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Conducting a Self-Audit

July 01, 2019 4058

The end of each year is the ideal time to set your practice up for success for the next calendar year. It is a typical business practice for companies to complete a variety of audits as the end of the year approaches that help the business plan and meet certain projections for the next year. The following practice management audits are intended to help the practice owner plan, budget, manage both the dental team and patients, and determine where improvements need to be made.

Update the Practice’s Strategic Plan and Identify Goals for the Next Calendar Year:

  • Review the practice’s vision statement and make updates if applicable.
  • Hold a strategic planning/brainstorming session at a staff meeting and update the practice’s goals (or areas to improve) for the next year. Be specific and identify the small action steps that will be necessary to reach each goal.
  • Document the action plan and assign specific team members to each goal that you wish to accomplish in the next year. This action plan should be reviewed at least each month and updated throughout the year.

Determine Production Goals and Make Revisions to the Schedule:

  • Calculate production and collection goals for the next year. 
  • If the revised production goals affect the schedule (i.e. a higher daily production goal is calculated as a result of hiring a second hygienist), make changes to the schedule according to the production changes. Furthermore, review the practice’s procedure data from the previous year to make sure that your blocked schedule template accurately reflects the volume of procedures you anticipate for the next year.

Conduct a Detailed Chart Audit:

  • Review all charts to ensure an accurate number of active patients.
  • Make sure patients who are overdue for treatment or hygiene have been contacted and scheduled. If the patient declines treatment, note the reasons for the refusal and make sure the patient understands the risks. 
  • Deactivate patients in the practice’s software if the patient has moved, requested a transfer of records, or otherwise indicated he/she will not be returning to the practice. Be sure to send letters to these patients to notify them of their inactive status with the practice. If patients have requested a transfer of records, conduct a quick ‘exit interview’ by simply contacting them and stating, “I’m sorry to hear you are leaving the practice. Would you be comfortable sharing your reasons for requesting a transfer of records?” This quick question can provide your practice with valuable information to identify areas in which you can improve.
  • Update treatment plans and contact patients who have not been seen in the practice for 2 years or more. If these patients intend on staying with your practice, treat them as new patients and conduct comprehensive exams as well as update radiographs as necessary. Have them complete your new patient forms to ensure current medical health history as well as acknowledgement of the practice’s patient policies and procedures.
  • For sample new patient forms, please reference the New Patient Forms Bundle.

Conduct a Financial Audit:

  • Review the practice’s Accounts Receivables. Although this should be reviewed each month, the end-of-year is a good time to ensure patients do not have overdue balances with the practice. Contact patients who do owe money to the practice, and check on pending dental benefit claims if applicable. If your practice is not filing claims electronically, look into this option, as it will expedite payment from plans.
  • Contact patients who have dental benefits available to use toward diagnosed treatment before the benefits expire at the end of the year. 
  • Review the practice’s fee schedule and determine if fees should be adjusted. Fees should be evaluated at least once a year, and the practice owner should analyze whether an increase in fees is warranted.
  • Review the dental benefit plans in which the practice is contracted. Compare the practice’s fee schedule to the contracted fee schedule to assess whether it is in the practice’s best interest to continue working with that particular plan. For a more in-depth analysis of your practice’s contracted dental benefit plans, reference the Evaluating Dental Benefit Plans Checklist.
  • Review your practice’s financial agreement and consent form. Ensure that your practice is offering payment options that meet the needs of your patient-base. Assess whether certain payment options should be added or removed from your financial agreement.

Review Tools for Billing:

  • CDT books are updated annually. This is a good time to order the new books and review the revisions. Each new publication will have new codes and inactive codes. Ensure your software for the New Year reflects this information. You may also want to order the CDT Companion book from the ADA. It contains information about cross coding Dental/Medical codes.
  • Order copies of any applicable Provider Handbooks or manuals for plans you are contracted with. These books outline the plan’s processing and payment policies.
  • Review the CDA Dental Benefit Plan Handbook with any new billing staff. There are 12 comprehensive chapters covering daily procedures and communications with dental plans.
  • Review billing forms to ensure all the information is current. Is the practice phone address and phone number correct? Does the information on the form match the information the clearinghouse has on file?
  • Is the Tax Identification Number (TIN) correct on the billing forms? Plans must receive correct TIN information to report income paid to you. This information must match information reported to the IRS or it will be subject to backup withholding.
  • Review plan contracts and amendments. Ensure you have updated billing addresses and customer service phone numbers. Review legislation that may be effective in the New Year.
  • Notify patients if you are discontinuing any plan contracts in the New Year. Please reference: What You Need to Know About Dropping Dental Plan Contracts.

Update the Practice’s Management Policies and Procedures:

  • This should naturally occur with conducting a strategic planning and action plan meeting, however, it is important to update all management policies, both in terms of employees and patients, and ensure all staff understand the revisions that have been made. Make sure you provide training on any management policy that affects your staff and have your staff sign an acknowledgement that they understand the policy revisions.