New MexicoLand of Enchantment
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DENTAL REFERRAL PROCESS
Lindsie Beard, RDHLa Casa Family Health
CenterPortales, NM
(505) 359-3806
Location: Portales, New Mexico Population Served: 4,664 Total Population: 18,018 Four Clinic Sites: Portales, Clovis, Roswell
and Hondo, New Mexico Cardiovascular And Diabetic Population:
– Includes migrant, homeless, rural, urban, and dental
Hondo
LA CASALOCATIONS
THEN– Two-bedroom house located in Portales, New Mexico– One family practice physician– Five employees administering the clinic – 1,000 patients seen in the first year– Patients were seen on a first come first serve basis
NOW– Four clinics located in Roosevelt, Curry, Chavez, and
Lincoln county– 16 providers specializing in various medical fields– Dental clinic added at two sites– Approximately 100 employees – Generate over 65,000 patient visits annually
1976La Casa de Buena Salud
The House of Good Health
La Casa Portales Clinic
La Casa Clovis Clinic
LA CA SA FA M ILY H EA LTH CENTER
DENTAL CLINIC
DENTAL CLINIC
MEDICAL DIABETIC CONSULTATION
APPOINTMENT
REFERRAL TO DENTAL
PHYSICIAN’S PATIENT ADVOCATE CALLS DENTAL
CLINIC TO SCHEDULE APPOINTMENT FOR
DENTAL CONSULTATION
AT DENTAL CONSULTATION…
ASSESSMENT OF ORAL HEALTH,
TENTATIVE TREATMENT PLAN,
PATIENT EDUCATION
RE-APPOINT PATIENT FOR
FURTHER TREATMENT
AT NEXT DENTAL VISIT…(USUALLY CLEANING APPOINTMENT)
RADIOGRAPHS, COMPREHENSIVE EXAM, TREATMENT PLAN, ORAL HYGIENE
INSTRUCTION AND PERIODONTAL PROBING
DATA ENTERED
INTO PECS SYSTEM
COPY OF REFERRAL IS SENT
BACK TO REFERRING PHYSICIAN
REFERRAL PROCESS TO DENTAL
MEDICAL DIABETIC CONSULTATION
PHYSICIAN DISCUSSES IMPORTANCE OF DENTAL CHECK-UP WITH DIABETIC PATIENT– PHYSICIAN INFORMS PATIENT THAT DENTAL CONSULTATION IS
FREE OF CHARGE• THIS INCREASES PATIENT COMPLIANCE
PHYSICIAN FILLS OUT DENTAL REFERRAL SHEET– REFERRAL SHEETS ARE PRINTED ON GREEN PAPER– PHYSICIAN’S PATIENT ADVOCATE CALLS DENTAL CLINIC TO
SCHEDULE APPOINTMENT• DENTAL CLINIC WILL SEE THESE PATIENTS AS WALK-INS• APPOINTMENT DATE AND TIME WRITTEN ON REFERRAL• PATIENT IS INSTRUCTED TO TAKE REFERRAL SHEET TO DENTAL VISIT
– REFERRAL IS RECORDED IN PHYSICIAN’S LOG– PATIENT IS HANDED REFERRAL
Patient Name:________________________ _____________________________
Date of Birth:_______________________________________________________
Do you have a dentist? Y E S N O
Have you seen a dentist in the last year? Y E S N O
For routine exam and cleaning? Y E S N O
For emergency care or pain relief? Y E S N O
Do you have loose or painful teeth? Y E S N O
Do your gums bleed when you brush or floss? Y E S N O
Do you have bad breath? Y E S N O
Type Diabetes: 1 2 (circle one)
Medical Allergies:____________________________________________________
___________________________________________________________________
Remarks: __________________________________________________________
___________________________________________________________________
Referring Physician:______________________________ Date:______________
Dental Diabetes Referral
Appointment Date:_________________Appointment Time:_________________
Chart No.:_________________
LA CASA FAMILY HEALTH CENTER
Last First
REFERRALTO
DENTAL
DENTAL DIABETIC CONSULTATION
(RECEPTION AREA) DENTAL CONSULTATION IS FREE OF
CHARGE AT THE FRONT DESK
– PATIENT CHECKS IN WITH RECEPTIONIST AND IS GIVEN APPROPRIATE MEDICAL HISTORY AND CONSENT FORMS TO FILL OUT
– A DENTAL CHART IS BUILT SEPARATE FROM MEDICAL CHART
DENTAL DIABETIC CONSULTATION
(WITH THE DENTIST) PATIENT IS TAKEN BACK TO TREATMENT
AREA PATIENT RECEIVES
– ASSESSMENT OF OVERALL ORAL HEALTH– TENATIVE TREATMENT PLAN– IN SOME CASES, DEPENDING ON INSURANCE STATUS,
APPROPRIATE RADIOGRAPHS ARE TAKEN– PATIENT EDUCATION
COLORED REFERRAL SHEET IS KEPT IN DENTAL CHART– COPY OF REFERRAL IS SENT TO PECS DATA ENTRY
PERSON
RE-APPOINT FOR TREATMENT
PATIENT MAKES FURTHER APPOINTMENTS FOR TREATMENT– NEXT APPOINTMENT IS GENERALLY
FOR PROPHY WITH HYGIENIST– PATIENT IS INFORMED AT THIS TIME
OF PRICES FOR TREATMENT AND WHERE THEY FALL ON OUR SLIDING SCALE FEE
DATA ENTERED INTO PECS SYSTEM
INFORMATION IS ENTERED INTO PECS SYSTEM– INCLUDES DATE OF REFERRAL – DATE OF SERVICE– DECLINE DATES
PROPHY APPOINTMENT AT CLEANING APPOINTMENT
– RADIOGRAPHS TAKEN– COMPREHENSIVE EXAM– TREATMENT PLAN– PERIODONTAL PROBING– DIAGNOSIS– EXTENSIVE PATIENT EDUCATION
• HYGIENIST USES X-RAYS AND PROBE READINGS TO TEACH PATIENT ABOUT CORRELATION BETWEEN DIABETES AND PERIODONTAL DISEASE
• HYGIENIST ALSO TEACHES ORAL HYGIENE INSTRUCTION AND PREVENTION METHODS
– APPOINTMENTS ARE MADE FOR ANY ADDITIONAL TREATMENT AT THIS TIME
• EXTRACTIONS, FILLINGS, ETC.
COMPLETING THE CIRCLE
COPY OF ORIGINAL REFERRAL– DATE PATIENT WAS SEEN BY THE DENTIST IS
PRINTED ON COPY
COPIES SENT BACK TO RESPECTIVE PHYSICIAN– ONE TIME PER MONTH COPIES ARE GATHERED AND
SENT BACK TO PHYSICIAN AND/OR TEAM MEMBER
– PHYSICIAN CAN THEN UPDATE REFERRAL LOG
BOOKS
SPECIAL CIRCUMSTANCES
IF PATIENT REFUSES DENTAL VISIT– CHECK BOX IN THE PECS DATA ENTRY SCREEN LABLED “DECLINED”
IF PATIENT HAS FULL DENTURES– PATIENT CAN STILL BE REFERRED FOR DENTAL CONSULTATION– AT CONSULTATION,DENTIST WILL EVALUATE DENTURE FIT AND SCREEN FOR
SIGNS OF FUNGAL INFECTION
IF PATIENT USES PRIVATE DENTIST– PATIENT IS REFERRED TO THEIR PRIVATE DENTIST– PHYSICIAN’S ADVOCATE CALLS TO MAKE APPOINTMENT FOR PATIENT– REFERRAL IS NOTED IN REFERRAL LOG BOOK– ADVOCATE CALLS PRIVATE DENTIST TO CONFIRM WHETHER PATIENT
PRESENTED FOR APPOINTMENT– SAME DATA CAN THEN BE ENTERED INTO PECS SYSTEM
D9310 DENTAL CONSULTATION D0150 COMPREHENSIVE EXAM D0274 4 BITEWING RADIOGRAPHS D0330 PANORAMIC RADIOGRAPH D1110 ADULT PROPHYLAXIS D4341 PERIODONTAL SCRP D1330 ORAL HYGIENE
INSTRUCTION D7140 EXTRACTION SINGLE
TOOTH
520.0 ANODONTIA 521.0 DENTAL CARIES 873.63 BROKEN TOOTH 523.0 ACUTE GINGIVITIS 523.1 CHRONIC GINGIVITIS 523.3 ACUTE PERIODONTITIS 523.4 CHRONIC PERIODONTITIS 112.0 ORAL CANDIDIASIS
COMMON TREATMENT AND DIAGNOSIS CODES
BEST PRACTICES Buy-in of providers, support staff, CEO, and
Board of Directors Having dental person on collaborative core
team Cooperation of dentist and dental Staff Flexibility of dental staff to see walk-ins Utilizing internal incentive plans for
providers to meet collaborative goals Providing PECS registry and summary
reports to all providers and Board of Directors on a monthly basis
Information presented at quarterly QA (quality assurance) meetings and monthly Board of Directors meetings
MEDICAL DIABETIC CONSULTATION
APPOINTMENT
REFERRAL TO DENTAL
PHYSICIAN’S PATIENT ADVOCATE CALLS DENTAL CLINIC TO SCHEDULE APPOINTMENT FOR
DENTAL CONSULTATION
AT DENTAL CONSULTATION…
ASSESSMENT OF ORAL HEALTH,
TENTATIVE TREATMENT PLAN,
PATIENT EDUCATION
RE-APPOINT PATIENT FOR FURTHER TREATMENT
AT NEXT DENTAL VISIT…(USUALLY CLEANING APPOINTMENT)
RADIOGRAPHS, COMPREHENSIVE EXAM, TREATMENT PLAN, ORAL HYGIENE INSTRUCTION AND PERIODONTAL
PROBING
DATA ENTERED
INTO PECS SYSTEM
COPY OF REFERRAL IS SENT BACK TO
REFERRING PHYSICIAN
REFERRAL PROCESS TO DENTAL
D93
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