How to use a dental X-ray correctly?
Sep 08, 2020 · These in-depth case studies have been designed specifically for dental hygiene students. Each case includes the patient documentation (Patient History and Periodontal Charting) and images (Radiographs and Intraoral images). These case studies may be used in a number of ways, such as: • Individual study followed by in class testing.
Should I send a photo or X-ray for dental insurance claim?
Oct 26, 2017 · Decision process for recommending dental x-rays. My current context is low risk: no decay for the past 10 years. All probing depths 3 mm or less, 2 hours or more between snacks and meals, brushing and flossing 3 times per day, using fluoridated toothpaste. In this light, my dentist should have based his prescription for x-rays at my last dental ...
Are dental X-rays a standard of care issue?
Mar 26, 2012 · You can refuse treatment. Absolutely. Dental x-rays are not treatment. They are diagnostic. If you refuse x-rays, we simply cannot continue to see you. It’s that simple. If the cost is truly a concern, without hesitation I will do them at no charge. No kidding. They are that important – dentally, ethically, and legally.
What defenses are used in a dental malpractice case?
Oct 14, 2016 · Dental Malpractice Cases Require Proper Documentation. One of the most important defenses in a dental malpractice case is proper documentation. The patient’s dental record must contain a clear chronology of events, future treatment plans, and all the important communication between the dentist and patient.
What is the most important use of radiography in the dental practice?
X-rays, also known as radiographs, allow your dentist to see between and inside your teeth. Dental X-rays are important because they give your dentist the whole picture. They help dentists see the condition of your teeth and also the roots, jaw placement, and facial bone composition.
How do you explain a dental treatment plan?
Your dental treatment plan outlines exactly what dental services your dentist recommends, in what timeframe, and how much they will cost after insurance, if applicable. It is a comprehensive, big-picture approach to oral care and is designed to prevent small issues from getting bigger and more expensive.
What methods that can be used for filing patient information dental?
Many dental offices use a color-coded filing system for patient record files. Color-coded labels — usually the first two letters of the patient's last name and active date of treatment — are placed on the patient's file. This can help make record retrieval fast and easy.
What is the most important document that is maintained for each patient in a dental practice?
Patient records are a vital part of your practice. Among other things, they contain information about the patient's treatment plan and care that has been delivered. Dental records are especially important when submitting dental benefit claims or responding to lawsuits.
What is the definition of treatment plan?
(TREET-ment plan) A detailed plan with information about a patient's disease, the goal of treatment, the treatment options for the disease and possible side effects, and the expected length of treatment.
What should happen before the treatment plan is implemented dental?
Preclinical exam—Before the examination begins, it is important that the dentist or team member conducts a preclinical exam to understand why the patient is there, past experiences, desired changes, any problems occurring, and more.Mar 20, 2018
What are the six basic filing methods?
Methods of filing Filing in Alphabetical order. Filing by Numbers/Numerical order. Filing by Places/Geographical order. Filing by Dates/Chronological order.
How do you identify someone by dental records?
Dental IdentificationA forensic dentist can extract DNA from the pulp chamber to crossmatch and identify a victim.Investigators can examine dental records to match them to a corpse, or to match a bite mark to a perpetrator.A forensic dentist can utilize ameloglyphics, or enamel rod patterns.More items...•Jul 6, 2020
How do you maintain dental records?
Individual records should be stored securely, not left unattended or in public areas. No entry should be erased. All entries made in pen should be legible and reproducible. All errors in the records should be indicated and the correct entry should be mentioned along with the date, time and a signature.
Why is documentation important in dental hygiene?
Dental professionals are without excuse for poor, inadequate records. Thorough documentation includes the complete and accurate recording of all collected data, treatment planned and provided, recommendations, and other information relevant to patient care and treatment.Jun 30, 2009
What are the components of a medical dental record?
Patient treatment requires an updated medical history, clinical chart with treatment record and progress notes, periodontal screenings, and radiographic images. To complete monetary transactions, a patient registration form which includes financial responsibility and/or insurance eligibility must be obtained.
How long does a dental practice have to keep records?
10 yearsThis states that general Dental Services records should be retained for a minimum period of 10 years from the date of discharge of the patient from the practice or when the patient was last seen.Jul 30, 2019
What is the key to a good dental X-ray?
One of the keys to a good dental X-ray is alignment. The receptor, a dental assistant tool that goes into the patient’s mouth and captures the images, should be positioned in the correct position according to the area in the mouth. The X-ray beam, which produces the images, should also be placed at the correct angle in accordance.
How to take X-rays?
Your patient’s comfort is also the key to taking good X-rays. If your patient is uncomfortable, he or she may move or try to reposition while you’re taking the X-rays, causing the final images to appear blurred or poorly defined. Below are some tips to keep them still: 1 Give Your Patient Support: Make sure your patient’s head and neck are supported before you begin taking X-rays. 2 Ease the Gag Reflex: We all have a gag reflex that can be easily triggered, but some patients may have a more sensitive gag reflex than others. If gagging is still a problem, tell your patient to breathe deeply through their nose, hum, or refocus his or her attention elsewhere.
How to keep X-rays still?
Below are some tips to keep them still: Give Your Patient Support: Make sure your patient’s head and neck are supported before you begin taking X-rays. Ease the Ga g Reflex: We all have a gag reflex that can be easily triggered, but some patients may have a more sensitive gag reflex than others.
What is a panoramic x-ray?
If you need to take panoramic X-rays, a Panoramic x-ray includes all sections of the mouth, even those missing teeth. For example, capture images of the third molars, or wisdom teeth, even if they have been removed.
What happens if the X-ray beam is not in accordance?
If the receptor, beam, or both, are not in accordance, the teeth could appear elongated, shortened, or over lapped in the X-rays.
Can a small mouth be overexposed?
A child or petite adult will require a lower setting than a larger adult. If the exposure is not set correctly, your images may end up under or overexposed.
With x-rays your dentist can see between teeth and under fillings
Mary is right! With her naked eyes, she can not see between my teeth or under my fillings and I do have many fillings in my mouth. All together, 15 of my teeth have been restored, including 2 crowns and one root canal treatment.
Dental x-rays must be prescribed according to your risk level
X-rays are a great diagnostic tool but there are clear rules to follow when prescribing them. Dentists must first examine the patient, then justify and optimize the use of radiation based on the ALARA principle (As Low As Reasonably Achievable).
Decision process for recommending dental x-rays
My current context is low risk: no decay for the past 10 years. All probing depths 3 mm or less, 2 hours or more between snacks and meals, brushing and flossing 3 times per day, using fluoridated toothpaste.
Know your risk level
Next time you go to your dentist, show up informed. Know your risk level. Radiation is serious business: your dentist must optimize her prescription for x-rays according to your very own risk level and / or circumstances… NEVER a cookie cutter approach. Ask your dentists what risk level (s)he has assigned to you.
What to do if tooth condition is not documented?
If tooth condition is not completely documented by the x-ray, then send a photograph. It is not unusual for an initial claim to be denied but allowed upon appeal when photo is sent because necessity is seen on the photograph but not the x-ray.
What is a copy of clinical notes?
A copy of actual clinical notes can be helpful in documentation.#N #Examination findings, and accompanying diagnoses.#N#Diagnostic process that was used to actually diagnose Cracked Tooth Syndrome.#N#Level of surgical involvement for extractions.
What to do if you resubmit a claim on appeal?
If resubmitting a claim on appeal, send additional documentation of some kind. Don't just resubmit the claim in hopes it will be reviewed differently the next time.#N#Additional narrative explaining your claim submission.#N#Additional or better x-rays.#N#Additional or better photographs.#N#Additional or better chart notes.#N#Additional or better pathology report.
What is the most important defense in a dental malpractice case?
What To Know About Dental Negligence Lawsuits. One of the most important defenses in a dental malpractice case is proper documentation. The patient’s dental record must contain a clear chronology of events, future treatment plans, and all the important communication between the dentist and patient.
How to sue a dentist for medical malpractice?
To sue a dentist for medical malpractice, you must be able to prove that you suffered an injury as a result of a dentist’s provision of sub-standard care. To establish proof when suing a dentist, you will need to prove these four principles: Duty, Breach of Duty, Causation, and Damages.
What is the second most common alleged negligence?
The second most common alleged negligence was due to endodontic procedures. Of the above negligence claims due to endodontic procedures, all of the defendants were general dentists. The complications included instruments left in canals, nerve and sinus perforations, air embolisms, and life-threatening infections, including four fatalities. Of the life-threatening infections, seven were due to brain abscesses, and one due to osteomyelitis. Of these eight infections, four were fatalities and four resulted in irreversible brain damage.
How many implants were lost in the negligence lawsuit?
In the implant loss subset, two to 10 implants were lost, and treatment planning was alleged to be deficient to non-existent. The patient with the post-operative infection succumbed to the infection. In 24 of the negligence claims involving dental implant surgery, the defendants were general dentists, and one was a periodontist.
How many cases of failure to diagnose periodontal disease in a timely fashion?
There were 19 cases of failure to diagnose or treat periodontal disease in a timely fashion. All defendants were general dentists. In the majority of these cases, X-rays were not taken routinely, and periodontal probings were rarely or never recorded.
What is a dental note?
A clear treatment plan (including documentation explaining the reason for any treatment for which the patient has been billed), and. Notes were written at or near the time of the patient’s treatment. Keep in mind that many people will examine the dental record if there is a lawsuit.
How many patients died from a severed nerve infection?
In the infection requiring hospitalization subset, all patients were hospitalized, and of these, eight patients died from the infections. In the severed nerve subset, the injuries were permanent and the dentists involved did not refer or follow up the nerve injuries.
Who is in the know about dental procedures?
In dentistry, the only people “in the know” are you (who presumably is not an expert), the staff who work directly for the dentist, and the dentist him or herself.
How does dental care work?
The reality of how dental care works is that it’s up to the patient and the insurance company to make sure the right treatment plan is prescribed and implemented. With lower “dental IQ” than dental staff and providers, both you and your insurance company aren’t in a great place to make sure everything is above board.
What do dentists do before they come to the office?
Before a patient first comes to a dental office, a member of the office staff will contact their dental insurance company to find out what’s covered under the dental plan. So before you walk in the room, a dentist has a list of everything he can bill for during your dental visit.
How does HMO dental insurance work?
HMO dental insurance plans work by paying “capitations” to dentists per person assigned to that provider. It’s a few dollars each month to the dentist, whether the patient shows up or not. To be profitable in this scenario, dentists need to diagnose and prescribe things beyond a standard cleaning.
How many root canals does Lori have?
Lori takes it for granted that her dentist has her best interests at heart, so she goes forward with the four root canals and three fillings she’s prescribed, as well as a scaling and root planing.
Why is it important to have a dentist?
The right dentist understands the mouth-body connection and enables you to have a healthier, longer life by maximizing your oral health. Do not underestimate the value of a dentist who is your partner in health—it will extend your and your family’s lifespan, quality of life, and well-being.
What is a good dentist?
A good dentist is your partner in health who works with you to optimize your well-being and prevent disease. The right dental health partner for you is the dentist who is wholly concerned with your overall health and not the health of her pocketbook. The wrong dentist can wreak havoc on your mouth and do permanent damage with too much work you ...
Why do dental offices use deals?
The reason for this is that advertising-driven offices often use deals as a tool to get patients in the door and then pressure them to accept an expensive treatment plan, whether they need work done or not. Oftentimes, they're corporate-owned chains, like Aspen Dental .
What is the best way to protect your molars from plaque?
5) Sealants . Dental sealants are preventative coatings applied to the surface of your molars to prevent plaque from accumulating in the pits on their surfaces. They can be useful in some cases — especially for cavity-prone kids — but are also overprescribed by some dentists.
What does a dark spot on a tooth mean?
A dark spot or blemish, in general, corresponds to a cavity. And in general, the dentist should be willing and able to explain why you need certain procedures, both by using X-rays and other means. if the first dentist seems reluctant to let you get it, that's a bad sign.
Do dental plans have a cap?
Most dental plans come with a hard cap on the total amount of treatment they'll pay for in a given year — the exact opposite of the out-of-pocket maximums in medical insurance plans. Even more problematically, insurance plans put perverse incentives in place for in-network dentists.
Can you opt out of dental insurance?
As a result, people can opt out of dental insurance, then build up treatment needs over the course of several years, then opt in. Dental companies know this, and so to turn a profit, they're forced to cover relatively little, in terms of treatment.
Do dentists disagree about fissures?
Two honest dentists can disagree about whether a tiny fissure requires a filling or not, and all dentists fall on a continuum of philosophies ranging from conservative to aggressiv e in their treatments . Some dishonest ones, though, abuse this uncertainty to increase their profits.
Do dental school students do quality work?
And in general — and contrary to many people's idea of dentists-in-training — dental school students do quality work by the time they're treating actual patients, after learning on models.
What is the most common payment method for a patient?
Cash, cheque, and debit cards are the most common. Many practices allow patients to pay 50 percent of the treatment fee when the appointment is booked and the balance when treatment is complete. Other popular options include VISA and Mastercard. Another option that has recently been made available is CareCredit.
What do patients need to know about treatment?
Patients need to know the details about recommended treatment, including the advantages, reasons, and consequences of not completing treatment , before they will make a commitment to proceed. I find that patients often have questions about treatment, but are sometimes hesitant and uncomfortable asking the doctor. This is one of the reasons I recommend having a trained treatment coordinator handle the presentation of treatment and fees. Outside the clinical environment, in a private consultation room, they can review the doctor’s recommendations and costs with the patient and answer questions.
Why is phase one important?
With Phase One dentistry, it’s important to communicate to the patient the urgency of the doctor’s treatment plan, because to postpone this type of dentistry will make correction more difficult. Phase Two dentistry is the “next level,” and should also be discussed with the patient.
Why is it important to present both fees and insurance reimbursement policies?
Just as important as confidently presenting both fees and insurance reimbursement policies is the presentation of a patient’s payment options. The reason to offer patients several payment options is to make it easier for them to find a comfortable financial solution so they can begin treatment.
Why is practice management important?
Practice Management: Successfully Presenting Treatment Plans & Fees. Providing quality dentistry is important. It keeps your patients happy and increases referrals. But, as a business owner, being profitable is as important, because it allows you to pay your team well and invest in your facilities, equipment and future.
Why do you offer no interest payment plans?
And, offering no interest payment plans not only helps increase treatment acceptance, but can improve patient retention and loyalty by taking finances and unpaid bills out of the relationship . You get paid right away and there’s no responsibility to your practice if the patient is slow paying or defaults.
Why do you need a treatment coordinator?
I recommend using a trained treatment coordinator, because you will have a higher success rate when someone is an excellent communicator, and can comfortably and confidently present the financial protocol and treatment fees. In larger practices, there may be several people involved in the discussion of treatment and fees.
X-Rays
- Do not send original x-rays. Always send duplicates or copies.
- Send x-ray documentation for these procedures:
- Send appropriate pre-op and/or post-op x-rays.
- Send quality, clear, diagnostic x-rays.
Periodontal Chart
- Send perio chart for these procedures:
- Perio chart should include, at a minimum, pocket depth measurements for all teeth in the area of the procedure, and indicate missing teeth.
- A date of exam should be on each chart, or each set of measurements.
- Also helpful are gingival margin level, furcation involvement, mobility, bleeding points, attach…
- Send perio chart for these procedures:
- Perio chart should include, at a minimum, pocket depth measurements for all teeth in the area of the procedure, and indicate missing teeth.
- A date of exam should be on each chart, or each set of measurements.
- Also helpful are gingival margin level, furcation involvement, mobility, bleeding points, attached gingiva width.
Clinical Photographs
- If tooth condition is not completely documented by the x-ray, then send a photograph. It is not unusual for an initial claim to be denied but allowed upon appeal when photo is sent because necessit...
- Make sure photo clearly shows the tooth or condition in question, and adds supporting information for the submitted procedure.
- If tooth condition is not completely documented by the x-ray, then send a photograph. It is not unusual for an initial claim to be denied but allowed upon appeal when photo is sent because necessit...
- Make sure photo clearly shows the tooth or condition in question, and adds supporting information for the submitted procedure.
- Label photo with tooth number, left/right, patient name, photo date.
- If photo is reversed because of mirror use, then mention this.
Narratives
- Be concise.
- Be specific.
- Describe objective clinical findings. Limit your subjective opinions.
- If narrative does not fit on the claim form, write it on a separate page, and note this on the claim in the narrative section.
Other Attachments
- A copy of actual clinical notes can be helpful in documentation.
- Pathology reports can help document biopsies, cysts, tumors.
- Reports from specialists.
Claim Form
- Use the latest, most up-to-date ADA claim form.
- Use the most current CDT codes.
- Fill in all pertinent sections on the claim form.
- For crowns, bridges, and other fixed or removable prosthesis, accurately note whether it is a replacement or not.
Miscellaneous Tips
- If you will be doing more scaling/root planing or osseous surgery in other quadrants later, but not submitting for all of them on the claim, go ahead and include x-rays and perio chart of all four...
- Use the correct terminology. For example, do not write "prognosis" if it is actually a "diagnosis." Do not refer to a restoration as an "onlay" if it is actually an "inlay."
- If you will be doing more scaling/root planing or osseous surgery in other quadrants later, but not submitting for all of them on the claim, go ahead and include x-rays and perio chart of all four...
- Use the correct terminology. For example, do not write "prognosis" if it is actually a "diagnosis." Do not refer to a restoration as an "onlay" if it is actually an "inlay."
- Become intimately familiar with the CDT codes and the descriptors. Re-read them regularly to refresh your memory about the descriptor for codes you might not use very frequently. Make sure the enti...
- If you get a request for information after submitting a claim, then send the requested information...plus more. This means the claim is being evaluated by a human rather than pro…
Appeals
- If resubmitting a claim on appeal, send additional documentation of some kind. Don't just resubmit the claim in hopes it will be reviewed differently the next time.
- Write "Appeal" on the resubmitted claim.
- If claim is being resubmitted with corrected information, write "Corrected Claim" on it, and call attention to the corrected information.
- If resubmitting a claim on appeal, send additional documentation of some kind. Don't just resubmit the claim in hopes it will be reviewed differently the next time.
- Write "Appeal" on the resubmitted claim.
- If claim is being resubmitted with corrected information, write "Corrected Claim" on it, and call attention to the corrected information.
- Call attention to the new information being submitted.
Things to Remember
- If payment is denied for a procedure, this does not always mean you cannot do it. It simply means that it is not a benefit in the insurance plan that the patient's employer purchased for them.
- Submit quality x-rays. If you cannot see the condition in question on the submitted x-ray, then nobody at the insurance company can either.
- If payment is denied for a procedure, this does not always mean you cannot do it. It simply means that it is not a benefit in the insurance plan that the patient's employer purchased for them.
- Submit quality x-rays. If you cannot see the condition in question on the submitted x-ray, then nobody at the insurance company can either.
- Do not commit insurance fraud. This can be very costly in terms of legal costs, reimbursements, and dental board sanctions. Fraud can take many subtle forms, such as:
- Insurance companies usually can request copies of records to investigate the validity of any filed claim (this concept is true for any insurance claim, not just dental insurance claims). Keep in mi...
See Also
- Download form: Insurance Narrative For Restorative Benefits
- Download form: Insurance Narrative For Perio Surgery Benefits
- Dental Claim Form - Provider Specialty Codes
- Dental Claim Form - Place of Treatment Codes