Documenting Treatment Plans and FA in OD

ONE SENTENCE SUMMARY

Everything you need to know about how to enter treatment plans and FA's in the patient’s chart so that you set the rest of your team up to be successful.

BEST CASE SCENARIO IF WE ARE 100% CONFIDENT

Patients feel like their experience is seamless, organized, and professional.

WORST CASE SCENARIO IF SOME OF US ARE NOT

We get confused about who is doing what and when. Nobody seems to know what is happening. We have to rely on the doctor’s remembering what happened last visit, what we’re doing today, and what’s happening next. We never know when to ask patients for money and when it's already been taken care of, which leads to embarrassing situations. Patients lose confidence in us, especially the ones who are paying tens of thousands of dollars and expect a certain level of customer service and professional expertise.

WHAT DOES 100% CONFIDENT MEAN?

HOW IT WORKS IN 7 STEPS OR LESS

1. Chart notes

2. Financial notes

3. Treatment planning module

4. Dental Intel vs Google Sheets follow up

Chart notes

What does a proper chart note look like?

1. The chart notes should be complete – no blanks in the autonotes

2. Initialed by the DA/RDH and DDS

3. NV (next visit) noted, including:

a. What treatment is required next

b. Which provider

c. How many units

d. FA for that visit

Chart notes for complex treatment plans

If the treatment plan consists of multiple stages, treatment types, and/or providers, then you should enter a separate chart note clearly explaining the treatment plan. If in doubt, add this note!

Think of it this way: Do you think this type of note would be helpful for the next DA who sees this patient?

This note should be placed in this section circled in pink, just below the odontogram. Make sure to include the date and your initials.

Example treatment plan note for a complex case:

01-27-22 ML Tx plan: 1. Invisalign with Sorana; 2. 16 implant/sinus, 34, 35 implants with Mike; 3. 17 to 27, 37 to 47 crowns with Mike; 4. NG and hygiene. FA – prepaid in full

Another example:

01-27-22 ML Tx plan: 1. 16 endo/core/crown, fills as per chart; 2. 46 exo/graft and then implant in 4 months; 3. NG and hygiene. All with Sorana. FA – fills DOS, 16 payment plan, 46 pt hopes to prepay in full but has not paid yet

Financial notes

HOW to document the FA

In the clinic, we need enough detail in the FA documentation to know whether or not we need to discuss finances with our patient.

There are 4 codes we use for FA documentation:

1. DOS – “day of service”. This means the patient will pay for their next visit on that day

2. Prepay – The patient has already paid for their visit

3. Payment plan – The patient has a payment plan in place

4. NC – “no charge”. The patient does not need to pay at all

NOTE: This documentation is sufficient for the clinic. The FD team may add more detail to their FA documentation. For example, they should record the details of the payment plan.

ALSO NOTE: If the next visit is hygiene, no FA documentation is required. We assume that it is DOS. The only exception is for some big cases where certain hygiene visits are included with their case fee. In that case, the FA documentation should say NC.

WHERE to document the FA

The FA should be documented in 3 places:

1. At the end of the note from the previous visit, along with the NV notes.

Example: NV – 46 endo/core/crown, 12U with Jacob, prepaid in full

2. For complex treatment plans as described above, in this section:

3. In the accounts tab, in this section:

IMPORTANT!!!

The dental assistant (or RDH for hygiene patients, or treatment coordinator for consult patients) is responsible for making sure there is an FA in place for the next visit, and it is documented properly.

If the DA/RDH doesn’t have time to do the FA themselves, it is their responsibility to transfer that patient to FD for the FA.

Also - if you give the patient anything to take home - treatment options, written summary, FA options, etc - you MUST make a copy to keep in their chart.

Treatment planning module

1. Enter the procedure codes for the entire treatment plan in the treatment planning module.

2. Organize the codes into phases, if necessary

3. Plan the next appointment

NOTE: For larger treatment plans, this can be time consuming. While the treatment plan doesn't have to be entered right away, it should be done by the end of the day.

ALSO NOTE: The only way we know that a patient requires follow up is by running reports for procedure codes in Open Dental. That’s why it’s so important to enter the treatment plan in procedure codes in this section, and not just in writing in the chart notes. If there are no procedure codes, then we would never know to follow up with the patient.

Dental Intel vs Google Sheets follow up

1. Dental Intel Follow Up

Dental Intel is our main follow up method. There are 3 types of patients who get follow up through Dental Intel:

A. Patients who have planned treatment, but have not booked an appointment for that treatment yet.

- For these patients, the only thing you have to do is enter the procedure codes for the treatment plan. Open Dental and Dental Intel will then automatically generate reports and call lists when follow up is required.

B. Patients who had an appointment booked, but then cancelled or didn’t show up for that appointment.

- For these patients, you need to break the appointment in Open Dental and mark it as unscheduled.

C. Patients who tell us to call them in a week (or whenever) to check in on their decision. For example, “I need to check my work schedule – can we figure out an appt time next week?”

2. Google Sheets Follow Up

We use Google Sheets to follow up with “big cases”.

For these purposes, a big case is:

- Anything involving implants

- Invisalign

- Treatment plans over $5,000

The follow up for these patients is less automated than “regular follow up”, and much more thorough and personal.

The ONLY way that patients get onto the big case follow up list is if we add them manually to Google Sheets.

So if you see a patient who has discussed implants, Invisalign, or treatment plan greater than $5,000, tell FD via slack to add that patient to Google Sheets.

In addition, if you have a big case patient who is booked for a consult or for treatment, and they cancel or no show, instead of just unscheduling their appointment and marking as broken in Open Dental like for regular patients, you should also tell FD via Slack so they can follow up with these patients more closely.