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Patient Management & Forms

Patient Financial Policy

A well-defined patient financial policy helps set expectations, reduce misunderstandings and support a more efficient practice workflow. This resource offers step-by-step guidance for developing or refining a patient financial policy with confidence.

Patient Financial Policy

A well-defined patient financial policy helps set expectations, reduce misunderstandings and support a more efficient practice workflow. This resource offers step-by-step guidance for developing or refining a patient financial policy with confidence.

Patient Notifications and Disclosures Checklist

This is a checklist of required patient and public notifications and disclosures.

Patient Personal Information Form

This form is designed for internal office use only. It should not be shared with the patient and is intended to provide the practice with a way to document personal information about the patient to help refresh staff members’ minds prior to the patient visiting the practice.

Patient Records - Requirements and Best Practices

Format and content, patient access to records and requests to amend, disclosure of information, data breach notification, retention and disposal, transferring records in a sale.

Patient Request to Access Records (Records Release) Form and Q&A

Summary of records release rules with customizable sample form. Patients have the right to access their record and can request paper, film or electronic copies.

Patient Request to Restrict Disclosure of Patient Health Information to a Dental Benefit or Health Care Plan

Includes information on this patient right to restrict disclosure of patient health information to a dental benefit or health care plan and a sample form to use for a patient who requests such a restriction.

Payment Considerations with Dental Benefit Plans

Common patient collection considerations while working with dental benefit plans.

Prepare for Financial Consultation Success

Here you’ll find a compiled list of items to help prepare you for the financial consultation and ensure your team is ready to have a knowledgeable conversation.

Rules for Communicating via Telephone, Cellphone and Email

This is a guide to the rules for communicating via these technologies with patients and other individuals via telephone, cellphone, text message or email.

Sample AI Scribe Patient Consent Form

California eavesdropping law requires an individual give authorization before or when another individual or entity records them speaking in private conversation. This sample consent form is provided in response to increasing interest by dental practices to use artificial intelligence-enabled software to record patients and treatment providers in order to draft notes for the clinical chart.

Scripts for Practice Financial Policy

Sample scripts to help make sure the entire staff is saying the same thing when having financial discussions with patients.

Steps to Comply with the No Surprises Act

Information regarding the requirements to comply with the No Surprises Act which became effective January 1st, 2022.  The No Surprises Act is an effort to protect individuals and provide transparency related to health care costs. Instructions as well as samples of the required notification and the Good Faith Estimate are included.

 

Tips for the Financial Consultation

Here you’ll find some tips to help prepare your team for financial consultations. 

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