Evaluation
[Insert In-Class Act icon] In-Class Activities
❑ Skills Mastery Assessment (Parts A-B, All Objectives). Goal: To show learners how much they already know and to set the stage for further learning. Ask learners to take the Skills Mastery Assessment in Chapters _____of the textbook at the beginning of class. Reassure them that this is an ungraded activity, and that, in fact, only they will know their score. They are then to compare their answers to the answer key located at the back of the textbook. They are then to re-take the assessment at the conclusion of the section to check their progress.
❑ Mission Possible (Part A, Objective 1). Goal: To show learners how actual dental practices express their mission. Hand out examples of area practices’ mission statements. Ask learners to compare what they contain with what they have read in the textbooks. Conduct a group discussion to assess the mission statements and to explore how learners might approach developing a practice philosophy and writing a mission statement.
❑ Dental Team Match Game (Part A, Objective 1). Goal: To quickly familiarize learners with the variety of disciplines that make up the dental team. This is a timed exercise. Divide learners into teams. The instructor will read the job definition drawn from the textbooks for each of the following: dentist, dental hygienist, dental office manager, chairside dental assistant, dental lab technician, denturist, infection control coordinator, dental supply representative, and dental service representative. One member from each team will go to the board, write the name of the job position, and return to his or her seat. When the faster team member is seated, the instructor will read the next definition and the next person on that team will go to the board and so on. The group with the most correct dental team job positions on the board when time is called wins.
❑ Who Brought the Donuts: Getting into the Morning Huddle (Part A, Objectives 4 and 7). Goal: To have learners get the feel of a widely used dental management technique. Randomly assign team member roles to learners. If there are more learners than there are roles, divide the group into as many teams as will accommodate the size of the group. Present the teams with a list of possible concerns for the day’s clinic, and ask them to simulate problem solving in the morning huddle. Examples of last-minute glitches might include: (1) An established patient calls with a dental emergency. (2) A patient is being seen today for an extensive procedure but the ball has been dropped on obtaining precertification from the insurance company. (3) A new patient expects to be seen today, but they do not appear on the schedule. (4) A patient scheduled today for required surgical follow-up has called this morning to cancel. Ask learners to contribute boo-boo scenarios from their own experiences. After everyone has had a chance to participate, re-group to discuss what has been learned.
❑ Personnel Problem-Solving (Part A, Objective 3-4, 6-7). Goal: To give learners a chance to try some of the management techniques being introduced. Give learners scenarios detailing actual personnel problems experienced in area dental practices. (Do not use real names or addresses.) Ask learners to assess the case histories and to develop a response plan based on the information contained in Chapter ____ of the textbook. Learners may work individually or in groups. At the conclusion of the activity, learners will re-group to discuss application of the principles and to learn what steps the actual practice manager took to solve the problem.
❑ Panel of Experts (Part A, Objectives 1-5). Goal: To frame learners’ classroom experience with insights provided by dental office managers working in the area and to give learners the chance to network). The instructor will arrange for at least five dental office managers currently working in the field to talk about the most current challenges and opportunities they are grappling with. Learners are to have at least one question prepared ahead of time to ask the panelists. If possible, before or after the panel discussion, the instructor will arrange to introduce learners to the panel members in a social setting (perhaps with simple refreshments) and will encourage them to practice their networking skills. Learners will follow up the event with a thank you note to each panel participant.
[Insert In-Class Dis Ques icon] In-Class Discussion
1. What are an office manager’s typical duties in a small office? In a larger practice?.
The dental office manager handles all business activities involved in running a practice. In a small office, the office manager may wear all the hats: receptionist, appointment secretary, and billing clerk. In a larger practice, the office manager supervises employees who work in the front office and at chairside.
2. What is the purpose of the morning huddle?
The morning huddle is an opportunity to efficiently share information. It is a chance for members of the dental team to be on the same page as they approach a clinic day. Before clinic starts, the team gathers to set the tone, strategize procedures, discuss specific patient needs, and communicate any last minute changes. Some of the information communicated includes any problems from the previous day, identification of new or special patients, the flexibility of the day’s schedule, important financial information about the day’s patients, and a check on possible marketing opportunities in the day’s schedule.
3. Who on the dental team can be held liable in a malpractice suit?
Vicarious or second-hand liability means that the dentist may be held liable for the action or deed of an employee or independent contractor. In fact, a dentist or dental practice owner may be held liable without having ever met the complaining patient. However, although the dentist is the primary defendant in a malpractice suit or complaint, each member of the dental team has the potential of being held liable.
4. What is the importance of the telephone to a dental practice?
Most of the time, the telephone is the patient’s primary means of contact with the dental practice. More often that not, a patient’s first impressions are formed through phone contact, which means that professionalism and etiquette are important. A practice should have a telephone system that makes it easy for patients’ calls to get through, and the office manager must choose a phone system that efficiently handles call volume. While front desk personnel must have strategies for managing incoming calls, the office manager can take advantage of the brief time that callers are placed on hold by running pre-recorded messages that market the practice and/or provide helpful information. Communication with emergency patients also is important and the office manager must make sure that the equipment and services that support this communication are reliable.
[Insert Home Ass icon] Homework Assignments
Textbook Assignment. Read pgs. ____ in the textbook.
Oral Charting Flash Cards. Learners are to make flashcards with abbreviations and charting symbols covered in Chapter ____ of the textbook on one side and the answers on the other. They are to use these to prepare for class and to study as needed. Suggest that learners choose flashcard buddies for more effective practice.
Presentation Tools
Note: If you change Objectives or Assignments, don’t forget to change the slides accordingly.
|Slide 1 |[Insert DOM-1-1] |Power Point Presentation for Dental Office Management |
| | |Module: Clinical and Financial Management |
| |DOM – Stands for Dental Office Management. The 1st |Introduce the module. |
| |number represents the Module called Clinical and |Start by asking learners what they expect from this module. |
| |Financial Management. The 2nd number represents the| |
| |slide number. | |
|Slide 2 |[Insert DOM 1-2] |Module: Clinical and Financial Management |
| | |Introduce the sections and each part. |
|Slide 3 |[Insert DOM 1-3] |Section 1: Managing Clinical Issues |
| | |Discuss each objective in detail. Learners need to know what they will be |
| | |learning and why. Try to relate it back to their careers in the health care |
| | |field. |
|Slide 4 |[Insert DOM 1-4] |Section 1: Managing Clinical Issues (cont.) |
| | |Continue to discuss each objective in detail. |
|Slide 5 |[Insert DOM 1-5] |Section 1: Managing Clinical Issues (cont.) |
| | |Continue to discuss each objective in detail. |
|Slide 6 |[Insert DOM 1-6] |Key Terms |
| | |Review each key term and discuss. |
| | |Note to Instructor: If available as a resource, for legal terms and law and |
| | |ethics discussion in this Part, refer to Chapter ____ in Dental Assisting, A |
| | |Comprehensive Approach, 2nd edition, by Phinney and Halstead, a Delmar |
| | |Learning textbook. |
| | |In-Class Activity: Stop here for the Skills Mastery Assessment activity. |
|Slide 7 |[Insert DOM 1-7] |Part A: Managing the Dental Team |
| | |Address the difference between a dental practice philosophy, mission and goal.|
| | |Discuss the idea of the mission statement as a reflection of the entire dental|
| | |team. |
| | |Examine what it can and cannot express about a dental practice. |
| | |Stress that the overriding mission of any dental office is to make the patient|
| | |the first priority. |
| | |In-Class Activity: Stop here for the Mission Possible activity. |
|Slide 8 |[Insert DOM 1-8] |Members of the Dental Team |
| | |Go over each member of the dental team and present their scope of practice and|
| | |credentialing requirements. |
| | |Discuss the eight dental specialties recognized in the U.S. |
| | |Consider how different specialties may make different demands on the DA and |
| | |the dental office manager. |
| | |Explain the dentist’s supervisory role with all members of the dental team. |
| | |Examine the education/certification requirements of the eight disciplines |
| | |listed in the textbook. |
| | |Present the dental office manager’s role in coordinating these disciplines |
| | |into a functioning team. |
| | |In-Class Activity: Stop here for the Dental Team Match Game activity. |
|Slide 9 |[Insert DOM 1-9] |DA Qualifications and Credentials |
| | |Explain the difference between licensure/registration and certification and |
| | |identify the corresponding organizations. |
| | |Point out that each state issues its own license and registration provisions |
| | |and that these may differ from state to state. |
| | |Define DANB and ADA. |
| | |Short Activity: Stop here so that learners can go on line to locate their |
| | |state’s board of dental examiners’ website. Ask learners to examine the |
| | |details of licensure, registration, and license renewal and to discuss these |
| | |as a group. |
|Slide 10 |[Insert DOM 1-10] |DA Eligibility Pathways |
| | |Detail the requirements for each pathway to certification. |
| | |Point out the options that exist for many of the steps. |
| | |Emphasize the importance of learners staying current on their CPR health care |
| | |provider level certification. |
| | |Discuss what is involved in the infection control exam (ICE) and the dental |
| | |radiation health and safety exam (RHS) and note that the ICE and RHS exams |
| | |make up two-thirds of the CDA exam. |
|Slide 11 | |Continuing CDA Education |
| | |Go over the nine CDA re-certification guidelines. |
| | |Explain the process of earning 12 hours of accredited CDE courses every year. |
| | |Discuss what re-certification resources are available in the learners’ |
| | |community. |
| | |Question: Ask learners which method or mix of methods they think they would |
| | |prefer to use and have them explain why. |
| | |Review the multiple certification renewal CDE requirements. |
| | |Describe the annual random CDE audit. |
| | |Point out that proof of CDE should be retained by the CDE for the two previous|
| | |years. |
|Slide 12 |[Insert DOM 1-12] |Working Together as a Dental Team |
| | |Examine the different ways team members can solve problems in the dental |
| | |office. |
| | |Compare routine opportunities to address issues to ad hoc approaches that take|
| | |place as problems crop up. |
| | |Review steps the office manager can take to organize effective staff |
| | |meetings. |
| | |Underline the importance of keeping the routine meeting focused and only as |
| | |long as is necessary to accomplish office business. |
| | |Stress that the office manager may facilitate the meeting but that the dentist|
| | |is always the final decision maker. |
| | |Provide learners with ideas on how to effectively interact with the dentist on|
| | |addressing practice issues in the context of a regular staff meeting. |
| | |Give examples of how to build consensus among the various members of the |
| | |dental team during regular staff meetings. |
| | |Discuss how to hold a regular morning huddle and detail the benefits of this |
| | |technique. |
| | |In-Class Activity: Stop here for the Who Brought the Donuts: The Dental Team |
| | |Morning Huddle activity. |
|Slide 13 |[Insert DOM 1-13] |Law, Ethics, and the Dental Team |
| | |Ask learners to compare jurisprudence with ethics, how they differ and when |
| | |they come into play. |
| | |Contrast and compare the ADA code of ethics with the ADAA code of ethics. |
| | |Address the difference between civil, criminal, and contract law. |
| | |Explain what the purpose and function of the State Board of Dental Examiners. |
| | |Examine the State Dental Practice Act and the status of expanded DA functions |
| | |in your state. |
| | |Discuss the Doctrine of Respondeat Superior and how it relates to the function|
| | |that the dental assistant performs. |
| | |Define what a contract is and discuss the differences between an expressed vs.|
| | |an implied contract. |
| | |Point out how a contact can be terminated and when this is appropriate. |
| | |Explain the role that each member of the dental team plays in the ethical |
| | |treatment of patients and in reducing or eliminating the risk of malpractice. |
| | |Address the purpose of the Good Samaritan Law. |
| | |Discuss the purpose of the AwDA. |
| | |Explain the difference between an informed consent vs. an implied consent. |
| | |Point out the purpose for the HIPAA and the privacy policies and standards |
| | |that must be followed by a dental practice. |
| | |Review the code of professional conduct that each member of the American |
| | |Dental Assistant Association must pledge to comply with. |
|Slide 14 |[Insert DOM 1-14] |Dental Team Management |
| | |Point out the dentist’s role as ultimate supervisor of the team. |
| | |Discuss the dentist’s responsibility in general and direct supervision and |
| | |give examples of direct supervision of delegatable duties as opposed to duties|
| | |that staff can perform without having the dentist present. |
| | |Question: What potential impact would there be on the dentist should errors |
| | |occur under his/her general or direct supervision? |
| | |In-Class Activity: Stop here for the Personnel Problem-Solving activity. |
|Slide 15 |[Insert DOM 1-15] |The Law and Dental Team Supervision |
| | |Explain the importance of communicating effectively with the members of the |
| | |dental team. |
| | |Review the legal requirements for hiring, employing, and firing employees. |
| | |Point out the value of the office manual for establishing policies and |
| | |procedures and educating employees on office expectations. |
| | |Examine the purpose of the office manual as containing the right information |
| | |for preventing and solving routine problems and for bringing new employees up |
| | |to speed. |
| | |Discuss ways to make the office manual user friendly and easy to update. |
| | |Review personnel policies and underline the importance of making positive use |
| | |of performance reviews. |
| | |Look at the five provisions of the AwDA and point out the implications for the|
| | |dental office including office renovations. |
|Slide 16 |[Insert DOM 1-16] |Risk Management |
| | |Emphasize the role that the office manager as well as the entire team plays in|
| | |reducing exposure to malpractice actions. |
| | |Define negligence and give examples drawn from actual practices to illustrate |
| | |the consequence of adverse actions. |
| | |Discuss the National Practitioner Data Bank and explain how to access this |
| | |information. |
| | |Examine the concepts of standard of care, abandonment, and burden of proof in |
| | |relation to the dental office. |
| | |Review the elements of malpractice, the circumstances that can lead to |
| | |malpractice suits, and the steps to preventing malpractice. |
| | |Emphasize the deleterious effect of a patient’s unrealistic expectations and |
| | |link this to the upcoming section on patient relations. |
|Slide 17 |[Insert DOM 1-15] |Managing Office Equipment |
| | |Explain why the successful office manager never takes office equipment for |
| | |granted. |
| | |Ask learners to consider all the reasons that a properly working phone system |
| | |is essential. |
| | |Discuss the importance to the dental practice of a properly working fax |
| | |machine and photocopier and how these machines support excellent patient care.|
| | |Provide learners with insight into the ins and outs of working with equipment |
| | |vendors and what to look for when negotiating equipment leases. |
| | |Talk about establishing a reliable maintenance system for equipment and |
| | |building a good relationship with equipment repair personnel. |
| | |In-Class Activity: Stop here for the Panel of Experts activity. |
| | |Homework Assignment: Stop here to assign and discuss the homework. |
Part B: Managing the Dental Record
Overview
People skills are essential, but in the medical/dental field, impeccable management of the written record is just as important. The dental record holds the history of the practice in relationship to the patient. It is a legal document and an invaluable component of risk management and must be handled with confidentiality and care. In addition, the top-notch office manager must be fluent in the dental terminology and nomenclature used in the dental chart to communicate each team member’s interaction with the patient.
Initial Questions and Activities
1. Describe the best-managed records system you have ever experienced. Describe the worst. (Learners may use examples from any industry.) Compare and contrast the two experiences. Did you learn anything from the best or the worst that has stayed with you to this day?
In this discussion, focus learners on the specifics of what made one record system’s management superior while another system was substandard. Encourage learners to write the points on the board with one column for the best managed and another for the worst. Once the specifics have been teased out, have learners work together to examine the two columns. Mention that it is sometimes possible to learn more from a failed system than a successful one.
2. Have you ever searched for a file and been unable to find it? If so, what did you do? What did you say to the customer/patient? Was the situation an emergency?
Ask learners to relate brief stories of lost files. Guide the discussion toward how the problem was solved, if it was solved, and whether the reason for the error was ever discovered. If it was discovered, was an established policy broken or did a new policy need to be established? Ask learners how they communicated to the patient that they did not have the file? What did they say and how did they say it? What followup occurred with the patient after the file was located, or not located? If there is time, ask learners if anyone has ever had his or her dental or medical file lost? How did they react? Was the problem solved, and, if not, what did they do?
|Key Concepts |References and Activities |Slides |
|Dental Record Nomenclature and Terminology |Chapter ____, pp. ____ |Slides 18-25 |
| |[Insert In(Class Activity icon] Skills Mastery Assessment | |
| |[Insert Group Activity icon] Reality Tooth Identification | |
|Dental Charting Tools and Techniques |Chapter ____, pp. ____ |Slides 26-40 |
| |[Insert Group Activity icon] Reality Charting | |
|Compents and Uses of the Dental Patient Record |Chapter ____, pp. ____ |Slides 41-49 |
| |[Insert In(Class Activity icon] Reality versus the Classroom | |
| |[Insert Homework Ass icon] Cutting Edge Scheduling Software | |
[ ] Group Activities [ ] Homework [ ] Individual Activity [ ] Internet Activity [ ] In-Class Discussion [ ] In-Class Act [ ] Evaluation
[Insert In-Class Act icon] In-Class Activities
❑ Skills Mastery Assessment (Parts A-B, All Objectives). Goal: To show learners how much they already know and to set the stage for further learning. Have learners retake the Skills Mastery Assessments in Chapters ____in the textbook. They are then to compare their answers to the answer key located at the back of the textbook and check their progress of learning compared to their answers given when this activity was performed in Part A.
❑ Reality Tooth Identification (Part B, Objective 8). Goal: To reinforce learners’ understanding of the material with hands-on experience. Divide learners into three groups for a hands-on tooth ID session in the class operatory. (If your school does not have an operatory, use classroom chairs.) One group will be examiners, the second will be assistants, and the third will be the patient. Make sure that learners are wearing all their personal protective equipment before beginning this activity. Take care that each learner gets a chance to play all three roles during the duration of this activity. Call out the names of individual teeth and ask examiners to raise their hands when they have located them. Keep learners focused on the task at hand and then re-group to discuss what has been learned.
❑ Reality Charting (Part B, Objective 9). Goal: To allow learners to practice what they have been learning about the dental chart. Divide learners into two groups. Give each group the components of a manual dental patient chart. Have each group assemble the chart and make note of any missing or incomplete information. Once the chart is assembled, give learners updated information about the patient and ask them to chart this information using all necessary symbols and abbreviations.
❑ Reality versus the Classroom (Part B, Objective 12). Goal: To give learners a heads up about real practice. Learners are to create a managerial checklist that includes the main points of this section. They are to use this checklist as a guide in interviewing the office manager for their dentist’s office. (If a learner does not have a dentist, help him or her find a dental office that will cooperate.) Learners are to interview managers about the ways in which they accomplish their duties in a real-world office. If possible, learners are to seek out the procedures and methods that work for managers but have not yet found their way into any textbook. With the information they gather, learners will write a paper that describes the questions asked and the answers given. The final paragraph will evaluate the material available in class with the point of view of a real-world dental office manager. They will bring their papers to class and present them to the group. Learners will then discuss what they have learned.
[Insert In-Class Dis Ques icon] In-Class Discussion
1. Why should the office manager be proficient in dental nomenclature and terminology?
The effective office manager has to speak the language. By understanding the nomenclature and related terminology used by the clinical team, the office manager is in the position of accurately translating information to patients, educating patients, giving case presentations, and working successfully with third-party payors. It would be impossible to professionally manage a dental office without a command of dental language, anatomy, abbreviations, and symbols.
2. What is the relationship between risk management and the accuracy and integrity of the clinical record?
The dental chart is a permanent record of a patient’s oral condition. It contains history of patient health and dental work, diagnostic records, and diagnosis-treatment plans. It also is a record of the procedures that the dental team has performed and when they were performed. Because the dental chart is an accurate picture of a patient’s experience in a dental office, it provides a form of testimony in avoiding or prevailing in malpractice suits. Therefore, the integrity of the dental chart is paramount. No member of the dental team must ever even consider falsifying or altering clinical charting and notations. More than that, the office manager must clearly communicate to team members the rules for properly handling the patient chart.
3. What is case presentation?
When the dentist recommends an extensive treatment plan for a patient, the office manager in larger offices will meet with the patient (and perhaps family) to explain the dentist’s diagnosis and the phases of the treatment plan. Issues such as the cost and length of treatment also may be discussed. At the close of the case presentation, the office manager will give the patient a written treatment-plan estimate. If the patient accepts the treatment plan, the office manager schedules the sequential appointments. The office manager also makes financial arrangements verbally and in writing with the patient prior to treatment.
4. What are the office manager’s responsibilities regarding the dental drug prescription?
The office manager is responsible for the documentation of a patient’s drug prescriptions. Accurate recording and tracking avoids mistakes, confusion, misunderstandings, drug interactions and overdoses, and stolen or forged scripts. The office manager never issues a drug refill.
[Insert Home Ass icon] Homework Assignments
Textbook Assignment. Read pgs. ____ in the textbook.
Cutting Edge Scheduling Software. Learners are to research vendor websites for the most up-to-date dental office scheduling software they can find. They are to choose three softwares to present to the class. They are to write a paragraph on each explaining why they chose this software over others. Learners are to bring this assignment to class for discussion.
Ideas for learners who are ahead and want to learn more…
❑ Report from the Field. Arrange for the learner to shadow a member of the dental team. The learner will spend at least three hours with the team member and will make note of all the interactions that the team member has with other members of the dental team and with people outside the practice including patients. The learner will then write a report detailing what he or she has learned about the view of a dental practice from the vantage point of that particular team discipline.
Presentation Tools
Note: If you change Objectives or Assignments, don’t forget to change the slides accordingly.
|Slide 18 |[Insert DOM 1-18] |Part B: Managing the Dental Record |
| | |Review Part A. Make sure that any remaining questions are answered. |
| | |Go over the homework assignment in Part A. |
| | |Introduce Part B. |
| | |Clarify the relationship among these three elements of the patient record pyramid|
| | |and could affect the other. |
| | |Summarize the importance of the patient record both to the patient and to the |
| | |practice. |
| | |Link the integrity of the patient record with patient care and risk management. |
| | |In-Class Activity: Stop here for the Skills Mastery Assessment activity. |
|Slide 19 |[Insert DOM 1-19] |Four Quadrants ID |
| | |Ask learners to identify each quadrant of the adult oral cavity and the anterior |
| | |and posterior teeth. |
| | |Click to show the correct identification and discuss. |
|Slide 20 |[Insert DOM 1-20] |Periodontium ID |
| | |Ask learners to identify the parts of the periodontium, and then click to show |
| | |the correct labeling and discuss. |
|Slide 21 |[Insert DOM 1-21] |Hard and Soft Structures ID |
| | |Ask learners to identify the hard and soft structures in this break-away view of |
| | |an incisor and molar. |
| | |Click to show the correct identification and discuss. |
|Slide 22 |[Insert DOM 1-22] |Deciduous Dentition ID |
| | |Ask learners to identify the highlighted teeth in this maxillary right quadrant |
| | |section |
| | |Click to show the correct identification and discuss. |
| | |Suggest that learners relate the word deciduous to temporary teeth to deciduous |
| | |trees that lose their leaves in the fall. |
|Slide 23 |[Insert DOM 1-23] |Permanent Dentition ID |
| | |Ask learners to identify the two arches in this picture of all four quadrants of |
| | |adult dentition. |
| | |Also ask them to identify the molars, bicuspids/premolars, canines/cuspids and |
| | |incisors. ach quadrant of the adult oral cavity and the anterior and posterior |
| | |teeth. |
| | |Click to show the correct identification and discuss. |
|Slide 24 |[Insert DOM 1-24] |Surfaces and Edges ID |
| | |Ask learners to identify all of the surfaces and edges in this picture of the |
| | |maxilla. |
| | |Click to show the correct identification and discuss. |
|Slide 25 |[Insert DOM 1-25] |Cavity Classifications ID |
| | |Ask learners to identify the class of decay and the surface on which it is shown |
| | |for each of the eight pictures shown here. |
| | |Click to show the correct identification and discuss. |
| | |In-Class Activity: Stop here for the Reality Tooth Identification activity. |
|Slide 26 |[Insert DOM 1-26] |Oral Charting |
| | |Provide an overview of the complete dental chart. |
| | |Relate the importance of dental charting to patient care and risk management. |
| | |Re-emphasize the importance of precision. |
|Slide 27 |[Insert DOM 1-27] |Numbering and Charting Systems |
| | |Explain how teeth are numbered and compare the various numbering systems. |
| | |Distinguish the depiction of both adult and primary dentition in each of the |
| | |three systems described. |
| | |Point out the rationale for the development of the Universal System, and comment |
| | |on its adoption by the ADA. |
| | |Ask learners which pictorial system they find easiest to read. If you know which|
| | |method is favored in your area, tell the class. |
| | |Contrast and compare the anatomic chart with the geometric chart. Ask learners |
| | |which pictorial system they prefer and why. |
|Slide 28 |[Insert DOM 1-28] |Charting Abbreviation Quiz |
| | |Click on the slide and give learners time to translate each of the abbreviations |
| | |onto a computer screen or a piece of paper. Inform learners before they begin |
| | |how much time they will have before the next slide appears. Click on the next |
| | |slide and give learners time to translate each abbreviation. Give extra credit |
| | |for learners who include the alternate abbreviation along with the full term, |
| | |e.g., Amal = amalgam. Alternate abbreviation: AM. |
|Slide 29 |[Insert DOM 1-29] |Charting Abbreviation Quiz (cont.) |
| | |Click on the next slide and give learners time to translate each abbreviation. |
|Slide 30 |[Insert DOM 1-30] |Charting Abbreviation Quiz (cont.) |
| | |Click on the next slide and give learners time to translate each abbreviation. |
|Slide 31 |[Insert DOM 1-31] |Charting Abbreviation Quiz (cont.) |
| | |Click on the next slide and give learners time to translate each abbreviation. |
|Slide 32 |[Insert DOM 1-32] |Charting Abbreviation Quiz (cont.) |
| | |Click on the next slide and give learners time to translate each abbreviation. |
|Slide 33 |[Insert DOM 1-33] |Charting Abbreviation Answers |
| | |Click on the next slide and review the correct dental term for each abbreviation.|
|Slide 34 |[Insert DOM 1-34] |Charting Abbreviation Answers (cont.) |
| | |Click on the next slide and review the correct dental term for each abbreviation |
|Slide 35 |[Insert DOM 1-35] |Charting Abbreviation Answers (cont.) |
| | |Click on the next slide and review the correct dental term for each abbreviation.|
|Slide 36 |[Insert DOM 1-36] |Charting Abbreviation Answers (cont.) |
| | |Click on the next slide and review the correct dental term for each abbreviation |
|Slide 37 |[Insert DOM 1-37] |Charting Abbreviation Answers (cont.) |
| | |Click on the next slide and review the correct dental term for each abbreviation.|
| | |Review any of the abbreviations that learners still are unsure of. |
|Slide 38 |[Insert DOM 1-38] |Charting Symbols |
| | |Explain why it is important for dental offices to use symbols in the dental |
| | |chart. |
| | |Ask learners to carefully examine the charting symbols in the boxes and on a |
| | |piece of paper write down what each symbol means. |
|Slide 39 |[Insert DOM 1-39] |Charting Symbols |
| | |Have learners continue to examine the charting symbols in the boxes and write |
| | |down what each symbol means. |
|Slide 40 |[Insert DOM 1-40] |Charting Symbols Revealed |
| | |Note to the Instructor: Draw the symbol for caries and existing restorations on |
| | |the board as it is not included in these slides. |
| | |Click on each of the boxes to reveal the symbol’s meaning. |
| | |Note that these are the most commonly used charting symbols and can be entered on|
| | |the chart manually or electronically. |
| | |Have learners check the answers on the slide with the answers they wrote down. |
|Slide 41 |[Insert DOM 1-41] |Charting Symbols Revealed |
| | |Continue to click on each of the boxes to reveal the symbol’s meaning and have |
| | |learners check the answers on the slide with the answers they wrote down. |
| | |Repeat Slide 38 and 39 as necessary to ensure learner understanding regarding the|
| | |charting symbols. |
|Slide 42 |[Insert DOM 1-42] |ADA Coding |
| | |Explain why coding, rather than a written format, is used to identify procedures |
| | |performed by the dental office. |
| | |Explain the relationship between coding and maximum reimbursement. |
| | |Short Activity: Stop here so that learners can browse through an up-to-date ADA |
| | |coding book. Then ask learners to go online to search for more information about|
| | |dental coding. |
|Slide 43 |[Insert DOM 1-43] |The Dental Patient Record |
| | |Delineate the role of the office manager in managing the creation, maintenance, |
| | |and destruction of dental records. |
| | |Review the advantages of cross-training a staffer in records management to serve |
| | |as backup should the office manager be unavailable. |
| | |Distinguish between active and inactive records. |
| | |Explain the various precautions that a dental records manager must take to |
| | |protect manual and electronic files from damage, destruction, or theft. |
|Slide 44 |[Insert DOM 1-44] |Dental Record Contents |
| | |Review the components found in the dental record including clinical information, |
| | |statements of financial responsibility, informed consent documentation, |
| | |medical/dental patient histories, and health history forms. |
|Slide 45 |[Insert DOM 1-45] |Dental Record Ownership and Use |
| | |Explain why the dental record belongs to the practice. |
| | |Give learners pointers on how to explain this to patients and what they can do to|
| | |alleviate patient concerns about access. |
| | |Go over procedures to transfer records from one practice to another or to refer a|
| | |patient to another practice. |
| | |Examine record retention issues and describe archiving procedures that can |
| | |relieve the pressure on record storage. |
| | |Discuss the uses of the patient record in diagnosis, treatment planning, and case|
| | |presentation. |
|Slide 46 |[Insert DOM 1-46] |Other Components of the Record |
| | |Take a look at the other parts of the patient record that are specific to |
| | |dentistry. |
| | |Show learners how these components are stored manually and electronically. |
| | |Explain the importance of radiation safety and the use of a badge dosimeter to |
| | |protect members of the dental team and the patient. |
| | |Compare and contrast radiographs with radiovisiography and discuss the pros and |
| | |cons of each. |
|Slide 47 |[Insert DOM 1-47] |Nine Parts to the Drug Rx |
| | |Emphasize that only the dentist can write a prescription for a controlled drug. |
| | |List the uses for drugs in dentistry. |
| | |Review each part of the pharmaceutical prescription one by one and discuss what |
| | |each part must contain. |
| | |Bring in examples photocopies of scripts with patient names removed or blacked |
| | |out, and ask learners to identify the nine elements on each script. |
|Slide 48 |[Insert DOM 1-48] |Abbreviating the Rx |
| | |Read out each meaning before clicking on it. |
| | |Ask learners to respond with the abbreviation. |
| | |After completing the list aurally, click on each meaning and corresponding |
| | |abbreviation. |
| | |Re-emphasize why accuracy in transcription of drug dosing is so important. |
|Slide 49 |[Insert DOM 1-49] |Abbreviating the Rx (cont.) |
| | |Continue to read out each meaning before clicking on it, and ask learners to |
| | |respond with the abbreviation. |
| | |After completing the list aurally, click on each meaning and corresponding |
| | |abbreviation. |
| | |Examine the expectations placed on the office manager regarding drug |
| | |prescriptions including documentation on the patient’s chart, uses of the |
| | |duplicate prescription pad, and the need to maintain security of prescription |
| | |pads. |
| | |Emphasize what the office manager cannot do: Issue a refill for a prescription. |
| | |Distinguish the pharmaceutical Rx from the dental laboratory Rx and discuss the |
| | |office manager’s responsibilities in management of this type of script. |
| | |In-Class Activity: Stop here for the Reality Charting activity and for the |
| | |Reality versus the Classroom activity. |
| | |Homework Assignment: Stop here to assign and discuss the homework. |
Section 2: The Business of Dentistry
Section Overview
One of the most interesting aspects of managing a dental practice is the apparent contradiction between the requirements of providing medical care and the demands of running a business. The wise office manager realizes that without a stable business structure, the dental office would be unable to provide quality care. Therefore, the business of dentistry requires the office manager to pull the fiscal rabbit out of the hat without interfering with the dental team’s care of the dental patient.
Outline of Section 2
Part A: Appointment Scheduling
Part B: Getting and Spending
Learning Objectives and Competencies
These learning activities directly address the Learning Objectives and Competencies as stated
Knowledge
13. Define the key terms.
Comprehension
14. Identify the principles, goals, and strategies of appointment scheduling.
15. Describe common expenditure categories.
16. Examine treatment codes in scheduling.
17. Summarize payroll procedures.
18. Discuss the manager’s role in supply inventory and equipment maintenance.
Application
19. Demonstrate budget-writing skills.
20. Simulate schedule problem solving.
Analysis
21. Contrast and compare payment methods.
22. Differentiate types of patient insurance.
Synthesis and Evaluation
23. Devise security precautions for drugs inventory.
24. Evaluate the impact of scheduling policies and accounts payable/receivable on financial management of a
practice.
Learning Activities
These learning activities directly address the Learning Objectives and Competencies as stated.
[Insert In-Class Activity icon] Key Term Pass the Baton (Part A, Objective 13)
[Insert In-Class Activity icon] Learning from a Master Dental Scheduler (Part A, Objective 14)
[Insert In-Class Activity icon] Solving the Scheduling Jigsaw (Part A, Objective 16 and 20)
[Insert Homework Assignments icon] Textbook Assignment (Part A, Objectives 13-24)
[Insert Homework Assignments icon] ADA Coding Research (Part A, Objective 16)
[Insert In-Class Activity icon] ADA Coding (Part B, Objective 16)
[Insert In-Class Activity icon] How to See Patients and Lose Money (Part B, Objectives 16, 23 and 26)
[Insert In-Class Activity icon] Writing a Budget (Part B, Objective 19)
[Insert In-Class Activity icon] Be Your Own Drug Czar (Part B, Objective 23)
[Insert In-Class Activity icon] The Impact of Policies and Procedures on Practice Finances (Part B, Objective 24)
Part A: Appointment Scheduling
Overview
Effective appointment scheduling makes maximum use of the dental team’s energies while meeting production goals and providing patients with the access they want. Several methods are used to achieve this result, and the successful office manager understands all of them.
Initial Questions and Activities
1. Have you ever arrived for an appointment, medical or otherwise, to find that a scheduling error had occurred? How did you react? Did the snafu affect how you perceive the organization?
Ask learners to focus on specifics. How were they informed that a mistake had been made? What language and tone were used? Was an explanation given? Was it adequate? How much inconvenience did the mistake cause? What did the office do to address the situation? Were the alternatives offered acceptable? Which part of the encounter affected perception more: The original error or the way in which the office personnel handled it?
2. Have you ever experienced shifting from a manual scheduling system to a computerized system?
Ask those who have made this transition to explain the effect that it had on their own productivity, the productivity of the office as a whole, how much and what kind of preparation and planning was done, how involved the staff was in the process of choosing a computerized system, and how long it took the entire office to become comfortable and proficient in the new system. Inquire whether and how the manager worked with those who had the most difficulty making the change from manual to electronic.
|Key Concepts |References and Activities |Slides |
|Introduction to Section | |Slides 50-51 |
|Key Terms |Chapter ____, p. ____ |Slides 52-53 |
| |[Insert Group Activity icon] Key Term Pass the Baton | |
|Introduction to Appointment Scheduling |Chapter ____, pp. ____ |Slides 54-55 |
| |[Insert In-Class Activity icon] Learning from a Master Dental | |
| |Appointment Scheduler | |
| |[Insert In-Class Activity icon] Solving the Scheduling Jigsaw | |
| |[Insert Home Ass icon] Textbook Assignment | |
| |[Insert Home Ass icon] ADA Coding Research | |
[ ] Group Activities [ ] Homework [ ] Individual Activity [ ] Internet Activity [ ] In-Class Discussion [ ] In-Class Activity [ ] Evaluation
[Insert In-Class Act icon] In-Class Activities
❑ Key Term Pass the Baton (Part A, Objective 13). Goal: To reinforce learners’ comprehension of key terms. Divide learners into groups and ask them to sit adjacent to one another. The instructor will write one key term at a time on the front board. On an 8.5 x 11piece of notebook paper, one person on each team will write for one minute as much as he/she knows about the key term and then pass the paper off to the next team member. This person will read what has been written and add as much new information as they can in one minute. The last person to be passed the “baton” will determine if the definition is complete, write for no more than one minute as needed to complete it, and place the paper in a box next to the instructor (with the instructor located equidistant from each team). The team with the most complete definition within the time allowed wins. Learners will re-group to review the definitions.
❑ Learning from a Master Dental Scheduler (Part A, Objective 14). Goal: To allow experts working in the field a chance to share their expertise with learners. The instructor will arrange for a guest lecturer who has been an appointment scheduler in a large dental office for three to five years. The lecturer will discuss what has changed over time in scheduling, what are current best practices, tips and techniques for juggling competing demands, and what he or she sees coming in the future. The lecture will be followed by a Q&A period, and learners will be prepared to ask informed questions. At the next class, learners will discuss what they now know about dental appointment scheduling that they did not know before.
❑ Solving the Scheduling Jigsaw (Part A, Objective 16 and 20). Goal: To allow learners to apply the concepts they have been learning. Give learners a sheet that includes information about the dentist’s schedule preferences, the production goals set for the week, and a picture of the dental office layout. Follow this sheet up with a list of patients to be scheduled over the next week. Include information such as patient name, age, reason for appointment, type of appointment, treatment history, tardy/no-show history, and whether the patient has special needs. At the last minute, throw in a few palliative dental emergency visits. Then give learners treatment codes to match to each appointment. Have learners work individually or in groups to schedule the appointments to best meet practice goals of making best use of the dentist’s energies, meeting production goals, and providing convenience for patients. At the completion of this activity, have learners re-group to discuss.
[Insert In-Class Dis Ques icon] In-Class Discussion
1. What are three major considerations in appointment scheduling?
The dentist’s energy level is the first element that the office manager must take into account. Knowing when the dentist has the most energy for demanding procedures allows the manager to match the schedule to the dentist. Smart production strategies are an important consideration as they make the most of the time and energy of the entire dental team and generate adequate daily cash flow to run the practice and create a profit. Patient convenience also is a major consideration. The easier it is to make an appointment, the more likely it is patients will come in for treatment.
2. What is the purpose of scheduling particular appointments at specific times?
An example of this is oral surgery under general anesthesia, which is scheduled early in the morning because the patient must fast eight hours before surgery to avoid complications. In this way, the patient fasts while sleeping. Another example is in meeting production goals. The office manager may schedule higher production figures first and then schedules the shorter and less productive visits second.
3. What is the purpose of staggering apppointments?
Staggering takes advantage of the natural down-time that can occur during lengthy procedures. During the patient’s rest breaks, the dental team can fit in less complicated procedures.
4. What are some examples of special needs patients, and why should care be taken in scheduling their appointments?
Dental phobics, hyperactive children, physically or mentally handicapped patients, and frail elderly are some examples. Patients covered under the Americans with Disabilities Act also may have special needs. The office manager should check with the dentist before scheduling special-needs patients in order to schedule the appropriate amount of time. The office manager also should take care in scheduling particular patients at particular times of the day, e.g., diabetics early in the morning when insulin levels may be more stable.
[Insert Home Ass icon] Homework Assignments
Textbook Assignment. Read pgs. ____ in the textbook.
ADA Coding Research. Learners are to either conduct a web search for information about ADA coding and/or conduct research in the public or school libraries. They are to gather as many codes and descriptions as possible and bring these to class for an in-class activity.
Ideas for learners struggling with this material…
❑ Building a Knowledge Scaffold. Learners struggling with mastering new concepts may benefit from an instructional strategy based on cognitive development. The learner in the process of mastering a new concept but not yet succeeding provides the instructor with a zone of opportunity. The instructor can enhance the learner’s ability to adopt the new concept by focusing the learner on ideas that are just slightly ahead of his or her developmental level. The point is not to frustrate the learner but to provide a scaffolding. Scaffolding occurs when the instructor supports the learner in bridging the gap between the present skill level and the desired developmental level by providing guidance and modeling problem solving. As the gap narrows, the instructor’s influence is withdrawn.
Presentation Tools
Note: If you change Objectives or Assignments, don’t forget to change the slides accordingly.
|Slide 50 |[Insert DOM 1-50] |Section 2: The Business of Dentistry |
| | |Discuss each objective in detail. Learners need to know what they will be |
| | |learning and why. Try to relate it back to their careers in the health care |
| | |field. |
|Slide |[Insert DOM 1-51] |Section 2: The Business of Dentistry (cont.) |
|51 | |Continue to discuss each objective in detail. |
|Slide |[Insert DOM 1-52] |Key Terms |
|52 | |Review each key term and discuss. |
|Slide 53 |[Insert DOM 1-53] |Key Terms (cont.) |
| | |Continue to review each key term and discuss. |
| | |In-Class Activity: Stop here for the Key Term Pass the Baton activity. |
|Slide 54 |[Insert DOM 1-54] |Part A: Appointment Scheduling |
| | |Contrast and compare the three goals of appointment scheduling and discuss |
| | |methods for making them balance. |
| | |Discuss the importance of blocking out the schedule to prevent scheduling |
| | |mistakes. |
| | |Go over the use of blocks or units of time and how these are used in manual |
| | |and electronic scheduling. |
|Slide 55 |[Insert DOM 1-55] |Scheduling Strategies |
| | |Examine the appointment units calculated in Figure 11-2 in the textbook and |
| | |stress the need for the successful office manager to use methods for making |
| | |the most of the staff’s time when arranging schedules. The Figure can also be |
| | |found at the end of this faculty guide. |
| | |Explain the importance of identifying and screening patients. Discuss how to |
| | |handle special-needs patients, emergency patients, and patients who are |
| | |seeking medications. |
| | |Discuss the methods of multiple and double-booking for more efficient and |
| | |profitable scheduling. |
| | |In-Class Activity: Stop here for the Learning from a Master Dental Appointment|
| | |Scheduler activity and the Solving the Scheduling Jigsaw activity. |
| | |Homework Assignment: Stop here to assign and discuss the homework. |
Part B: Getting and Spending
Overview
Effective appointment schedule brings in patients. The next step is to make sure that the practice cash flow is tip top. Unlike the dental office manager of just a few years ago, today’s manager is faced with the challenge of the third-party payor. The successful manager makes the most of the benefits of managed care and avoids as many of the pitfalls as possible. The successful manager also is skilled in disbursing funds and managing supply inventories.
Initial Questions and Activities
1. Have you ever been charged with keeping an item stocked, even for a short period of time?
Urge learners to use any experience they have had in stocking supplies. Focus the discussion on the type of supply and its shelf life, the process of tracking supplies so that timely ordering can occur, the importance of communication so that supply needs are communicated effectively, and the role that costs play in supply-ordering strategies or failures (volume discounts, last-minute emergency ordering).
2. What was the biggest challenge you faced in keeping the right amount of stock available on a regular
basis?
Ask learners to describe the specific challenge that they encountered and to relate their thinking processes as they attempted to come up with a solution. Have learners reflect on their solutions and whether they would employ a similar strategy today.
|Key Concepts |References and Activities |Slides |
|Introduction to Dental Accounts Receivable |Chapter ____ , pp. ____ |Slides 56-60 |
| |[Insert In-Class Activity icon] ADA Coding | |
| |[Insert In-Class Activity icon] How to See Patients and Lose Money| |
|Introduction to Dental Accounts Payable |Chapter ____, pp. ____ |Slides 61-63 |
| |[Insert In-Class Activity icon] Writing a Budget | |
|Office Supply Ordering and Inventory Control |Chapter ____, pp. ____ |Slides 64-65 |
| |[Insert In-Class Activity icon] Be Your Own Drug Czar | |
| |[Insert In-Class Activity icon] The Impact of Policies and | |
| |Procedures on Practice Finances | |
| |[Insert Homework Ass icon] Textbook Assignment | |
|Summary of Module | |Slide 66 |
[ ] Group Activities [ ] Homework [ ] Individual Activity [ ] Internet Activity [ ] In-Class Discussion [ ] In-Class Activity [ ] Evaluation
[Insert In-Class Act icon] In-Class Activities
❑ ADA Coding (Part B, Objective 16). Goal: To reinforce learners’ understanding of dental coding. The instructor will give learners a page of clinical procedures common to dental practices. Using the information gleaned in the homework assignment and ADA coding manuals brought to the classroom, learners will code these procedures. Learners will re-group to receive the correct answers and to discuss the process.
❑ How to See Patients and Lose Money (Part B, Objectives 16, 23, and 26). Goal: To allow experts working in the field a chance to share their expertise with learners. The instructor will arrange for a guest lecturer who has expertise working with capitated managed care plans in dental offices. The lecturer will discuss what the learner should know about maintaining a practice’s financial health in the face of discounts for service and will cover what an office manager should know about negotiating contracts with third-party payors. The lecture will be followed by a Q&A period, and learners will be prepared to ask informed questions. At the next class, learners will discuss what they now know about accounts receivable and managed care that they did not know before.
❑ Writing a Budget (Part B, Objective 19). Goal: To give learners the experience of making hard budget choices in the safety of the classroom. Learners are to refer to the percentages listed in Chapter ____, on pgs ____of the textbook. They are to use these percentages to generate a budget for a fictitious dental practice that has $300,000 production budget for the year. Make sure that at least 30% is budgeted for the dentist’s income. Learners are to work separately, and re-group to discuss the choices that they have made.
❑ Be Your Own Drug Czar (Part B, Objective 23). Goal: To have learners apply what they have learned about drug inventory control. Learners are to use information in the textbooks and from websites to develop a plan to store and inventory controlled and prescription drugs in the office. They are free to devise any criteria they wish and the process may be manual or electronic. After learners have completed the activity, they will re-group and each learner will present his or her plan.
❑ The Impact of Policies and Procedures on Practice Finances (Part B, Objective 24). Goal: To give learners the opportunity to synthesize the information they have received in this section and evaluate factors that they will encounter in the field. The instructor will give learners information about a hypothetical dental practice. Learners will use this as the basis for establishing policies and procedures for appointment scheduling and contracting with third-party payors. They are then to evaluate the potential impact of these policies and procedures on the dental practice. The resulting paper should be no less than three pages.
[Insert In-Class Dis Ques icon] In-Class Discussion
1. What is the difference between accounts receivable and accounts payable?
Accounts receivable is the money that the practice brings in by providing services and products. Accounts payable is the money that the practice pays out to those whom it owes.
2. What is capitation, and why is understanding capitation important to the dental office manager?
In capitation, the insurer pays the providers a fixed amount for each patient treated regardless of the complexity of the case or the number of services utilized. Capitation is the method of payment in several HMO models. The office manager must be aware that the dentist assumes the risk of over-utilization of services by patients.
3. What is dental coding, and what coding sources exist for the office manager?
The dental office communicates with third-party payors by using treatment codes. Codes have been designed to standardize the billing process so that each procedure is billed accurately and that the provider is paid the correct amount. An important code resource is the American Dental Association’s CDT-2 book, which contains an extensive list of dental and related procedure codes organized by category and treatment. Because most offices repeat a constellation of procedures, the office manager can save time by creating a short list of commonly used codes tailored to the practice.
4. What is the largest category of office expense, and what does this mean to effective budget management?
Personnel expenses eat up the largest part of the accounts payable pie and can run as high as 20% to 30%. This includes employee payroll and benefits. The effective office manager carefully considers the full initial cost of hiring an employee and calculates the full impact of hiring over time (calculating the cost of promotions and raises).
5. What are some of the other costs in a practice’s overhead?
In addition to personnel expenses, these include occupancy expenses, administrative expenses, equipment and furnishings, clinical and dental supplies, laboratory fees, and marketing costs.
Presentation Tools
Note: If you change Objectives or Assignments, don’t forget to change the slides accordingly.
|Slide 56 |[Insert DOM 1-56] |Part B: Getting and Spending |
| | |Review Part A. Make sure that any remaining questions are answered. |
| | |Go over the homework assignment in Part A. |
| | |Introduce Part B. |
|Slide |[Insert DOM 1-57] |Income and Outgo |
|57 | |Establish that accounts receivable is income and accounts payable is outgo. |
| | |Make sure that learners completely understand the difference between the two. |
| | |Distinguish the duties the office manager must perform for AC versus AP. |
|Slide 58 |[Insert DOM 1-58] |Third-Party Payment |
| | |Summarize the impact of third-party payors and, in particular, the impact of the |
| | |managed care model on the financial cycles of the dental practice. |
| | |Clearly separate the different forms of managed care. |
| | |Discuss the considerations a dental office manager and dentist must understand |
| | |when contracting in a capitated system. |
| | |Emphasize the importance of accurate coding when making claims to third-party |
| | |payors. |
| | |In-Class Activity: Stop here for the ADA Coding activity. |
|Slide |[Insert DOM 1-59] |Patient Methods of Payment |
|59 | |Examine the different methods of payment for services and weigh the pros and cons|
| | |of each. |
| | |Point out the considerations that an office manager must make when choosing how |
| | |payment will be received including the costs of processing the payment. |
| | |Analyze what it costs in labor to capture revenue including proper coding, |
| | |pre-authorization, claims processing, and claims tracking. |
| | |Balance these against the level of reimbursement to be received. |
| | |In-Class Activity: Stop here for the How to See Patients and Lose Money |
| | |activity. |
|Slide |[Insert DOM 1-60] |Accounts Payable |
|60 | |Examine the office manager’s duties in the area of disbursement of funds to pay |
| | |for materials and services that the practice receives. |
|Slide |[Insert DOM 1-61] |Expense Categories |
|61 | |Discuss the variety of expense categories that a practice can be expected to |
| | |have. |
| | |Review the demands of overhead and compare fixed and variable expenses. |
|Slide |[Insert DOM 1-62] |Overhead Examples |
|62 | |Follow up expense categories with look at overhead expenses in greater detail. |
| | |Ask learners how they would economize on these expenses if they were running a |
| | |dental practice. |
| | |Present considerations regarding the office manager’s relationship with the |
| | |practice’s bank, including writing checks, making deposits and balancing the |
| | |checking account. |
| | |Review the components of a bank statement and a retention policy for canceled |
| | |checks should there be an audit. |
| | |Discuss the pros and cons of electronic funds transfer and automatic payment |
| | |systems. |
| | |Comment on what the office manager should know about electronic and automated |
| | |systems. |
|Slide |[Insert DOM 1-63] |Payroll Records and Reporting |
|63 | |Review the choices in handling payroll and what the office manager should know |
| | |about each method. |
| | |Recount the duties the office manager in relationship to government tax |
| | |authorities, and emphasize the importance of having a current IRS employer’s tax |
| | |table available in the office. |
| | |Delineate the office manager’s payroll responsibilities including: |
| | |Maintaining employee earnings records |
| | |Calculating payroll deductions for FICA and income tax withholding |
| | |Depositing these deductions |
| | |Paying federal unemployment tax |
| | |Making wage and tax statements |
| | |Reporting on withheld income tax |
| | |Retaining payroll and tax records. |
| | |Comment on the consequences that could result should tax-related duties not be |
| | |carried out. |
| | |In-Class Activity: Stop here for the Writing a Budget activity. |
|Slide |[Insert DOM 1-64] |Supplies and Inventory |
|64 | |Describe the manager’s role in ordering supplies and keeping an inventory. |
| | |Familiarize learners with the savings that can be had when buying in bulk or at |
| | |discount, but point out the possible downside of some of these endeavors. |
| | |Examine the need to establish security for all supplies but especially the |
| | |in-office drug supply. |
| | |Describe the importance of maintaining equipment warranties and service repairs. |
| | |In-Class Activity: Stop here for the Be Your Own Drug Czar activity. |
|Slide |[Insert DOM 1-65] |Supply Types and Quantities |
|65 | |Focus on the four categories of supplies and how each may require a different |
| | |approach in ordering and tracking. |
| | |Look at how supplies differ by type and demand particular handling. |
| | |Point out the steps needed to track and manage supply quantity needs in the |
| | |office. |
| | |In-Class Activity: Stop here for the Impact of Policies and Procedures on |
| | |Practice Finances activity. |
|Slide |[Insert DOM 1-66] |Summary of Module |
|66 | |Summarize the module and make sure that all learner questions and concerns have |
| | |been addressed. |
-----------------------
Part A: Managing the Dental Team
Part B: Managing the Dental Record
Part A: Appointment Scheduling
Part B: Getting and Spending
Section 1:
Managing Clinical Issues
Section 2:
The Business of Dentistry
Faculty Teaching Guide for
Dental Office Management
Module:
Clinical and Financial Management
The Adult Learner…
may carry the whole world into the classroom: Kids, in-laws, mortgages, marital spats. In other words, the kitchen sink. At the start of each class, ask learners to shut the door on their distractions and use class time to rejuvenate. Frame class as a special experience designed just for them and their own progress.
Teaching Tip
Prime learners for what’s to come. Present at least three dental practice management problems similar to those they will encounter during the module. Demonstrate a variety of solutions, but don’t ask learners try their hands yet. The idea is to point learners’ attention toward what you soon will be teaching them.
Teaching Tip
A key to adult learning is to link the lesson to the reality of the workplace . Relate activity goals to the actual skills needed in the dental office setting. Present real-world examples from your own experience and encourage learners to illustrate concepts with their own workplace stories.
Teaching Tip
When marking learners’ work, consider using a color other than red. A bright green or blue may have a less negative impact and may help a learner to react less negatively. Make it clear to learners that corrected work is not a reflection of who they are as a person but is an opportunity to improve and develop.
The Adult Learner…
Teaching Tip
Self-evaluation is important for adult learners. When they see themselves either successfully applying their knowledge and skills or not successfully applying their knowledge and skills, they tend to pay attention more closely. Also, repetition of learning is essential. Each time a learner makes an evaluation, the concept is more firmly established in their memory.
wants to be treated as an individual. Pay attention to each learner and attempt to have everyone speak during discussions. Be careful to include shyer people, and pay attention to the good learner (who can be overlooked as you work with less able learners).
Teaching Tip
Teaching Tip
In all courses, learners should have an opportunity to present in front of their peers. This task is daunting to some individuals. Consider starting out with less risky presentations like class discussion and then move to more difficult speaking tasks. Provide encouragement and be empathetic to learners who struggle in this area. Always point out the positive aspects of any attempt before providing a critique. Consider distributing a list of positive presentation behaviors to establish expectations.
Give learners a diagnostic test at the beginning of the module. Test their retention of ethics and legal issues to determine the level of knowledge across the class. Make sure learners understand that this is a purely diagnostic tool and does not impact on grades. Use the results of the diagnostic to better tailor lecture, activities and homework assignments.
The Adult Learner…
often has a high expectation of respect. This can mean different things to different learners. However, for all learners it is wise to dress neatly, speak politely, and make sure that all the printed materials given to learners are well designed, easy to read and contain no misspellings.
The Adult Learner…
may or may not be familiar with what is required to produce professionally prepared documents. Clearly explain, and even demonstrate, what you are looking for and require that learners present professional documents as part of their preparation for the demands of today’s workplace.
Teaching Tip
Learners just entering school may not be in the habit of producing professional documents. If you would like the appearance of learners’ written work to improve, demonstrate, what you are looking for. Consider holding workshops to improve writing skills. Require learners to meet the standards of the workplace.
Teaching Tip
Set high expectations. Remember that you are training learners for success in the workplace, not just in a course. Explain to learners the professional skills they will need in the field. Incorporate training and skills practice in class, and provide as much feedback and encouragement in these areas as you can.
Teaching Tip
Take the time to notice the shy learners in the class. Make eye contact with them. This lets them know that it’s okay to make eye contact with you and may establish a positive bond. Consider too appointing shy learners to head small groups as a way of setting the bar for moving past their shyness.
Teaching Tip
Frequent instructor – learner contact is important to adult learners, and it may have a positive effect on retention. Tailoring activities to a learner’s ability and interest facilitates the learner-instructor relationship as well as meets learners at their level of knowledge, another important principle of adult learning.
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