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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

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