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Dealing with Bankruptcies in the Dental Practice
Marianne Harper

If you work in the business office of a dental practice you have probably seen this in the mail at least once – a letter advising you that one of your patients has filed for bankruptcy. With bankruptcies on the rise, it is important that you understand the steps that you should take.
The first notices that you will receive are a notice of commencement of the case, a notice of the creditors' meeting and the closing document. Once your patient files for any chapter of the bankruptcy law, an automatic stay is issued. Your practice must cease all billing and collection activity for any account balance incurred prior to the date of the filing. At this point, your practice must not contact the patient regarding the account. In addition, if there is a collection agency involved, you must alert them to the fact that this patient has filed for bankruptcy so that they will cease their work on that account. If any contact is made regarding the debt, your practice can be at risk for thousands of dollars in fines.

Your chance of obtaining any funds on this account once the court has discharged the debt is pretty slim. Medical bills are classified as unsecured debt. It may be a waste of your valuable time to attempt to recover funds owed, as medical bills are usually completely discharged in Chapter 7 bankruptcies and may be repaid only partially in a Chapter 13 filing. To attempt recovery, you must file a proof of claim with the bankruptcy court within ninety days after the first date set for the creditors' meeting and you must attach all information required.

Keep in mind that, at the time of discharge, if any effort is made by the dental practice to collect on that debt, you can be subject to punishment for contempt.

With bankruptcies you are most likely left with only being able to write off this debt. This write-off may or may not be able to be a tax deduction for your practice. Practices that are cash basis pay taxes only on income received so they are not able to take a tax write-off. However, practices on an accrual basis pay taxes on revenues earned and not collected which allows them to write off uncollected debt. It is said that about 2% of a practice's accounts receivable may be uncollectible. Bankruptcies are part of the reason. These stats should drive home the importance of reviewing your collection policies to help prevent these costly write offs. If you are unsure of how effective your policies are, please contact me. I would be happy to help your practice develop a very successful collection system.

Retreating with Adjunctive Antimicrobials
Colleen Rutledge, RDH

Hygienists often ask me how many times to retreat an unresponsive pocket with an adjunctive antimicrobial product (Periochip, Arestin, Atridox). Many things affect this decision. It's best to use a comprehensive approach and look at the "whole picture" when considering retreatment.

First and foremost check for any remaining calculus, making sure to rule out burnished calculus. Evaluate the area for overhangs, food traps or ill-fitting crowns and bridges thoroughly reviewing a current full mouth series of radiographs

Consider if the patient may clench or grind their teeth. Bruxing habits can be insidious and often go unrecognized. However, reoccurring pockets may be a result of occlusal forces, encouraging the bacteria to migrate along the root surfaces of chronically traumatized teeth.

Keep in mind that a whole host of risk factors may be impeding results: smoking, diabetes, history of cardiovascular disease, etc. Often results are positively affected when low-dose doxycycline hyclate is prescribed.

Lastly, consider the technique used when the product was placed. Did the antimicrobial get to the base of the pocket where the red complex of bacteria thrives? Did the patient follow post-operative instructions?

Most importantly, referral to a periodontist is indicated when the patient is unresponsive to non-surgical periodontal therapy.

When considering retreatment with locally-applied antimicrobials, a comprehensive approach provides better clinical outcomes and ensures that the root cause hasn't been overlooked.

To get a "Top 10 List for Retreating with Locally-Applied Antimicrobials" email me at

In addition, there is currently a 20% OFF Pre-Sale Special on all of my DVD's & CD's until August 1, 2012! Please visit for more information.

Special Guest Article - Chris Mullins, The Phone Sales Doctor™
The Front Office Is The Most Important Sales & Marketing Tool In Your Business
Every Doctor knows getting the phone to ring with the right type patient is no easy task. It's extremely time consuming and very expensive, sometimes as much as a minimum of $500.00. When I listen to mystery calls I am looking for that WOW, grateful, joyful tone that says I appreciate you and your call. It's easy to take your phone calls prospects and patients for granted, but imagine, for a moment, if your phone stops ringing; then what? So when your phone rings you want to WOW that caller. The front office is the face of your practice and everything they do will dictate how that call and ongoing relationship will go with that patient.

Importance of the front desk: To properly reflect your brand on the phone you must focus on communication skills. No matter how busy the receptionist is how they handle the phone projects your professional image and makes a great first impression. The front office is your sales and marketing commercial.

Answering promptly with a smile: Your office is crazy busy, the phone is ringing off the hook. How do you handle this? Breathe, be calm, and use a well prepared script; it will help you to focus on getting the appointment.

Communication: When patients call, two of the most important needs they have are to be LISTENED TO and RESPECTED. When a caller is listened to they become more relaxed and open to setting that appointment.

Behavior that says I'm too busy for you: Putting the caller on hold for a long time, eating or chewing gum while on the phone, talking to someone else and not acknowledging the caller gives them the impression your practice is too busy and they won't get the attention they want and need.

Remember each team member in your business is a sales and marketing tool both on and off the job. What do you want your patient to see?

If you would like a FREE mystery call made to your office to see how your staff is doing, call or email me today at - put Dental Pearls in the subject line and we can arrange that for you.
  Insurance Alert
Dental – The Health Reform Act has specified the procedures that providers must follow regarding overpayments from Medicare. The requirement is that all overpayments must be repaid within 60 days of discovery. Failure to do so may result in fraud claims and possible civil or even criminal penalties. At present, this only applies to Medicare but many carriers eventually adopt the same rules that apply to Medicare.
Exciting New Product Is Now Available
Cross Coding Encounter Forms
An encounter form (route slip) is an invaluable tool to use in dental practices that have implemented a dental-medical cross coding system. Encounter forms are probably the best communication medium for dental practices because they simplify cross coding. These encounter forms provide most of the more common diagnosis and procedure codes needed for cross coding and provide a surefire way for the clinical area of the dental practice to communicate the correct medical code choices to the business office. Many medical practices routinely use encounter forms for the same reasons. You can choose narratives based on a specialty area or a general form. Due to the numbers of codes required, most of these will print as two-sided forms. All that you will need to do is to either print the forms yourself or have your printer print them as a one sided form.
Visit for more information, or download the Order Form now!
General Procedures Encounter Form
Periodontal and Implant Encounter Form
Trauma Encounter Form
TMD Encounter Form
Sleep Apnea Encounter Form
Pediatric Encounter Form
Endodontic Encounter Form
Medical – The transition to HIPAA version 5010 had been extended to June 30, 2012. There is little time left to check on compliance. For those practices that cross code, you need to check to be sure that your billing service or clearinghouse is compliant with the 5010 version.
  Time Line
Update your cross coding manual –
The 2012 update is now ready
For those practices that have purchased my cross coding manual, "CrossWalking – A Guide Through the CrossWalk of Dental to Medical Coding", please take note that it is now time to update your manual. Please order your updates ASAP by emailing Marianne at
Effective since 2011 – Medicare now requires that all physician and non-physician practitioners that submit Medicare claims must be enrolled in PECOS (Provider Enrollment, Chain and Ownership System) as well as all ordering and referring practitioners, or claims may not be paid. Practitioners can enroll online at
Effective since January 1, 2012 – All covered entities listed below are required to upgrade to HIPAA 5010 Standards which are new sets of standards that regulate the electronic transmission of specific healthcare transactions including eligibility, claim status, referrals, claims, and remittances. Covered entities may use a clearinghouse to assist them with complying with the rules.
Additionally, even though software vendors are not included in the list of covered entities, in order to support their customers they will need to upgrade their products to support HIPAA 5010 and NCDPD D.0 as a business imperative.
October 1, 2014 – The new date for ICD-10 implementation

Favorite Quotes:
Life is an opportunity, benefit from it.
Life is beauty, admire it.
Life is bliss, taste it.
Life is a dream, realize it.
Life is a challenge, meet it.
Life is a duty, complete it.
Life is a game, play it.
Life is a promise, fulfill it.
Life is sorrow, overcome it.
Life is a song, sing it.
Life is a struggle, accept it.
Life is a tragedy, confront it.
Life is an adventure, dare it.
Life is luck, make it.
Life is too precious, do not destroy it.
Life is life, fight for it.

~ Mother Teresa

I was fortunate to recently listen in on one of Vanessa Emerson's great teleseminars. In this teleseminar titled "Three Things Dental Speakers Can Do To Get More Stuff Done", Vanessa interviewed Don Khouri and, in one hour, he showed us how to create and categorize our to-do lists and thereby stay more productive and organized. If you would be interested in hearing the audio recording of this great teleseminar, go to:
Don's email address is

Points of Interest:
Do you know what PARAPROSDOKIANS are (and do you also have a hard time pronouncing this word)? They are actually figures of speech in which the latter part of a sentence or phrase is surprising or unexpected and is often used in a humorous situation. Examples of paraprosdokians are:
Where there's a will, I want to be in it
If I agreed with you, we'd both be wrong
Where there's a will, there are relatives

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The contents of this publication reflect the opinion of the authors only. This publication is for informational purposes only.
Any reference to a company or product is done only to provide information about the same and does not reflect any connection between
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