Collect Coinsurance

While you may think it would be a nice to waive the copayment for a patient—think twice before you do. If your practice routinely does not collect all or only a portion of the copayment or coinsurance from the patient, it may be considered overbilling, a potentially fraudulent billing practice. The MDS Dental Practice and Benefits Committee reminds you that collecting copayments is a contractual obligation in most participating provider contracts. When in doubt, refer to the specific contract.

Are Your Patients Getting the Most from Their Benefits?

Most dental insurance plans come with a maximum annual benefit typically ranging from $1,000 - $2,000. Many of these maximums are tied to year's end and will terminate on December 31, 2019. Did you know that only 2% - 4% of Americans use their yearly maximum dental insurance allowance?

As we begin the last quarter of the year, the MDS Dental Practice and Benefits Committee encourages you to speak to your patients so that they are aware that many still have coverage available and that this would be an ideal time to schedule any dental care you have recommended to them to get the most out of their benefits.

Claims Coding Support

The MDS Dental Practice and Benefits Committee wants to be sure that MDS members know that you can get one-on-one support for your dental coding issues through the American Dental Association (ADA) Third Party Payer Concierge™ services. Simply email your claims coding question to dentalcode@ada.org or call the ADA’s Third Party Payer Concierge™ at 800.621.8099 Monday – Friday between 8:30 am – 5:00 pm (CDT).

You can gain learn more about claims from the dental consultant's perspective by attending the ADA's complimentary webinar on July 23, 2019 from 1:00 - 2:00 pm (and earn 1 CERP credit). 

For any other questions, contact the MDS Member Assistance Center (MAC) at 800.342.8747, option 5.

Read the Delta Package Carefully

Delta Dental of Massachusetts recently sent all participating providers a package of information regarding the new fee methodology that was approved by the Division of Insurance. The Massachusetts Dental Society (MDS) has received numerous questions from members regarding these materials. As a result, the MDS spoke with Delta regarding these questions and prepared this special Dental Practice Insights tip to help guide members through the process. Read more by clicking through the Delta Dental of Massachusetts page.

No CDT Code -- Now What?

Dentists are required to bill for procedures performed. But what happens when you can't find a CDT Code that accurately describes the care you have provided? The MDS Dental Practice and Benefits Committee recommends that when you can't find the corresponding code(s) after checking the current 2019 CDT Dental Procedure Guide, you should use the "unspecified . . . procedure by report" CDT Code (e.g., D2999 unspecified restorative procedure, by report) listed at the end of each category of service section. These codes require significant corresponding documentation. In addition, this is an opportunity for you to submit a CDT Code action request to the ADA for consideration to fill the gap.

How to Report a Privacy Violation

The MDS Dental Practice and Benefits committee reminds you that all dental practices must follow Health Insurance Portability and Accountability Act (HIPAA) protection guidelines. This means you must have privacy protection standards in place in your office to protect individual identifiable health information. But what happens if you suspect the privacy of your patient records has been compromised?

If you discover that the integrity of your data has been compromised, you must report the issue to the U.S. Department of Health and Human Services (HHS). The timeline for reporting depends on if the breach impacts 500 or more individuals. A HIPAA-covered entity must report annually any breach of protected health information affecting less than 500 individuals to the HHS. The deadline to report such breaches is before the 60th day of the year following the date of the breach. A breach affecting 500 or more individuals must be reported to the agency within 60 days of the incident. Learn more about how to submit a violation report. 

Stay Up-to-Date with CDT Code Changes

January 1 kicks off the New Year and for dental offices, this means the new CDT codes get ushered in. Before the ball drops in Times Square, you need to be in the know with all CPT changes. The MDS Dental Practice and Benefits Committee encourages all members to order the CDT 2019 and Companion Kit from the ADA. There are 15 new codes, five revised codes, and four deleted codes. This important resource will help your team code more accurately, which will ultimately reduce the amount of rejected claims. Be sure you are up-to-date and order your reference kit today!

Need Help Filling Out a Claim Form?

Need help filling out a claim form? Not sure if you should report tooth or oral cavity information on a claim? The ADA Practice Institute has a new tool, “The ADA Guide to Dental Procedures" to help you sort through the confusion.

The MDS Dental Practice Committee encourages you to use this complimentary guide to help you determine which CDT code should be reported with either an oral cavity area code or tooth number and surface, or both.

Pay Attention to Recredentialing

Dental benefit plans require participating dentists to undergo recredentialing on scheduled time intervals, typically ranging from 2 to 5 years, in accordance with their quality assurance guidelines. 

If you are contacted by a dental benefit plan that you participate with regarding a recredentialing request, don't ignore it. The recredentialing process is time-sensitive and failure to respond could jeopardize your participation status. Take the time to review the request, identify the compliance date, and follow their instructions closely. The MDS Dental Practice Committee strongly encourages you to meet all recredentailing deadlines and follow up directly with the benefit plan with any questions you may have well in advance of the pending deadline.

Spot Check Licenses

All licensed dental professionals (dentist, hygienist, dental assistant) in your office must post a current professional license or a copy of said license. Licences must be posted in an area where they can be observed by the public. If your practice has multiple locations, the professional licenses must be posted in each location.

The MDS Dental Practice Committee encourages all dental offices to do a spot check on license postings. Verify that all licenses are posted and that they are current. This is a common violation cited by the Board of Registration in Dentistry, and one that can easily be avoided by doing a simple annual check.

Dental License Attestation Requirement

Massachusetts dentists are required to renew their dental licenses by March 31, 2020. M.G.L. c. 112, s. 45 mandates that the Board of Registration in Dentistry (BORID) condition the renewal of all dental licenses on a dentist’s application to participate in MassHealth as an Ordering, Referring, and Prescribing (ORP) non-billing provider unless the dentist is already enrolled as an approved billing provider. Accordingly, you will not be permitted to renew your dental license unless and until you submit an ORP enrollment form to MassHealth.  

While this law went into effect in November 2017, this is the second time that Massachusetts dentists will need to attest to participating as a MassHealth provider or as a non-billing provider as a condition of the license renewal process. Note: You must answer "yes" to the following attestation questions:

• Are you enrolled in MassHealth as a fully participating provider or non-billing provider OR have you submitted a thoroughly completed application to be a fully participating provider and a signed provider contract with MassHealth? 
• Do you consent to the Bureau of Health Professions Licensure and the Massachusetts Executive Office of Health and Human Services, and its enrollment vendor, to obtain, read, copy and share with each other information regarding your MassHealth application and enrollment status and professional licensure status? 

Still have questions about this attestation requirement? Find the answers here.

PFML Employer Action

All Massachusetts employers (including dental practices) are responsible for informing your workforce about the state's new Paid Family and Medical Leave (PFML) law. As referenced in an earlier Dental Practice Insights tip, all employers were required to post notification of this new regulation by July 1, 2019. In addition, employers are also required to provide written notice to employees and obtain written acknowledgement from your staff that he/she has been informed of this new regulation. The MDS Dental Practice and Benefits Committee urges you to take the following actions (if you have not already done so):

How Long to Keep Patient Records and Radiographs

"How long do I need to keep patients' original dental records and original radiographs?" is one of the most common questions we get asked. The MDS Dental Practice and Benefits Committee wants to remind all dentists of the importance of keeping dental records. The Board of Registration in Dentistry regulations require that you keep them for a minimum of seven years from the date of the last patient treatment. In addition, the patient record of a minor shall be retained for a minimum of seven years from the date of the last patient treatment or three years from when the patient has reached the age of maturity, whichever is later. (Currently, the age of maturity in Massachusetts is 18.) Refer to regulation 234 CMR 5.14 (5). Some malpractice insurers, including EDIC, recommend records be kept for longer. EDIC recommends records be kept for 10 years and seven years after the age of majority. Check with your malpractice insurer to determine its related recommendations.

BORID Crackdown on Dental Assistants

The MDS Dental Practice and Benefits Committee shared with members in January 2019 that the Massachusetts Board of Registration in Dentistry (BORID) had expressed concern regarding unlicensed dental assistants, and we urged dentists to comply with this state law. Unfortunately, the MDS recently learned from BORID that there are still a number of dental assistants practicing without a license, with an expired license, and/or without sufficient continuing education credits. Due to this persistent issue, BORID has advised the MDS that it will be cracking down on violators in the coming months, and this will include increasing penalties against dentist-owners who employ and allow auxiliaries to practice without a valid license. 

In case you missed our previous notifications about this urgent matter, we ask that you please heed our warning and make sure your dental assistants are practicing under a current license for both your own and your patients' protection. Check your license postings on your wall today to be sure.

Are You in Compliance with this New Law?

In case you missed our previous notifications about the new Paid Family Medical Leave (PFML) law, this is a reminder that by July 1, 2019, you are required to have updated your labor law posters and provide your employees with written notification on PFML. You must also obtain a written statement from each employee acknowledging receipt of the notice or a statement indicating the employee's refusal to acknowledge the notice.

The MDS Dental Practice and Benefits Committee recommends that you do the following today:

1. Download this template provided by Department of Family and Medical Leave (or create your own), fill in your practice information, and distribute/collect from your staff
2. Post this PFML notice near your labor law poster
3. Contact your payroll company to discuss the employer contribution component

In the event that you missed our previous PFML updates, here is more information on PFML. Beginning October 1, 2019, all Massachusetts businesses—including dental practices—that employ one or more individuals are subject to the new Paid Family and Medical Leave (PFML) state law and must submit contributions on behalf of workers and covered individuals. (Note: PFML benefits will not be available for employees to use until January 1, 2021.)

Massachusetts will require employers with 25 or more employees to provide PFML to workers through a state-run plan. Employers with fewer than 25 employees must submit contributions on behalf of employees to cover a portion of the PFML. The new law requires each employer to contribute to and participate in the state-run program, unless the employer opts out under strict statutory and regulatory guidelines.

BORID Crackdown on Dental Assistants

The MDS Dental Practice and Benefits Committee shared with members in January 2019 that the Massachusetts Board of Registration in Dentistry (BORID) had expressed concern regarding unlicensed dental assistants, and we urged dentists to comply with this state law. Unfortunately, the MDS recently learned from BORID that there are still a number of dental assistants practicing without a license, with an expired license, and/or without sufficient continuing education credits. Due to this persistent issue, BORID has advised the MDS that it will be cracking down on violators in the coming months, and this will include increasing penalties against dentist-owners who employ and allow auxiliaries to practice without a valid license.  

Please heed our warning and make sure your dental assistants are practicing under a current license for your protection and your patients' protection. Check your license posting today on your wall to be sure.

Are You in Compliance with This New Law?

The new Paid Family Medical Leave (PFML) law requires that you update your labor law posters by July 1, 2019, and provide your employees with written notification on PFML. You must also obtain from each employee a written statement acknowledging receipt of the notice or a statement indicating the employee's refusal to acknowledge the notice.

The MDS Dental Practice and Benefits Committee recommends that you do the following today:
1. Download this template provided by Department of Family and Medical Leave (or create your own), fill in your practice information, and distribute/collect from your staff
2. Post this PFML notice near your labor law poster
3. Contact your payroll company to discuss the employer contribution component

PFML Background: 

Beginning July 1, 2019, all Massachusetts businesses—including dental practices—that employ one or more individuals are subject to the new Paid Family and Medical Leave (PFML) state law and must submit contributions on behalf of workers and covered individuals. (Note: Benefits for PFML will not be available for employees to use until January 1, 2021.) Massachusetts will require employers with 25 or more employees to provide PFML to workers through a state-run plan. Employers with fewer than 25 employees must submit contributions on behalf of employees to cover a portion of the PFML. The new law requires each employer to contribute to and participate in the state-run program, unless the employer opts out under strict statutory and regulatory guidelines.

New Paid Family and Medical Leave Law

The MDS Dental Practice and Benefits Committee wants members to be aware that beginning July 1, 2019, all Massachusetts businesses—including dental practices—that employ one or more individuals are subject to the new Paid Family and Medical Leave (PMFL) state law and must submit contributions on behalf of workers and covered individuals. (Note: Benefits for PFML will not be available for employees to use until January 1, 2021.)

Massachusetts will require employers with 25 or more employees to provide Paid Family and Medical Leave to workers through a state-run plan. Employers with fewer than 25 employees must submit contributions on behalf of employees to cover a portion of the PFML. The new law requires each employer to contribute to and participate in the state-run program, unless the employer opts out under strict statutory and regulatory guidelines. This new PFML law also requires that you update your labor law posters by July 1, 2019.

Sound confusing? To help clarify the new regulations, the MDS will be presenting a webinar hosted by Spring Insurance on Friday, April 26. A recorded version will be available to members on Monday, April 29.

Who Has to Take the Pain Management Class?

Who has to take the pain management class? This is a common question that is asked to the MDS Member Assistance Center. The answer to this question is a bit complicated as it involves one statutory provision, MGL c. 94C, s. 18(e) and the Board of Registration in Dentistry (BORID) regulations 234 CMR. 

If a dentist has a current Massachusetts Controlled Substance Registration (MCSR) then MGL c. 94C, s. 18(e) requires ALL dentists to complete biennial training on safe and effective opioid prescribing/pain management. While several dentists, especially orthodontists, may not prescribe controlled substances in their daily practice, all dentists are required to maintain a current emergency drug kit in their respective offices per BORID regulations and therefore, must maintain a valid MCSR and take the required pain management class.  

Why? According to BORID, a dentist may not order a new emergency drug kit or replenish the content of his/her existing emergency drug kit from a dental wholesaler without also providing a valid MCSR number to the wholesaler. Therefore, even if a dentist does not write prescriptions, he/she must maintain a valid MCSR for the sole purpose of ordering/replenishing the required emergency drug kit.  

The MDS Dental Practice and Benefits Committee encourages all dentists to maintain their MCSR and take the required biennial training on safe and effective pain management every renewal cycle.

If you have questions, please contact the MCSR.

BORID Top 10 Violations

The Massachusetts Board of Registration in Dentistry (BORID) has shared its Top 10 Most Frequent Causes for Complaints and Discipline Against Dentists summary. They are as follows:

1. Inadequate infection control measures
2. Failure to conduct weekly spore testing
3. Inadequate documentation
4. Lack of treatment planning
5. Lack of informed consent (general and specific consents)
6. Inadequate risk management practices
7. Lack of required continuing education, which includes safe and effective opioid prescribing and BLS and CDC guidelines)
8. No or incorrect anesthesia and sedation permits
9. Unlicensed practice—failure to renew (self and/or staff)
10. Treatment below the standard of care

The MDS Dental Practice and Benefits Committee urges you to review this list and evaluate how you and your practice would fare and make the necessary adjustments to stay compliant with the state regulations. Also, be sure to regularly review the regulations.

Dental Assistant License Crack Down

The MDS Dental Practice and Benefits Committee reminds you that all dental assistants practicing in your office MUST be licensed.
 
At a recent Board of Registration in Dentistry (BORID) meeting, BORID discussed the increasing number of cases of dental assistants practicing without a license, an expired license, and/or without sufficient continuing education credits. Due to this persistent issue, BORID is considering, as a matter of policy, increasing penalties against dentist-owners who employ and allow auxiliaries to practice without a valid license.

Don't take the risk—make sure your dental assistants are practicing under a current license for your protection and your patients' protection. Check your license posting today on your wall to be sure.

Prescription Monitoring State Law Required Compliance

The MDS Dental Practice and Benefits Committee reminds all dentists who write prescriptions that Massachusetts state law requires that you:

1. Enroll in the MassPAT Prescription monitoring program.
2. Query the Prescription Monitoring Program (PMP) database prior to issuing a prescription to a patient for a Schedule II or III narcotic drug and prior to the first time prescribing a benzodiazepine to a patient.

If you or an assigned delegate are not performing this lookup in the database as required, you are not following the law and are putting yourself and your practice at risk.

The MDS expects Board of Registration in Dentistry (BORID) to take disciplinary action against those who do not comply, so take the necessary steps and be sure you are in compliance.

Watch the PMP webinar recording, and learn more at mass.gov/MassPAT.

Prescription Lookup: Are You at Risk?

The MDS Dental Practice and Benefits Committee reminds all dentists who write prescriptions that Massachusetts state law requires you to query the Prescription Monitoring Program (PMP) database prior to issuing a prescription to a patient for a Schedule II or III narcotic drug and prior to the first time prescribing a benzodiazepine to a patient. If you or an assigned delegate are not performing this lookup in the database as required, you are not following the law and are putting yourself and your practice at risk. 

Watch last week's PMP webinar recording to learn more about how to reduce your risk and ensure PMP compliance.

Changes to Noncompete Agreements Law

The rules for employee noncompetition agreements in Massachusetts have changed effective today, October 1. The MDS Dental Practice and Benefits Committee knows that some dental practices may have these agreements in place and wants to make sure members know that the rules apply to all Massachusetts-based employees, including independent contractors. If you have noncompete agreements in place now for some employees, you do not have to modify existing agreements; however, if you later amend those agreements, you may need to update the noncompete provisions to comply with the new rules. Employers may want to revisit existing noncompete agreements to ensure consistency throughout the workforce and whether those noncompete agreements are still needed for that particular employee.

Some other significant changes in the law include the stipulation that new agreements must provide “garden leave” pay during the noncompetition period. The “garden leave” pay must be at least 50% of the employee’s highest base salary during the last two years. Also, new noncompete agreements can only last 12 months in duration. Be sure to review the law in its entirety.

What's on Your Sign?

What's on your office sign? According to state regulations, advertisements—which includes signs—must include the name of at least one owner of the practice who is currently licensed to practice dentistry in the Commonwealth. Take the time to review your sign and be sure you are in compliance with state regulations.

Stop and Document

Audits on contracted providers are becoming more common by benefit plans. The best defense for an audit is good, complete record keeping. Treatment records are legally binding documents. So, if the treatment record doesn't say something occurred, it may be impossible to prove it happened. Take time to document all the care provided to a patient. The MDS Dental Practice Committee recommends that you document everything that is related to the diagnosis and treatment of the patient.

Keep Your CE Records

The MDS Dental Practice Committee reminds all licensed dental professionals (dentists, dental hygienists, and dental assistants) that you are required to maintain documentation of your completed continuing education credits for four years or two renewal cycles. The Massachusetts Board of Registration in Dentistry has the right to request proof of continuing education, so be sure to keep your documentation in a safe place and take advantage of your free member benefit—the CE registry—to help you stay organized.

Lunch Break Compensation

In Massachusetts, you are required to provide a 30-minute meal break to an employee if they work more than 6 hours in a day, but this time does not have to be paid. The MDS Dental Practice Committee advises that a bona fide lunch break - meaning an employee is relieved of regular duties to eat a meal - for at least 30 minutes.

New Equal Pay Law: Are You Prepared?

A new Massachusetts pay equality law goes into effect July 1, 2018. The Massachusetts Equal Pay Act (MEPA) applies to all employers regardless of size. The law is designed to close the pay gap for working women in Massachusetts who, on average, earn 84.3% of what men earn.

The MDS Dental Practice recommends that you take the following steps to prepare:

1. Conduct a self-evaluation now and review your employees' pay. Determine if pay scales differ for men and women doing the same roles with the same level of experience in your practice.
2. Make reasonable progress toward equal pay to protect yourself from claims under the new law.
3. Review your employment application to ensure it does not ask about prior salary history and update it if necessary.
4. Train anyone involved in the interview and recruitment process that they cannot ask any information about salary history.
5. Consult your lawyer if you need additional support.

Jury Duty Pay

If an employee serves on a jury trial in Massachusetts, employers are required to pay the employee's regular wages for any work missed for the first three days of jury duty. After the third day, the state will compensate jurors at the rate of $50 per day. The employee should provide you with documentation from the state for proof of service.

Do You Use Sign-In Sheets?

Using patient sign-in sheets in your office is a practice decision; some offices choose to use them and others do not. According to the HIPAA Privacy Rule, dental offices are permitted to use patient sign-in sheets or call out patient names in waiting rooms, as long as the information disclosed is appropriately limited. The sheet should not include space for medical information that is not necessary to list or diagnostic information. Sign-in sheets are optional, and practices should decide on whether they wish to use them or not. The MDS Dental Practice Committee recommends you refer to the guidance on the HHS website for more information.

Referral Compensation

It is not permissible for dentists licensed in the Commonwealth to offer or accept anything of value—no matter how small—as compensation for the referral of a patient, according to Massachuetts state regulations 234 CMR. So what can you do instead? Consider promoting patient loyalty through tokens of appreciation throughout the year, such as personalized birthday emails, thank you letters to patients for referrals, or prizes for good brushing habits. The MDS Dental Practice Committee recommends these patient appreciation best practices be incorporated into your practice.

New Tip of the Week

The MDS Dental Practice Committee published a Dental Insights tip on April 23, 2018, entitled "Dispensing Prescriptions in Your Office - Permit Requirements." The tip stated that while you do not need a special permit to write a prescription (e.g., anti-anxiety medication) to be filled at a pharmacy, you do need a D facility permit if you administer anesthesia/sedation above the level of local anesthesia in your practice. In addition to the D facility permit, the prescribing dentist must also have a permit B. Both permits D and B must be renewed every two years coinciding with your license renewal cycle.

This Dental Insight tip resulted in several dental offices contacting the MDS Member Assistance Center (MAC) with a concern regarding the practice of dispensing antibiotics in their office to patients in the event a patient fails to pre-medicate due to some medical issue prior to a scheduled dental procedure and questioning if this practice requires additional permits. The tip above applies specifically to the practice of administering anesthesia/sedation to patients above the level of local anesthesia. The Board of Registration in Dentistry (BORID) has confirmed to the MDS that dentists are permitted to dispense antibiotics to their patients in their offices to pre-medicate, and as long as the dentist is duly licensed and holds current DEA and MCSR registrations, no additional permits are required. Be sure to document in the patient record that you are dispensing antibiotics to patient.

Dispensing Prescriptions in Your Office - Permit Requirements

The MDS Dental Practice Committee wants to be sure you are informed that while you do not need a special permit to write a prescription (e.g., anti-anxiety medication) to be filled at a pharmacy, you do need a D facililty permit if you dispense prescription drugs within your office. In addition to the D facility permit, the prescribing dentist must also have a permit B. Both permits D and B must be renewed every two years coinciding with your license renewal cycle.

What's on Your Wall?

Now that you have renewed your dental license with BORID, be sure to post your updated license in a prominent location in your office. The MDS Dental Practice Committee encourages you not only to post your license, but also to take the time to review all of your dental team license postings to be sure that they are also up-to-date and posted. The ultimate compliance responsibility falls on the dentist/employer, so make this review a priority.

Hepatitis B Vaccines: Who Needs to Get It?

Dental professionals who provide chairside services can be exposed to many hazards in the operatory, including the hepatitis B virus (HBV). This virus is transmitted through contact with an infected person's bodily fluids.

OSHA requires all dental employers to offer HBV vaccines to at-risk dental team members at no cost to the dental professional. The vaccine must be administered according to the recommendations of the U.S. Public Health Service current at the time the procedure takes place.

Dentists must ensure that all occupationally exposed dental team members are trained about the vaccine and vaccination, including efficacy, safety, method of administration, and the benefits of vaccination. 

 An employee has the right to decline the vaccination. Should an employee decline the HBV vaccination, employers should require them to complete a declination form. Employers are required to maintain an accurate copy of each employee's hepatitis B vaccination status, including the dates of all the vaccinations or declination forms. The MDS Dental Practice Committee recommends that dental offices keep a file separate from the regular employee file indicating an employee’s OSHA medical records. Front office staff are not required to receive HBV vaccines.

Check Your Junk Mail for BORID Notification!

Last week, the Massachusetts Board of Registration in Dentistry (BORID) sent an email to all dentists who renewed their licenses from January 1 – January 28, 2018, with additional attestation steps they needed to take to comply with state regulations. If you fall into this category but did not receive the email, the MDS Dental Practice Committee recommends that you check your junk mail folder to see if it inadvertently ended up there. This has happened to several members!

If you renewed your dental license between January 1 and January 28, 2018, you MUST respond to BORID with corrective action by March 31, 2018. Don't delay! Please note that failure to submit the attestation to BORID by the close of business on March 31 may result in BORID initiating action to rescind the renewal of your license based on failure to meet statutory requirements.

What to Know About Treating a Family Member

A limitation common to most dental insurance plans is the Familial Relation clause. This family-related exclusion means that a doctor cannot treat his or her immediate family members and file a claim for services rendered. This applies to both in-network and out-of-network providers.

The MDS Dental Practice and Benefits Committee recommends that you review the contract language of your family member's plan to determine if you can submit a claim. Language among payers varies and the limitation may be stated in a variety of ways. Some examples of this contract language include: “immediate family or immediate family of spouse,” or “enrollee’s spouse, child, brother, sister, or parent,” or “a person who lives in the covered person’s home or who is related to the covered person by blood or marriage.” 

Unvaccinated Patients: Should You Treat Them?

Choosing whether or not to treat an unvaccinated patient is a personal decision. Dentists have an ethical and legal obligation to protect the health of their patients. But what happens when a patient with the measles or chicken pox potentially puts an unvaccinated patient—not to mention other patients, you, and your staff—at risk?

Ethically, dentists are not legally obligated to accept an unvaccinated patient into their care, nor are they required to retain them. But the MDS Dental Practice and Benefits Committee reminds you that if you choose to dismiss a patient, you must follow the standard protocol for dismissing a patient and give him or her adequate notice and the opportunity to find another dentist. You also must remain available for emergency treatment for a minimum of 30 days until the patient finds care through another practitioner. It's best to screen patients prior to providing treatment and ask them upfront about their vaccination status.

Before-and-After Photos

Want to showcase a patient's new-and-improved smile with before-and-after photos on your website or social media channels? Great idea, but be sure you get the patient's written approval. The patient (or guardian, if he or she is a minor) must sign a consent form that he or she is okay with you posting the photos. In the event the patient is a minor, the MDS Dental Practice and Benefits Committee recommends that you also get the written permission of the minor, since teens may be sensitive to social coverage.

Make the Call

You hear this all the time, but so few dentists actually do this: Call your patients at the end of your day or the day following a non-routine appointment. The MDS Dental Practice and Benefits Committee believes that this is the greatest practice builder you can do! Patients are usually stunned and very pleased that the doctor took the time to call and check on them. This personal touch is completely unexpected in this day and age. It is a true win-win. If the patient is experiencing a side effect, you will be able to intercept it immediately and address it. If there is no problem, the patient will remember the outreach and the care that was delivered. So make the call and create a long-lasting patient-dentist relationship.

Help Your Patients Navigate Open Enrollment

Many companies have January 1 as the date that new benefits begin, which typically means that their open enrollment period (the time period to make benefit selections) is in the November/December time frame. 

We all know that dental benefits can be difficult for patients to understand, and choosing a suitable plan can be overwhelming. The MDS Dental Practice and Benefits Committee encourages you to direct your patients to MouthHealthy.org, the ADA's online resource for patients. MouthHealthy.org offers information on types of dental plans, coverage, terms, and what patients should consider when choosing a plan that is right for them.

How to Talk to Your Patients About "DIY" Dentistry

The Massachusetts Dental Society (MDS) and the American Dental Association discourage the use of direct-to-consumer dental products, including aligners, veneers, mouthguards, snoring appliances, teeth whitening trays, and bleaching products. Self-administered, unsupervised dental treatments have the potential to cause damage and irreversible complications for patients.

The MDS Dental Practice and Benefits Committee encourages you to educate your patients about the benefits of an office visit and the potential risks of these remote DIY options, including bone loss and receding gums, loose teeth, a misaligned bite, and other issues.

If my patient tells me they are considering DIY orthodontics and remote treatment through an online company, what should I tell them?

While many patients believe that direct-to-consumer orthodontics sounds simple, the American Association of Orthodontists has published a flier listing questions patients may first want to consider. You can download and print the flier to share with your patients or direct them to the list of questions posted at massdental.org/DIY. You can also share with patients the most recent edition of Word of Mouth, which features the cover story, "Online Orthodontics: Too Good To Be True?"

What if my patients have already undergone DIY treatment and encountered problems?

If you have seen patients who have experienced injury or adverse results from using mail-order orthodontic devices or other DIY dental treatments, the MDS Dental Practice and Benefits Committee encourages you to direct them to the MDS website at massdental.org/DIY, where they can locate contact information for reporting the issue to state and federal regulators.

Terminating Network Participation

Deciding to terminate a relationship with an insurance company is a difficult decision. If you decide to move forward with terminating network participation, it is important that you inform your patients of your reasons for this decision. Most insurance providers send out letters to your patients suggesting the patient changes to a "network dentist" so don't let them have the last word.

The MDS Dental Practice and Benefits Committee recommends that you send a letter to your corresponding patient base informing them that you are terminating participation, explain your decision, what the change will mean, and the high value you place on the dentist-patient relationship.

Learn more about what the letter should contain and view a sample template.

Read more strategies from the ADA on dealing with unwanted contracts.

Educate Parents on Brushing

A recent study by the U.S. Centers for Disease Control and Prevention (CDC) found that nearly 40% of children ages 3 to 6 used too much toothpaste when brushing their teeth.

The MDS Dental Practice and Benefits Committee encourages dentists and hygienists to take the time to visually show parents/guardians the correct amount of toothpaste, which according to both the CDC and the ADA is no more than a pea-sized amount, to avoid possible fluorosis.

Dealing with Savvy Consumer Patients

Today, most dental patients want to be treated as consumers of care, especially when it comes to case presentation and treatment recommendations. This distinction is important, as consumers of care are savvy, often do their own research, and are willing to change practices if their needs are not met.  

As a result, the Dental Practice and Benefits Committee recommends that you take a close look at your case presentation process to see if it supports the needs of consumers of care. Consider the following in your review:

Are you spending more time orienting patients to your practice and what makes it unique? Do you clearly explain all treatment and financial options? Do you offer follow-up consultations for patient questions? Do you clearly explain which option you feel is in the best interest of the patient, while being sure to leave all options on the table? Do you take the time to educate the patient about his or her specific situation?

If not, take the time to reevaluate your process and see how it can change to adapt to the new style of patient.

How Do You Communicate Treatment Plans?

There are many ways to communicate treatment plan options to patients, but they are not all equally effective. The MDS Dental Practice and Benefits Committee recommends that you explain the treatment options in a direct, positive, and personal manner. For example, saying “The ideal treatment is...” or “The treatment I would recommend for my own family...” is more powerful and potentially more effective than saying, “What I’d like to do...” 

Your goal is to empower your patients with the information they need to make an informed decision about their oral health, so take the time to deliver a clear message to get the best results from your treatment plans. Doing so could also help you strengthen your relationships with your patients. Learn more tips from the ADA on how to cultivate loyal patients.

Charging for Dental Records

A patient is entitled to a copy of his/her dental record including radiographs upon request. According to Massachusetts state law, these records must be supplied within a reasonable amount of time not to exceed 30 calendar days from the date of request.

You may choose to charge a reasonable fee for the expense of providing a patient dental records, not to exceed the cost of either labor or materials, although many dentists provide copies of dental records at no charge as a courtesy to patients. The MDS Dental Practice Committee reminds you to never give a patient the original record, which you are responsible for maintaining.

Retain Patients by Asking the Tough Questions

Make it a point before the patient leaves your office to ask questions about his/her appointment experience. Giving the patient that opportunity may lead to uncovering something that should be improved in your office. The MDS Dental Practice Committee urges you to listen carefully to the responses. Are there issues with wait times, front desk processes, appointment scheduling etc.? If so, address these issues head on and you may be spared a bad review or the loss of a patient.

Resources for Identifying and Reporting Child Abuse

April is National Child Abuse Prevention Month, and this creates a great opportunity to remind MDS members of their mandated reporting responsibilities. The MDS Access, Prevention, and Interprofessional Relations Committee encourages all licensed dental professionals to take advantage of resources the MDS offers to help members identify signs of abuse, and learn the steps for documenting and reporting suspected cases to the appropriate authorities.

Child abuse crosses all ethnic, cultural, and socioeconomic lines. According to the U.S. Department of Health and Human Services’ Child Maltreatment Report, 31,089 children were abused or neglected in Massachusetts in 2015.

Here’s what the Access Committee recommends you do:

1. Visit the MDS Resource Center to access A Guide to Identifying Abuse and Neglect for the Dental Team. This brochure explains the dentist’s obligation as a mandated reporter, offers guidelines for interviewing a suspected victim, and outlines steps to take when reporting the abuse of children.
2. Display the Do You Need Help? poster in your office to provide patients with contact information for reporting abuse.
3. While dental hygienists and dental assistants are not mandated reporters, they are still in a unique position to notice signs of abuse. Encourage your entire dental team to participate in a self-paced online training program provided by the Middlesex District Attorney’s Office so that they, too, can learn about the signs of abuse and neglect and how they can help protect their patients.

Patient Facebook Photos

A great method to promote your practice is by posting photos of patient experiences on your practice's Facebook or website. However, MDS Dental Practice Committee cautions you to obtain their written consent prior to posting a patient's photo to avoid any HIPAA violation. Take the time in your morning huddle with your staff to train your team on your practice's social medial policy. Make sure everyone is clear on what they can post, the proper protocol for engaging patients in your social media campaign, and where to go if there's a related question.

Eligibility Made Easier

Need to verify eligibility status or benefits for a patient? Maximize your time management by verifying patient eligibility online instead of by phone. Most plans you contract with provide you with a web provider portal. This option allows you to view a patient's benefits summary, which usually includes remaining maximum and deductible information, quickly at your own convenience.

The MDS Dental Practice Committee encourages you to log in to the benefit plan provider portal. Be sure to have your taxpayer identification number handy, along with the subscriber's ID and date of birth, and the corresponding patient's date of birth. This will avoid you having to wait on hold for phone support. Another plus? You can print out the information for supporting documentation.

Responding to a Bad Review

When a patient posts a negative comment about your office online, the first thing you should do is stay calm and not respond out of emotion. Instead, read the review several times and think about the feedback. Try to understand the points the reviewer is trying to make. Then check with your staff to better understand the context of the review. The MDS Dental Practice Committee encourages you to answer all reviews, good or bad. You should formulate your response in a general, short, and professional manner, avoiding the temptation to go point by point, and offer a simple apology.
 
Here are some sample responses:

Complaint About Procedure
Our office maintains strict patient confidentiality standards to ensure HIPAA compliance. As a result, we are unable to comment on the details of the statements made in this review. However, we’d like to discuss this situation with you privately. Please call us at xxx-xxx-xxxx or email us at xx at your convenience.

Delayed Appointment
Please accept my apology for your appointment delay. We are usually very punctual but there are times when we get behind our schedule due to unexpected care needs of our patients. All of our patients receive the same high quality of care, which on occasion, may require additional time. We recognize that your time is important and we will do our best to adhere to our scheduled appointments whenever possible in the future. Thank you for being our patient.

Guidance for Staffing Concerns

To help dental practitioners navigate the myriad staffing questions that have arisen as a result of the COVID-19 public health emergency and resulting temporary dental office closures, the Massachusetts Dental Society (MDS) has compiled a list of frequently asked questions and obtained answers from human resource experts in Massachusetts. (Please note that this guidance is not a substitute for legal advice, and we recommend that you seek appropriate legal counsel for answers to more specific questions.)

This comprehensive guidance includes clarification on questions such as:

Do I need to pay my staff during this shut down?

Answer: Employers must be mindful of an employee’s exempt (salaried) or non-exempt (hourly) status. 

An employer is obligated to pay an exempt (salaried) employee their entire salary for the work week if the employee performs any work during the week, including work completed remotely or if the employee works only a partial week.

Non-exempt (hourly) employees must be paid for all work performed whether performed onsite or remotely. Hourly employees are not entitled to compensation unless company work has been performed. (Reviewing and responding to company emails are considered work for the company.)

Thus, if you are forced to close your business temporarily due to COVID-19 issues, you are not required to pay non-exempt employees for hours the non-exempt employees do not work, even though they may have been scheduled to work.

Find the answers to more staffing questions in the MDS’s “Staffing Considerations in Connection with a Temporary Office Closure” Q&A.

Coronavirus and Your Dental Practice

The MDS Member Assistance Center has received numerous calls from members with questions regarding dental practice protocols to protect against transmission of the novel coronavirus and the disease it causes, COVID-19. While the risk of transmission in the United States is still considered low at this time, it is important that your practice's infection control procedures and protocols are up-to-date and enforced. The MDS Dental Practice and Benefits Committee urges you to implement the following recommendations in your practice:

1. Meet with your staff to discuss the current outbreak and develop a consistent message that the patient’s well-being in the practice is the entire dental staffs' number-one consideration.  Reassure patients that your infection control and standard precautions are an excellent deterrent to the virus. Ask your patients to reschedule appointments if they are symptomatic or have traveled to affected areas. Here is a sample message you can relay to patients:

"Due to the recent concern over the novel coronavirus/COVID-19, and in order to protect other patients and staff, we ask that any patient who has traveled to or has been in close contact with anyone who has traveled to China, Japan, South Korea, Italy, Iran, or any other region affected by the coronavirus to please call our office before coming to your appointment. Also, if you have a cough or fever, please contact the office to reschedule any upcoming appointments."

2. Remind your staff that the continued use of standard infection control precautions keeps everyone safe. Review the Centers for Disease Control and Prevention's (CDC) Standard Precautions Guidelines for infection prevention and control in dental settings and make sure that they are being followed. Check your inventory of PPE—specifically gloves and masks—to be sure you have an adequate supply. The CDC is providing current updates and guidance on any PPE shortages, including information from suppliers and distributors.

4. Review the latest information and guidance on the outbreak. The CDC's COVID-19 situation webpage is updated daily and offers current insight on the outbreak and the CDC's response. The Massachusetts Department of Public Health website offers statistics and information specific to the current situation in the Commonwealth. The American Dental Association (ADA) has also created a coronavirus webpage that provides answers to frequently asked questions, information on patient assessment, and availability of personal protective equipment (PPE). 

Spot Check Licenses

All dental assistants were required to renew their licenses on or before October 31, 2019. Therefore, all dental assistants in your office should now have a revised—and current—license posted in your office. It should indicate a 10/31/2021 expiration date. The MDS Dental Practice and Benefits Committee encourages all dental offices to do a spot check on license postings to be sure that all dental assistants have updated their licenses and that the licenses are posted in an area where they can be observed by the public. 

Reminder: All licensed dental professionals (dentist, dental hygienist, and dental assistant) in your office must post a current professional license or a copy of said license. This is a common violation cited by the Board of Registration in Dentistry, and one that can easily be avoided by doing a simple annual spot check.

If your practice has multiple locations, the professional licenses must be posted in each location.

New Fraud Alert for 2020

Happy 2020! With the start of a new decade, experts warn of a unique opportunity for scammers: manipulating a shortened date on contracts and checks for fraudulent purposes.

That is why auditors and police departments have been issuing a warning that when you write a date on a document or check, don’t shorthand the year 2020 to just "20." Write out the whole date (i.e., "1-13-2020" instead of "1-13-20") as this will prevent scammers from adding numbers after the "20" to indicate another year (e.g., putting "19" after the "20" to indicate "2019") and forging a fraudulent document. The MDS Dental Practice and Benefits Committee encourages members to take the time to implement this best practice of writing out the whole date and year to anything you sign. This will prevent someone from committing fraud by easily changing a legal contract date and will protect you and your practice in the new decade.

What You Need to Know Before Terminating an Employee

As a practice owner, you know that your practice is only as strong as the team you hire to help you provide the best care to your patients. Unfortunately, due to a variety of reasons (e.g., poor performance, fraud, repeated tardiness or absences, or unprofessional behavior), there may come a time when you will need to make the decision to terminate the employment of a staff member. This is never an easy decision to reach, but it’s one you may need to make for the sake of your patients, your staff, and your practice. However, you should be aware of the proper steps to take when terminating an employee so that you don't put yourself or your practice at risk.

If you are thinking of making the difficult decision to terminate an employee, the MDS Dental Practice and Benefits Committee recommends that you start by reviewing the ADA's Checklist for Terminating an Employee. Also, because of the complexity of state law, it’s recommended that you consult with your attorney or one familiar with employment law.

Should You Google Your Practice?

Let's face it, more and more patients are turning to Google and other search engines for dental practice information. The MDS Dental Practice and Benefits Committee recommends that you check out your own information online to see how you look to prospective patients! Simply visit Google.com and search for your practice name to see what comes up and whether it is accurate.

If Google has outdated or incorrect information regarding your practice, you will want to set up a Google My Business account. This is a free service—visit Google.com/business to get started.

Also check your practice information on websites like Healthgrades, Vitals, and Yelp. Take charge of these listings by claiming your business on all of these sites.

Thinking of Selling Your Practice?

If you are thinking of selling your practice, there are many aspects you need to consider. One of the key decisions is whether your decision to sell will be confidential or transparent. The MDS Dental Practice and Benefits Committee encourages you to read the ADA Practice Transition Blog before you make the move to sell so you understand the trade offs between a confidential sale and a transparent sale.

Do You Have to Pay Staff for Holidays?

The MDS Dental Practice and Benefits Committee recommends that you annually review and distribute your practice's holiday schedule to your employees as some holidays may fall on days that the office is closed. This best practice will help to clarify in advance those holidays that will be observed. You should also clearly communicate to your staff if these are paid holidays and if part-time employees are eligible to receive holiday pay. 
 
Massachusetts is one of the few states that requires private employers to give employees holiday leave. Per the Massachusetts Blue Laws, private non-retail businesses are required to observe the following holidays:
• Labor Day
• Thanksgiving
• Christmas
• Memorial Day 
• Independence Day

Note: Employers may choose to observe more holidays at their discretion.

The choice to pay for holidays is up to the employer, but keeping and retaining staff is critical to the success of your practice so you may want to opt to offer paid holidays to maintain a competitive advantage and limit staff turnover.

Increase Case Acceptance

Whether you are starting a new practice or have been in the business for decades, low patient acceptance rate is one of the biggest challenges a dentist faces.  How you present your case treatment plan can make a huge difference in your acceptance rates.

The MDS Dental Practice and Benefits Committee recommends that you don't just focus on the clinical procedures. Instead, emphasize how patients will benefit from treatment, communicate the benefits clearly from a patient's point of view and preempt possible objections in your treatment plan presentation. If you take the time to demonstrate a positive attitude and a strong commitment to the patient's well-being in your presentation delivery, you should increase the likelihood of case acceptance.

Be sure to alert your staff about the presentations you'll make that day so team members can help influence case acceptance; often, patients are more comfortable talking to support staff so get them in the know. If possible, add visual aids to make your recommendation more understandable. Track your acceptance rates so you monitor improvements and adjust your presentation style accordingly.

Protect Yourself

The Federal Trade Commission reported nearly 400,000 cases of identity theft in the United States in 2016. It is important to protect yourself and your practice.To reduce the likelihood of identity theft, the MDS Dental Practice and Benefits Committee recommends that you monitor your financial accounts, set up email and text alerts on all of your accounts, change your passwords frequently, and report any unusual activity to your bank or credit card company as soon as possible. Do not rely exclusively on a staff member to do this—be sure to take the time to monitor this activity directly to minimize any staff mishandling/theft. 

Learn more tips on protecting yourself from identity theft from the ADA Center for Professional Success.

Team Members Matter

You may provide the best care to your patients using state-of-the-art technology and training, but if the experience your patient has in the waiting room is not positive, you may lose the patient and receive negative reviews on social media.

The MDS Dental Practice and Benefits Committee encourages you to spend time training your team members in the art of good, thoughtful customer service and make sure they understand the importance of their role as practice ambassadors. Talk about this topic in your morning huddle and role play scenarios to be sure everyone is on the same page and is willing to go the extra mile. Consider asking your front desk personnel to stand, smile, and shake the hand of every new patient at the first appointment to welcome them to your practice—these small gestures will help promote a warm, inviting experience.

Bartering for Services?

Some dentists agree to trade their work for other professional services. This use of bartering is not new—it dates back thousands of years, before there was hard currency. But before you set up a plan to say, barter dental services for landscaping or a home improvement project, you must understand the risks and potential liabilities associated with this type of arrangement.

The MDS Dental Practice and Benefits Committee recommends that you carefully weigh the risks of entering into a barter arrangement. If you choose to move forward with a barter arrangement, make sure you create a bartering agreement that clearly specifies the services to be traded. The written plan should include the estimated value of each service, details of what services are being provided, and the corresponding time frame for completion—recognizing that treatment plans need to be based on clinical findings and may vary from the initial findings. Similarly, the patient should create an agreement that outlines exactly what is included on his or her end. Both agreements should explain what happens if there is a problem with the treatment plan or services rendered. Remember: Dentists have an ethical responsibility to not abandon a patient in active treatment so proceed with caution and keep accurate documentation in the patient's record just as you would for any other patient.

There may be situations where bartering is a good decision but speak with your malpractice insurer prior to creating your barter deal. Also, the IRS has some rules addressing bartered income, so be sure to consult with your accountant. If the patient has insurance, you may be bound by your participating provider contract to bill for services. When in doubt, think twice about creating a barter arrangement.

DIY Patients at Risk

With the recent news of a CVS and SmileDirectClub partnership, the presence of do-it-yourself (DIY) dentistry has the potential to hit Massachusetts hard in the near future. This announcement revealed that CVS Health will devote sections of "hundreds" of its pharmacy locations to SmileDirectClub SmileShops. 
 
The SmileDirect advertisements read: In 3 easy steps, SmileDirectClub helps deliver a smile you'll love safely, discreetly, and without the hassle of in-person monthly visits. 

The Dental Practice and Benefits Committee agrees with ADA's position that these types of DIY dentistry options are putting patients at risk. The Committee urges dentists to have conversations with patients about the risks associated with DIY dentistry and recommends you utilize these ADA talking points to educate patients about possible adverse consequences. The ADA plans to launch a national anti-DIY campaign, but direct conversation between dentist and patient is the most effective way to drive this message home.

Are You Screening for Oral Cancer?

April is Oral Cancer Awareness Month and a good time to consider your role in screening for head-and-neck cancers. The Dental Practice and Benefits Committee encourages you to review the oral cancer clinical practice guidelines provided by the ADA Center for Evidence-Based Dentistry to help you best serve your patients.  

Among the guidelines is the recommendation that clinicians should obtain an updated medical, social, and dental history and perform an intraoral and extraoral conventional visual and tactile examination in all adult patients. The ADA offers a short video demonstrating how to check patients for oral cancer.

After-Hours Emergencies?

Dentists are obligated to make reasonable arrangements for the emergency care of patients of record. The MDS Dental Practice and Benefits Committee encourages you to educate your patients (before an emergency arises) on how you can be reached after hours in case of emergency. A charge of patient abandonment may result from a failure to make reasonable arrangements, so take the time to educate your patients on this important policy. This JADA article discusses how the ADA Principles of Ethics and Code of Professional Conduct addresses the ethical obligations of dental practitioners with regard to emergency care of patients.

Managing Auxiliaries

Get the most out of your staff and maximize efficiency by understanding the scope of practice for each of your team members. Each licensed professional in your office (dental assistant, dental hygienist, or dentist) has a unique set of delegable duties that he/she is permitted to perform. Review the delegable duties chart for more information. 

The MDS Dental Practice and Benefits Committee reminds you that the supervising dentist is ultimately responsible for all delegable acts and procedures performed by auxiliary staff, so make sure you understand which duties can be performed for each auxiliary and, conversely, which duties are not permitted.

SDF Instead of Fillings

Silver diamine fluoride (SDF) is a useful tool for stopping the progression of cavities in patients for whom a filling isn’t a good option. The MDS Dental Practice and Benefits Committee encourages MDS members to learn more about this treatment option by watching the ADA's new step-by-step "Silver Diamine Fluoride Application: Evidence-based Recommendation" webinar.

The ADA also has additional reference sources available on nonrestorative treatment options for children and adults—including the full SDF guideline and an online tool for personalized clinical recommendations—at ADA.org/caries. Be sure to stay on the cutting edge of dentistry with these great ADA resources.  

Also be sure to check out the MDS webinar Silver Diamine Fluoride: What Is Its Place in Oral Health Care?​.

DIY Dentistry: What Can You Do?

The volume of do-it-yourself (DIY) dentistry options is exploding, and putting patients at risk. The ADA House of Delegates recently adopted a resolution that “strongly discourages the practice of direct to the consumer [DTC] dental laboratory services because of the potential for irreversible harm to patients.” The new policy expands upon a 2017 ADA policy entitled “Do-It-Yourself Teeth Straightening” to include the sale of partial dentures, teeth whitening trays, snoring appliances, veneers, and mouth guards, in addition to DTC orthodontic services.  

If you have seen patients in your office who have had issues with DTC products—including aligners, partial dentures, and snoring products—the MDS Dental Practice and Benefits Committee encourages you to take action by reporting these issues to the U.S. Food and Drug Administration (FDA) through the MedWatch voluntary reporting form, which collects reports of problems with medical devices. Read more from ADA News.

Take Advantage of AP Fluoride Coverage

The Associated Press (AP) recently released an article titled Experts Question Benefits of Fluoride-Free Toothpaste, which resulted in more than 740 million views. Soon after, the Today Show—with an audience of more than 4 million people each day—aired a similar segment.

The MDS Dental Practice Committee encourages you to take advantage of this recent pro-fluoride press. This is an excellent time to remind your patients about the cavity-prevention benefits of fluoride and that all toothpastes with the ADA Seal of Acceptance contain fluoride. Point your patients to MouthHealthy for more information on fluoride

Does Your Office Speak Its Own Language?

Do you use abbreviations, acronyms, or symbols to explain procedures in your practice? If so, the MDS Dental Practice Committee recommends that you clearly document your practice's list of abbreviations, symbols, and/or acronyms that are specific to your office. This list should be made part of your office policy so that all team members use uniform terminology. Be sure to educate new staff members with this terminology. Also include a copy of the list of abbreviations used in your office along with any distributed copies of dental records.

Consult your legal counsel or professional liability insurer for specific guidance.

OSHA Training Scam Alert

The MDS Dental Practice Committee has been advised that several MDS members have received a misleading marketing communication letter from Medical Compliance Co., which is located in Washington, DC, regarding OSHA and HIPAA training requirements.

These letters suggest that the company's program is required to satisfy the OSHA and HIPAA training requirements: "This notice is a reminder that HIPAA and OSHA training is due August 1, 2018," and "failure to comply with these annual regulations may result in fines per violation." There is no August 1 deadline for training requirements nor are you required to complete this comany's program. When in doubt about an advertisement or solicitation, you should always contact the MDS Member Assistance Center at 800.342.8747, option 5, for clarification.

The Fine Print: Termination Clauses

The MDS Dental Practice Committee reminds you that before you sign any contract, you should take the time to understand its termination provision, and ask questions and negotiate—if possible—up front. Some contracts have a 90-day clause, others require you to terminate by a specific date. Failure to send the termination notice at the right time usually means that the contract rolls over to the next time the termination notice is allowed per the contract. Whether it is a contract with a dental supply company, lab, third-party insurer, or utility company, be sure to read the fine print and initiate your termination request in accordance with the defined terms.

Know Your Inventory

Don't just reorder supplies without doing an inventory review. Managing your inventory is key to ensuring you always have the right products and the right quantities on hand when you need them. The MDS Dental Practice Committee encourages you to keep a close eye on your inventory and identify patterns in what is being used and what is not being used. This diligence will allow you to make adjustments according to supply quantities and help you reduce your overhead expenses. You may also want to consider appointing a dedicated staff member to oversee inventory ordering/management process.

Don't Wash Your Hands of This Policy

The MDS Dental Practice Committee recommends that every dental team member start his or her work day with a 15-second handwash with warm water and liquid soap from a hands-free dispenser. Make this infection control practice a routine in your office, as this simple hand-washing routine will substantially reduce the risk of transferring pathogens to your patients or other dental team members.

Be sure to repeat this 15-second handwash:

• Between patients
• Before and after lunch, taking a break, or using the bathroom
• Before and after gloving
• Any other time they become contaminated
• At the end of the work day

OSHA Staff Emergency Kit Requirement

The MDS Dental Insights tip entitled “Staff Emergency Management” that was published on August 7, 2017, erroneously stated the required contents of the staff emergency kit practices should keep on site in the event that an employee is injured on the job. (Note: The staff emergency kit is not to be confused with the medical kit that BORID requires all practices to keep on site for injuries/emergencies involving patients or the public.) While the original Dental Insights email was correct in that dental offices need to have a staff emergency kit, there is no one-size-fits-all kit for dental offices, which the email suggested. Instead, the contents of your dental office’s staff emergency kit should reflect the degree of hazards, practice location and size, amount of staff training, and availability of professional medical services related to your specific practice. The MDS Dental Practice Committee apologizes for this confusion.

According the American National Standards Institute (ANSI) standard, which OSHA references, first aid kits should provide a basic range of supplies to handle most types of injuries encountered in workplaces, including dental practices. In addition, an employer must ensure prompt first aid treatment for injured employees, either by providing for the availability of a trained first aid provider at the workplace or by ensuring that emergency treatment services are within reasonable proximity of the workplace.

The MDS Dental Practice Committee recommends that dental offices assess their own practice and procedures to determine whether additional supplies or kits are needed, based on the size and complexity of your practice. In order to meet ANSI standards, your staff emergency kit should provide a basic range of supplies to handle most types of injuries encountered in workplaces such as the dental practice.

ANSI provides suggestions for other optional supplies to include in a first aid kit. Based on your own hazards assessment in the dental practice.

The MDS Dental Practice Committee stresses that you should take the time to inform your entire staff on the location of this emergency kit and discuss their roles during an emergency. Advance preparation can go a long way in keeping your staff calm during an emergency and potentially avoiding a tragedy in your office.

Get the Most Out of Your Yankee Experience

The MDS Dental Practice and Benefits Committee encourages you to make the most out of your time at Yankee Dental Congress 2020.

Don't miss out on these purchasing rewards!

• Spend & Get (Thursday, January 30, 9:30 am - 5:30 pm ONLY)

Spend $500 at ONE Yankee exhibitor and bring your receipt to the Information Booth on the Exhibit Hall Floor to receive a $50 gift card!

• Super Saturday Raffle (Saturday, February 1, 10:00 am - 3:00 pm ONLY)

Spend $100 or more on the Exhibit Hall Floor and bring your receipt(s) to the Information Booth on the Exhibit Hall Floor for the chance to win a $100 gift card!

• Yankee Rebate Program

Purchase goods and services totaling $2,500 or more from Yankee exhibitors and earn complimentary registration for Yankee 2021! NEW! – Upload your receipts on-site at yankeedental.com/rebate.

Bonding and Cementation

Bonding and cementation materials and techniques are constantly evolving. It is a challenge for dental practices to differentiate between products on the market and determine which to choose to ensure predictable results.

To help you better understand the options, the MDS Dental Practice and Benefits Committee invites you to attend the upcoming complimentary MDS webinar:

Bonding and Cementation, presented by Dr. Lee Ann Brady 
Wednesday, November 13, at 12:00 pm

This program will present the history and current science behind dentin adhesives, bonding systems, and cementation. It will compare total-etch to self-etch techniques and distinguish the risks and benefits of each. The presentation will detail a systematic approach to evaluating the different generations of dentin adhesives, and compare the clinical and research data of each. Clarification will also be provided on how to decrease post-operative sensitivity and increase the success of your adhesive dentistry.

Sign up for this webinar and earn 1 CE credit upon completion. Registration will close at 10:00 am on Wednesday, November 13.

Safeguard Your Practice

Did you know October is National Cyber Security Awareness Month? Now is a great time to upgrade your practice’s defenses. The Dental Practice and Benefits Committee recommends that you check out some of MDS Member Savings Program partner Aspida Mail’s tips below:

• Implement an email solution that offers anti-virus along with robust spam and malware protection
• Use long, complex passwords with a combination of letters, numbers, and symbols. Aspida recommends 12 characters at a minimum!
• Train your employees to spot red flags in emails (e.g., emails that ask you to log in with credentials, click links, or download attachments or suspicious files)
• Utilize a business-class firewall as a barrier between your practice and the internet
• Backup, backup, backup! Create a comprehensive backup strategy utilizing onsite and offsite storage, while periodically testing to ensure it's running successfully.

Let Aspida help you check off HIPAA-compliant encrypted email. Visit www.aspida.us/MDS for a member-only offer to try Aspida Mail for $1/month for the first three months!

Join Fellow MDS Members at Yankee Dental Congress

Did you know that more than 50 percent of the MDS membership attends the Yankee Dental Congress each year? Join your fellow members and thousands of dental professionals at the Yankee Dental Congress January 30 - February 1, 2020.

The MDS Dental Practice and Benefits Committee encourages you to register early and take advantage of exclusive member discounts and programs, such as these new offers for MDS members:

MDS Platinum Office Pass - $599 (A Discount of Up to $292)
An MDS member can register along with two other colleagues or staff and receive 2 paid courses each (up to $99 each). 

There are many more exclusive discounts. Find the one that is right for you and your practice.

MDS Clinician Corner
Five MDS member dentists will be offering one-hour complimentary courses as part of the first-ever MDS Clinician Corner. Take time to immerse yourself in this exceptional learning opportunity and network with fellow members.

Yankee provides so many opportunities for MDS members, so be sure to take advantage of all it has to offer.

Share Your Dental Expertise

Dental school does not fully prepare you for launching a career in dentistry. What's needed is first-hand knowledge from an established dentist. The MDS Dental Practice and Benefits Committee believes that the only way to obtain these practical skills is to learn from the best—an MDS member dentist.

Mentoring is a great way to give back and protect the future of the dental profession. Taking the time to connect with a dental student one-on-one can make a huge difference in the student's life as he/she is trying to navigate his/her way through dental school. As an established dentist, you are able to provide your mentee with information and guidance on building a career in dentistry and what to expect post-graduation. Consider signing up to be a mentor for the MDS/ASDA Mentor Program and help shape the next generation of dentists. Sign up for the program by October 31 to be matched with a dental student from one of the three Boston dental schools: Boston University Henry M. Goldman School of Dental Medicine, Tufts University School of Dental Medicine, or Harvard School of Dental Medicine.

Are You Connected?

The MDS Dental Practice and Benefits Committee wants to make sure you are reading the Society’s online member newsletter, the MDS Connection. This member benefit, which is published bi-monthly, is full of all the useful information you need to stay on top of the regulatory compliance and practice management issues that affect your practice. In fact, each issue of the newsletter features pages of helpful practice management information and news for both you and your staff, so be sure to share it with your team. You can download the MDS Connection in PDF format right from the newsletter webpage. In addition, you can also download past issues from the MDS Connection archive. We urge you to bookmark the MDS Connection webpage and check back often to stay connected with your MDS.

Get Your Member Discounts

The MDS Dental Practice and Benefits Committee wants you to take advantage of all of your member benefits. If you need proof that you are a member (e.g., to access Mercedes-Benz or hotel discounts), you can download and print a temporary ADA membership card directly from your ADA member profile online. Visit ada.org and use your ADA number as your user ID to access your member account. Select the option to "print' membership card. Then complete this order form to get your permanent personalized membership card and keep it in your wallet so you can access your ADA number easily.

Also be sure to check out the new MDS Member Savings partner PureLife. PureLife provides members with an affordable total compliance solution, from sharps waste to infection control services, education, training, and support. 

Get Paid Sooner

If you want to get paid faster from a dental benefit plan, the MDS Dental Practice and Benefits Committee suggests enrolling in direct deposit. The payments will be electronically deposited in your designated bank account, giving you access to your money sooner than waiting for a check to come in the mail. We have all experienced the check in the mail scenario and the long waits that can come with it.

Need an explanation of benefits to support deposit? Most dental benefit plans offer this service on their web portal. The direct deposit option is a free service that is typically available only to participating in-network dentists.

Yankee Mobile App

The 2019 Yankee Dental Congress is just days away! With receptions in the MDS State Lounge Booth #1244, hundreds of companies on the Exhibit Hall floor, and a wide array of courses being hosted each day—it may seem like a lot to keep track of. 

The Dental Practice and Benefits Committee encourages you to download the Yankee mobile app so that you can get the most out of your Yankee experience. The app allows you to easily find your courses and their room locations, enter your CE credits into your personal record, search for exhibitors and find their booth locations, and much more! Download the complimentary app today so that you can maximize your Yankee participation.

Get the Most Out of Your Yankee Experience

The MDS Dental Practice and Benefits Committee encourages you to make the most out of your time at Yankee Dental Congress 2019. Don't miss out on special offers throughout the Congress, including the Spend & Get event on Thursday, January 31, the Super Saturday Raffle on Saturday, February 2, and the Yankee Rebate Program. 

Make sure to join us in the MDS Booth (#1244) for a members-only chance to spin to win prizes and to enjoy our exclusive receptions each day: Taste of New England on Thursday, January 31 at 4:00 pm, Pizza in the Pavilion on Friday, February 1 at 4:00 pm, and Family Time on Saturday, February 2 at 10:00 am. 

Are Back and Neck Pain a Problem?

Do you suffer from back or neck pain? If so, you are not alone. According to the American Dental Association, 40-60% percent of dental professionals suffer from work-related musculoskeletal issues. The MDS Dental Practice and Benefits Committee recommends that you carefully analyze your work environment to determine if it is ergonomically adequate. Can you reach your dynamic and hand instrumentation? Is the lighting adequate? Is the cabinetry and peripheral equipment flexible? Do you have easy access to required instrumentation and materials for different working practices, clinical procedures, and patient types? How is the position of your dental chair? How is your posture during procedures? Posture plays an important role in your overall health. Not sure if your posture is good? While at Yankee Dental Congress 2019, come to the new MDS Dentist Health and Wellness Pavilion Booth #1039 - located at the back of the Exhibit Hall - to have your posture analyzed and receive useful tips to help you stay healthy.  

Be sure to build in to your routine daily stretching, exercise, or yoga practices to ensure a long and healthy career.

Make Sure Your Information Is Up-to-Date

In order to ensure that you are getting the most out of your MDS membership, the Dental Practice and Benefits Committee encourages you to visit to the MDS website and make sure all your information is up-to-date. Don't miss out on important regulatory updates, exclusive networking events, and more because your email address or mailing address is not current.

To see what information the MDS has on file, log in to the site and review your profile. If you need to make updates to your account, simply send the MDS an email letting us know what needs to be changed.

​Need help logging in?

Paying for Holidays

The holidays are just around the corner. A common question MDS Member Assistance Center advisers hear this time of year is, "What are the requirements for holiday time off and pay?" The MDS Dental Practice and Benefits Committee wants you to know there are no Massachusetts or federal holiday pay requirements in place. Therefore, paying employees for holidays is a nice benefit to offer but it is strictly a matter of employer choice. However, if your practices's personnel policy identifies specific days as company holidays and provides premium pay for working on a holiday or provides the day off with pay, all employees must be treated in accordance with this policy.

Reduce Your Musculoskeletal Pain

Working in a dental operatory, you spend a lot of time in uncomfortable positions performing repetitive hand motions, all of which can lead to a high risk of developing chronic musculoskeletal pain. To help combat this pain and ensure that you maintain good physical health, the MDS Dental Practice Committee advises you to watch the ADA's 7 Ergo Tips to Help You Stay Healthy and share them with your staff during your next group huddle. Your body will thank you!

Flu Tips For Your Practice

This has been a record-breaking flu season, and every dental office has most likely been impacted. The MDS Dental Practice Committee encourages you to apply the following safeguards in your practice to help minimize the spread of germs/pathogens in your office.

Post signage in your office to remind people to:

• Cover their mouth and nose with a tissue any time they cough or sneeze
• Place used tissues in the nearest waste receptacle
• Wash their hands
• Wear a face mask (have some available) if they have, or suspect they might have, a respiratory infection

• Use patient-reminder calls to identify patients reporting influenza-like illnesses and reschedule
• Postpone nonurgent visits until 24 hours after the patient is free of fever without the use of fever-reducing medicine
• Identify patients with influenza-like illness at check-in; offer a face mask or tissues to symptomatic patients
• Separate ill patients from others whenever possible if evaluating for urgent care

• All staff wear should wear face masks when coming into contact with any patient showing symptoms of a respiratory infection
• It's still not too late to get flu vaccine; encourage all dental team members to obtain the flu vaccine. Staff should not come to work when exhibiting flu-like symptoms.
• Throughly disinfect after each patient

Minimize Possible Emblezzlement

The MDS Dental Practice Committee recommends before hiring a new staff person for your office that you conduct—or consider hiring a third party to perform—a background check on the job candidate. The information received from this background check—including former employers, educational institutions, government sources, consumer credit agencies, Internet databases, and personal references—will help you know more about your potential employee and, as a result, may minimize your exposure to risk, such as fraud or embezzlement.

Retiring in the Next 10 Years?

How far away from retirement are you? The MDS Dental Practice Committee encourages you to plan ahead for retirement. Don't wait until you're ready to retire to start your transition plan. Begin your discussions five to 10 years before you want to retire, sit down with your financial advisor or contact a practice transition consultant to help you determine the value of your practice, if you plan to sell it and determine how it all fits into your retirement goals. You'll want to enjoy the last days of your dental practice with as little stress as possible.

Do You Lease Space?

Are you currently leasing space for your office and hoping to sell your practice in the future? Do you know if your lease permits you to sell your practice or transfer the lease to a new owner? Not all leases have these provisions. It’s critical for a practice owner to understand the terms of his or her lease and to ensure it is set up properly to allow for the sale of the practice and corresponding lease transfer. If not done correctly, the property owner may have the ability to prevent the sale from happening or the leverage to gain proceeds from the sale in exchange for granting permission to sell.

The MDS Dental Practice Committee urges you to consult a legal advisor before signing a lease or—if you are already in a lease arrangement—review your lease and evaluate the assignment clause language. Consult an advisor if the proper language is not in place. Getting out ahead of potential obstacles will eliminate any problems down the road and make way for a smooth practice transition.