Carol Tekavec, RDH
Dealing with new-patient emergencies is crucial to the management of the successful dental practice. Emergency patients can be an important source of new "regular" patients, helping to keep new people flowing into the practice, or they can be a financial and emotional drain on the office.
1. Set aside emergency-ap-pointment times each day. This can be accomplished by the dentist consulting the day`s schedule first thing in the morning. Appropriate times can be identified and designated on a daily basis; preferably both an a.m. and p.m. time slot.
2. Explain to calling emergency patients that they will need to complete a medical-history form upon their arrival, and ask if they have any heart or joint problems or allergies. If patients need to be premedicated, this needs to be known before they arrive at the office. Patients in pain are very unhappy if they are not able to receive care due to a lack of premedication. If health issues are apparent, it may be necessary to phone the attending physician for details before seeing the patient. Be sure that every patient who comes to the office completes a thorough medical history form. (Such as the "Dental and Medical Histories - Updates," C-113L, from Stepping Stones to Success or the Medical History Form from the ADA). While it is true that patients usually dislike filling out forms, it is not appropriate to use an abbreviated type of chart or record-keeping for emergency patients. All patients, child or adult, emergency or regular, must have detailed health histories.
3. Discuss insurance and fees up front. If your office wants finances to be very clear, make it a policy to briefly talk about insurance. For example, tell the patient if your office accepts insurance, and quote a range of fees for today`s emergency visit. This does not mean that you browbeat patients about finances before they have a chance to meet you; but, it does mean that you provide important facts so that patients can be prepared.
Patients who have insurance coverage need to know if you will work with their insurance plans or require them to handle insurance details themselves. Fees can be described for typical pain-alleviating treatment only. A script using patient-friendly terminology helps the front-desk person deal with these delicate issues. For example: "Our office is happy to work with your dental insurance. For today`s visit, however, we will need for you to cover the emergency-appointment charges. Appointments to alleviate pain usually run from $100-$150. We will help you with your insurance, so that if any reimbursement is made, it will be credited to your account."
4. Perform only emergency treatment - not an entire case-treatment plan - during the emergency appointment. Patients who are in pain need to have that pain treated quickly. They also need time to understand any other treatment needs they may have. It is a mistake to perform complete treatment, and not just palliative treatment, on a new-patient emergency. It destroys the schedule, puts pressure on the staff and patient, and actually may discourage patients from coming back for a complete exam.
The patient needs to have a complete exam, treatment plan, and written estimate before any definitive care is undertaken. (This issue is one that I address in detail in my ADA Seminar Series course, "Surrounded by Banana Peels." Cost estimates and treatment plans are crucial to patients and are one of the main "banana peels" that can trip up successful practice growth.)
5. Set up a complete exam for patients before they leave the office after their emergency visit. The front-desk person might say to the patient, "Dr. Smith has taken care of your pain today. Before another tooth becomes the problem this one has, it makes sense to have your other teeth examined."
Carol Tekavec, RDH, is the author of two insurance-coding manuals, co-designer of a dental chart, and a national lecturer with the ADA Seminar Series. Contact her at (800) 548-2164 or at www.steppingstonetosuccess.com.
