MEDICAL DIABETIC CONSULTATION

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New Mexico Land of Enchantment
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Albuquerque Balloon Festival
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DENTAL REFERRAL PROCESS

• Lindsie Beard, RDH
• La Casa Family Health Center
• Portales, NM
• [phone]

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• 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

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LA CASALOCATIONS
Hondo
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• 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

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1976 La Casa de Buena Salud The House of Good
Health
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La Casa Portales Clinic
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La Casa Clovis Clinic
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DENTAL CLINIC
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REFERRAL PROCESS TO DENTAL
RE-APPOINT PATIENT FOR FURTHER TREATMENT
DATA ENTERED INTO PECS SYSTEM
REFERRAL TO DENTAL
AT DENTAL CONSULTATION ASSESSMENT OF ORAL
HEALTH, TENTATIVE TREATMENT PLAN, PATIENT
EDUCATION
COPY OF REFERRAL IS SENT BACK TO REFERRING
PHYSICIAN
MEDICAL DIABETIC CONSULTATION APPOINTMENT
PHYSICIANS PATIENT ADVOCATE CALLS DENTAL CLINIC
TO SCHEDULE APPOINTMENT FOR DENTAL CONSULTATION
AT NEXT DENTAL VISIT (USUALLY CLEANING
APPOINTMENT) RADIOGRAPHS, COMPREHENSIVE EXAM,
TREATMENT PLAN, ORAL HYGIENE INSTRUCTION AND
PERIODONTAL PROBING
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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
• PHYSICIANS 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 PHYSICIANS LOG
• PATIENT IS HANDED REFERRAL

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Dental Diabetes Referral
Appointment Date_________________ Appointment
Time_________________ Chart No._________________
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 __________________________________
________________________ _________________________
__________________________________________ Referri
ng Physician______________________________
Date______________
Last
First
REFERRAL TO DENTAL
LA CASA FAMILY HEALTH CENTER
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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

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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

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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

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DATA ENTERED INTO PECS SYSTEM

• INFORMATION IS ENTERED INTO PECS SYSTEM
• INCLUDES DATE OF REFERRAL
• DATE OF SERVICE
• DECLINE DATES

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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.

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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

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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
• PHYSICIANS 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

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COMMON TREATMENT AND DIAGNOSIS CODES

• 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

• 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

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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

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REFERRAL PROCESS TO DENTAL
REFERRAL TO DENTAL
RE-APPOINT PATIENT FOR FURTHER TREATMENT
DATA ENTERED INTO PECS SYSTEM
COPY OF REFERRAL IS SENT BACK TO REFERRING
PHYSICIAN
MEDICAL DIABETIC CONSULTATION APPOINTMENT
AT DENTAL CONSULTATION ASSESSMENT OF ORAL
HEALTH, TENTATIVE TREATMENT PLAN, PATIENT
EDUCATION
AT NEXT DENTAL VISIT (USUALLY CLEANING
APPOINTMENT) RADIOGRAPHS, COMPREHENSIVE EXAM,
TREATMENT PLAN, ORAL HYGIENE INSTRUCTION AND
PERIODONTAL PROBING
PHYSICIANS PATIENT ADVOCATE CALLS DENTAL CLINIC
TO SCHEDULE APPOINTMENT FOR DENTAL CONSULTATION
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
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QUESTIONS