Afleveringen

  • Part 3: Walking Through a Corporate Integrity Agreement with Duane Tinker

    Part 3: Walking Through a Corporate Integrity Agreement with Duane Tinker

    · Talking with the Toothcop

    In this episode of Talking with the Toothcop, Duane Tinker walks you through an actual corporate integrity agreement (CIA) involving a pediatric dental practice. Discover the critical elements of a CIA, including compliance programs, training, claims review, and overpayment reporting. This is crucial information to learn how to navigate CIAs and protect your dental practice. Don't miss this essential episode in our CIA series!

    Connect with Duane Tinker on LinkedIn and explore Dental Compliance Specialists, your trusted partners in navigating the complexities of dental regulations and compliance. Schedule your consultation today by calling (817) 755-0035.

    Resources mentioned in this episode:

    • Closed Corporate Integrity Agreements
    • CMS Medicare Learning Network

    Thanks for listenting to Talking with the Toothcop! Don't forget to follow and turn on notifications for future episodes.

    *** Disclaimer: Duane Tinker is not an attorney and does not offer binding legal advice concerning regulatory compliance. The information in this podcast should not be relied upon or construed as legal advice in any way. Consult your attorney for legal advice concerning compliance matters as they pertain to your dental practice.

    This episode was edited and produced by http://parkerkane.co/

  • Part 2: CIAs and the OIG’s Focus On Compliance

    Part 2: CIAs and the OIG’s Focus On Compliance

    · Talking with the Toothcop

    In this episode of Talking with the Toothcop, we dive deeper into corporate integrity agreements (CIAs) and discuss the OIG’s Focus on Compliance roundtable. If you participate with Medicare or Medicaid, this is crucial information.

    Learn the importance of a code of conduct, board involvement, and internal audits. Discover how to maintain a low error rate in claims reviews and ensure compliance with federal regulations. Need help with compliance? Contact me!

    Connect with Duane Tinker on LinkedIn and explore Dental Compliance Specialists, your trusted partners in navigating the complexities of dental regulations and compliance. Schedule your consultation today by calling (817) 755-0035.

    Resources mentioned in this episode:

    • Focus on Compliance
    • HHS Compliance Resources
    • LIVE Compliance Training
    • Important Episode: The 7 Elements of Dental Compliance Programs

    Thanks for listenting to Talking with the Toothcop! Don't forget to follow and turn on notifications for future episodes.

    *** Disclaimer: Duane Tinker is not an attorney and does not offer binding legal advice concerning regulatory compliance. The information in this podcast should not be relied upon or construed as legal advice in any way. Consult your attorney for legal advice concerning compliance matters as they pertain to your dental practice.

    This episode was edited and produced by http://parkerkane.co/

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  • Part 1: CIAs and How a Compliance Program Can Save Your Bacon

    Part 1: CIAs and How a Compliance Program Can Save Your Bacon

    · Talking with the Toothcop

    In this episode of Talking with the Toothcop, we kick off a series on corporate integrity agreements (CIAs) and the importance of compliance programs. Learn what exactly a CIA entails, why you need a compliance program, and how it can protect your practice.

    Connect with Duane Tinker on LinkedIn and explore Dental Compliance Specialists, your trusted partners in navigating the complexities of dental regulations and compliance. Schedule your consultation today by calling (817) 755-0035.

    Resources mentioned in this episode:

    • LIVE Compliance Training
    • Compliance Guidance for Individual and Small Group Physician Practices
    • Compliance Program Guidance for Third-Party Medical Billing Companies
    • Important Episode: The 7 Elements of Dental Compliance Programs

    Thanks for listenting to Talking with the Toothcop! Don't forget to follow and turn on notifications for future episodes.

    *** Disclaimer: Duane Tinker is not an attorney and does not offer binding legal advice concerning regulatory compliance. The information in this podcast should not be relied upon or construed as legal advice in any way. Consult your attorney for legal advice concerning compliance matters as they pertain to your dental practice.

    This episode was edited and produced by http://parkerkane.co/

  • Optimizing Case Acceptance with The Practice Navigator's Sophia Dunkley

    Optimizing Case Acceptance with The Practice Navigator's Sophia Dunkley

    · Talking with the Toothcop

    Don't miss this insightful conversation with Duane Tinker and Sophia Dunkley, a practice management coach specializing in case acceptance. In this episode, Sophia shares her journey to becoming a consultant, highlighting the crucial role of case acceptance in dental practices. She talks about the importance of trust, communication, and her strategies to truly enhance practice management.

    Tune in to learn valuable strategies for cultivating collaboration, leadership, and patient trust in your dental practice. Connect with Sophia via her links below for a free consultation and to quickly learn how to elevate your practice!

    Connect with Duane Tinker on LinkedIn and explore Dental Compliance Specialists, your trusted partners in navigating the complexities of dental regulations and compliance. Schedule your consultation today by calling (817) 755-0035.

    Resources mentioned in this episode:

    The Practice Navigator: https://thepracticenavigator.com/
    Sophia Dunkley on LinkedIn: https://www.linkedin.com/in/sophiadunkley/

    Thanks for listenting to Talking with the Toothcop! Don't forget to follow and turn on notifications for future episodes.

    *** Disclaimer: Duane Tinker is not an attorney and does not offer binding legal advice concerning regulatory compliance. The information in this podcast should not be relied upon or construed as legal advice in any way. Consult your attorney for legal advice concerning compliance matters as they pertain to your dental practice.

    This episode was edited and produced by http://parkerkane.co/

  • Winning Patients Who Stay, Pay, and Refer with Linda Kane

    Winning Patients Who Stay, Pay, and Refer with Linda Kane

    · Talking with the Toothcop

    In this episode, Duane Tinker talks with Linda Kane of Zeroed-In Dental Solutions to explore the secrets of transforming dental offices and winning patients who stay, pay, and refer. Linda, a seasoned expert in dental billing and consulting, shares her journey from front office roles to becoming a renowned consultant and trainer in the industry.

    See how Linda's innovative approaches and her bestselling book, Dental Office Rescue, can help you optimize your dental practice. Learn about effective insurance billing, creating a cohesive team culture, and the importance of compliance to ensure your practice thrives. Don't miss this conversation — it's packed with practical tips and strategies to elevate your dental office to new heights.

    Link to Linda's new book! https://rescuemydentaloffice.com/

    Connect with Duane Tinker on LinkedIn and explore Dental Compliance Specialists, your trusted partners in navigating the complexities of dental regulations and compliance. Schedule your consultation today by calling (817) 755-0035.

    Thanks for listenting to Talking with the Toothcop! Don't forget to follow and turn on notifications for future episodes.

    *** Disclaimer: Duane Tinker is not an attorney and does not offer binding legal advice concerning regulatory compliance. The information in this podcast should not be relied upon or construed as legal advice in any way. Consult your attorney for legal advice concerning compliance matters as they pertain to your dental practice.

    This episode was edited and produced by http://parkerkane.co/

  • Important Compliance Reminders (Social Media, X-Rays, and Patient Selection)

    Important Compliance Reminders (Social Media, X-Rays, and Patient Selection)

    · Talking with the Toothcop

    In this episode of Talking with the Toothcop, Duane Tinker provides crucial compliance reminders for your dental practice. Are you aware of OSHA's stepped-up enforcement? Are your social media posts compliant? We cover these topics and more, including the importance of patient selection and creating a safe work culture.

    Connect with Duane Tinker on LinkedIn and explore Dental Compliance Specialists, your trusted partners in navigating the complexities of dental regulations and compliance. Schedule your consultation today by calling (817) 755-0035.

    Thanks for listenting to Talking with the Toothcop! Don't forget to follow and turn on notifications for future episodes.

    *** Disclaimer: Duane Tinker is not an attorney and does not offer binding legal advice concerning regulatory compliance. The information in this podcast should not be relied upon or construed as legal advice in any way. Consult your attorney for legal advice concerning compliance matters as they pertain to your dental practice.

    This episode was edited and produced by http://parkerkane.co/

  • 7 Must-Have Elements of a Dental Compliance Program

    7 Must-Have Elements of a Dental Compliance Program

    · Talking with the Toothcop

    In this episode of Talking with the Toothcop, Duane Tinker discusses the seven essential elements of a compliance program that you can't ignore to protect your dental practice. Learn how to comply with federal guidelines and avoid severe penalties under the False Claims Act.

    Connect with Duane Tinker on LinkedIn and explore Dental Compliance Specialists, your trusted partners in navigating the complexities of dental regulations and compliance. Schedule your consultation today by calling (817) 755-0035.

    Resources mentioned in this episode:

    Healthcare Fraud The False Claims Act Office of the Inspector General Website Corporate Integrity Agreements OIG Compliance for Individual and Small Group Physician Practices HEAT Provider Compliance Training Videos Measuring Compliance Program Effectiveness: A Resource Guide

    Thanks for listenting to Talking with the Toothcop! Don't forget to follow and turn on notifications for future episodes.

    *** Disclaimer: Duane Tinker is not an attorney and does not offer binding legal advice concerning regulatory compliance. The information in this podcast should not be relied upon or construed as legal advice in any way. Consult your attorney for legal advice concerning compliance matters as they pertain to your dental practice.

    This episode was edited and produced by http://parkerkane.co/

  • Elijah Desmond on Transforming Dentistry with Fun and Passion

    Elijah Desmond on Transforming Dentistry with Fun and Passion

    · Talking with the Toothcop

    In this episode of Talking with the Toothcop, Duane Tinker chats with Elijah Desmond, also known as DJ Smiles. Elijah is a dynamic entrepreneur and motivational speaker in the world of dentistry. His journey from dental hygiene to creating innovative and engaging dental events is truly inspiring.

    Elijah shares his path to success, the inspiration behind his many ventures, and his philosophy of blending fun with education in dentistry, making a positive impact on countless lives.

    Connect with Duane Tinker on LinkedIn and explore Dental Compliance Specialists, your trusted partners in navigating the complexities of dental regulations and compliance. Schedule your consultation today by calling (817) 755-0035.

    Learn more:

    Dental Compliance Specialists: https://dentalcompliance.com/
    Duane Tinker on LinkedIn: https://www.linkedin.com/in/duanetinker/

    Resources mentioned in this episode:

    Elijah's Website: https://elijahdesmond.com/
    Elijah Desmond on LinkedIn: https://www.linkedin.com/in/elijahdesmond/

    Thanks for listenting to Talking with the Toothcop! Don't forget to follow and turn on notifications for future episodes.

    *** Disclaimer: Duane Tinker is not an attorney and does not offer binding legal advice concerning regulatory compliance. The information in this podcast should not be relied upon or construed as legal advice in any way. Consult your attorney for legal advice concerning compliance matters as they pertain to your dental practice.

    This episode was edited and produced by http://parkerkane.co/

  • Knowing and Optimizing Your Team's Strengths with Dr. Matthew Norton

    Knowing and Optimizing Your Team's Strengths with Dr. Matthew Norton

    · Talking with the Toothcop

    In this episode of "Talking with the Toothcop," Duane talks with Dr. Matthew Norton, founder of People Plus Purpose, to discuss the transformative power of understanding and leveraging your team's strengths.

    Dr. Norton shares his tips on team coaching and leadership, including his "core 4" assessments that help boost team productivity and success. Don't miss this deep dive into building a purpose-driven, strengths-based workplace!

    Connect with Duane Tinker on LinkedIn and explore Dental Compliance Specialists, your trusted partners in navigating the complexities of dental regulations and compliance. Schedule your consultation today by calling (817) 755-0035.

    Learn more:

    Dental Compliance Specialists: https://dentalcompliance.com/
    Duane Tinker on LinkedIn: https://www.linkedin.com/in/duanetinker/

    Resources mentioned in this episode:

    People + Purpose: https://peoplepluspurpose.com/
    Duane on The Truth Behind Dentistry Podcast: https://youtu.be/SKznnqX39vM?feature=shared

    Thanks for listenting to Talking with the Toothcop! Don't forget to follow and turn on notifications for future episodes.

    *** Disclaimer: Duane Tinker is not an attorney and does not offer binding legal advice concerning regulatory compliance. The information in this podcast should not be relied upon or construed as legal advice in any way. Consult your attorney for legal advice concerning compliance matters as they pertain to your dental practice.

    This episode was edited and produced by http://parkerkane.co/

  • Revolutionizing Dental Assisting Training with Dr. Heather Dawn Lawson Myers

    Revolutionizing Dental Assisting Training with Dr. Heather Dawn Lawson Myers

    · Talking with the Toothcop

    In this episode of Talking with the Toothcop, Duane Tinker chats with Dr. Heather Dawn Lawson Myers, a practicing dentist in Jamaica and the founder of Dental Assisting Made Easy (DAME).

    Discover the importance of proper dental assisting training and how Dr. Lawson Myers' online platform is filling the gap in dental assistant education. From basic skills to advanced techniques, learn how this program is helping dental practices thrive.

    Connect with Duane Tinker on LinkedIn and explore Dental Compliance Specialists, your trusted partners in navigating the complexities of dental regulations and compliance. Schedule your consultation today by calling (817) 755-0035.

    Learn more:

    Dental Compliance Specialists: https://dentalcompliance.com/
    Duane Tinker on LinkedIn: https://www.linkedin.com/in/duanetinker/

    Resources mentioned in this episode:

    Dental Assisting Made Easy: https://www.dentalassistingmadeeasy.com/
    Train Your Dental Assistant: https://trainyourdentalassistant.com/

    Thanks for listenting to Talking with the Toothcop! Don't forget to follow and turn on notifications for future episodes.

    *** Disclaimer: Duane Tinker is not an attorney and does not offer binding legal advice concerning regulatory compliance. The information in this podcast should not be relied upon or construed as legal advice in any way. Consult your attorney for legal advice concerning compliance matters as they pertain to your dental practice.

    This episode was edited and produced by http://parkerkane.co/

  • Leveraging the Leads Your Dental Practice Already Has with Michael Gonzalez

    Leveraging the Leads Your Dental Practice Already Has with Michael Gonzalez

    · Talking with the Toothcop

    Join Duane Tinker, "The Toothcop," as he engages in a compelling conversation with Michael Gonzalez, an expert in maximizing dental practice potential by leveraging existing leads. Gain valuable insights into effectively converting your current dental practice leads into loyal, long-term patients!

    Michael shares his proven strategies and tactics to optimize your practice's performance, ensuring sustained growth and success. This insightful dialogue between Michael Gonzalez and The Toothcop can revolutionize your approach to lead management in dentistry.

    Connect with Duane Tinker on LinkedIn and explore Dental Compliance Specialists, your trusted partners in navigating the complexities of dental regulations and compliance. Schedule your consultation today by calling (817) 755-0035.

    Learn more:

    Dental Compliance Specialists: https://dentalcompliance.com/
    Duane Tinker on LinkedIn: https://www.linkedin.com/in/duanetinker/

    Resources mentioned in this episode:

    All On 4 Liaison: https://allon4liaison.com/
    Connect with Michael Gonzalez on LinkedIn: https://www.linkedin.com/in/michael-gonzalezjr/

    Thanks for listenting to Talking with the Toothcop! Don't forget to follow and turn on notifications for future episodes.

    *** Disclaimer: Duane Tinker is not an attorney and does not offer binding legal advice concerning regulatory compliance. The information in this podcast should not be relied upon or construed as legal advice in any way. Consult your attorney for legal advice concerning compliance matters as they pertain to your dental practice.

    This episode was edited and produced by http://parkerkane.co/

  • Maximizing Dental Practice Success

    Maximizing Dental Practice Success

    · Talking with the Toothcop

    Join Duane Tinker as he welcomes Leah Roling, an acclaimed life coach and celebrated author of "Shift" and "Nobody's Coming to Save You." Specializing in dental professionals' growth and success, Leah shares transformative insights aimed at enhancing both personal and professional realms.

    Embracing the Platinum Rule with Leah Roling: Discover the transition from the Golden Rule to the Platinum Rule with Leah Roling. Understand the pivotal shift towards treating individuals based on their personal preferences and needs, a cornerstone for effective communication and relationships in and beyond dental practices.

    Enhancing Communication within Dental Practices: Explore with Duane and Leah how effective communication transcends traditional dental services, fostering deeper connections with patients and promoting a thriving practice environment.

    The Path to Personal Growth Through Discipline: Leah delves into the essence of personal discipline, the motivational triad, and the journey towards self-improvement and enhanced professional outcomes.

    Foundations of Habit Formation for Dental Professionals: Learn Leah's strategies for establishing a sustainable baseline in habit formation, aiming to bolster consistent progress without the risk of burnout.

    The Power of Self-Reflection and Gift Sharing in Dentistry: Revisit insights from a prior session where Leah discussed the impact of self-reflection and the importance of sharing one's unique gifts within the dental community and beyond.

    Upcoming Opportunities for Professional Development: Stay ahead with Leah Roling's "Manifest Mind" course starting April 1, designed to empower individuals through mindset shifts and actionable steps towards crafting their desired life. Additionally, mark your calendar for an October event focusing on leadership and personal growth.

    Connect with Leah Roling: Reach out to Leah through her official website, engage with her on social media, tune into her podcast "Becoming You" with Leah Roling, or get in touch directly via email for insights into transforming your dental practice and personal growth.

    Leah Roling's Impact on Dental Leadership and Team Dynamics: Leah Roling stands as a transformative leader in dentistry, emphasizing leadership development, team dynamics, and engagement strategies to combat industry challenges such as burnout, turnover, and absenteeism. Through her innovative approach, Leah fosters environments of empowerment, confidence, and creativity, ensuring dental practices not only meet but exceed modern expectations.

    Engage with Leah Roling: Discover Leah's comprehensive suite of resources for dental professionals seeking to enhance their practice's dynamics and patient satisfaction through her website, LinkedIn, Facebook, YouTube, TikTok, Instagram, and her inspirational podcast.

    Your Invitation to Transform Your Dental Practice: In the ever-evolving changes in dentistry, the success of your practice hinges not just on the quality of care you provide but also on the health and harmony of your team. Recent shifts in the workforce landscape have brought to light the critical need for evolved leadership strategies that go beyond traditional management.

    As a dedicated leadership and team engagement strategist specializing in dentistry, I understand the unique challenges you face—burnout, turnover, and absenteeism are not just issues; they're barriers to your practice's growth and patient satisfaction. It's clear: to thrive in today's environment, simply leading and managing isn't enough. The key lies in enrolling your team in their potential, fostering a culture of confidence, decisiveness, and creativity, and shifting from expectations to empowerment.

    Are you ready to assess the health of your practice and explore practical strategies that have proven to reduce absenteeism by a staggering 81% and turnover by 18%? With the average cost of hiring reaching $45,000, reducing turnover isn't just beneficial; it's essential.

    I invite you to book a complimentary leadership call with me, where we'll conduct a 5-question assessment to pinpoint the health of your practice. Together, we'll tailor engagement strategies to your unique needs, setting you on the path to a more harmonious, productive, and resilient practice.

    The workforce has changed. Has your leadership? Let's explore how you can adapt and excel in this new era.

    Leah Roling

    Phone Number: 515-865-6716

    Email: [email protected]

    Social Media Handles

    Website: www.leahrolingcoaching.com

    LinkedIn- https://www.linkedin.com/in/leahroling/

    Facebook-https://www.facebook.com/profile.php?id=100087511623234

    Youtube - https://www.youtube.com/channel/UCkSOBSTuY97mQXacTbiufTA

    TikToK- https://www.tiktok.com/@leahrolingcoach

    Instagram- https://www.instagram.com/leahrolingcoaching/

    Podcast: https://podcasts.apple.com/us/podcast/the-becoming-you-show-with-leah-roling-inspire/id1608085445

  • Clinical Recordkeeping for Dental Assistants

    Clinical Recordkeeping for Dental Assistants

    · Talking with the Toothcop

    Clinical Recordkeeping for Dental Assistants for Nifty Thrifty Dentists Group

    🦷 The importance of proper documentation and compliance in dental practices: Learn from Dwayne Tinker, former police officer for the Texas Dental Board, as he shares insights on #DentalCompliance and record-keeping.

    Key Takeaways:

    1️⃣ Proper notations for medications and doctor's instructions are crucial.

    2️⃣ #HIPAA compliance is a must, especially for patient record access.

    3️⃣ Respect patient privacy and obtain consent during conversations.

    4️⃣ Ensure accuracy and reliability through thorough documentation.

    5️⃣ Fix problems in advance to maintain credibility and avoid audits.

    6️⃣ Comprehensive clinical notes are essential, including medical history, x-ray findings, and perio charts.

    Join us to stay informed about the legal implications of dental records! 📋🔒

    #DentalDocumentation #ComplianceMatters #PatientPrivacy #DentalRecords #HealthcareCompliance

    Connect With Duane https://www.dentalcompliance.com/ toothcop(at)dentalcompliance.com On Facebook On LinkedIn
  • Waterline Safety – Amanda Hill, RDH, BSDH

    Waterline Safety – Amanda Hill, RDH, BSDH

    · Talking with the Toothcop

    Amanda Hill RDH, BSDH has been a dental hygienist for over 26 years. When she took her annual infection control training in 2017, the speaker covered waterlines. She never knew that she had to do more than flush her waterlines. No one else in her dental office knew that they were supposed to do more.

    Her practice failed their first water test, badly. So Amanda dug in and got them to pass their water testing. Then she started offering to help other dental offices. In this episode, Amanda shares her expertise and we have a deep discussion about waterline testing.

    Outline of This Episode [1:56] Learn more about Amanda Hill AKA the “Waterline Warrior” [6:24] Open line versus closed waterline systems [11:10] What is a biofilm and how do you kill it? [16:08] Amanda’s favorite germicide delivery system [19:39] Reasons you need to do waterline testing [26:25] Why you want to be consistent with treatments [28:40] How frequently you should test your waterlines [33:24] Addressing the flushing your waterlines debate [38:33] Waterline testing must include documentation Resources & People Mentioned Email: [email protected] Friend on Facebook Follow on Instagram Connect on LinkedIn Check out Amanda’s Website Deanna Otts-Whitfield, RDH, BSDH, MSHQS BluTube Dental Unit Water Purification Cartridge Dental procedures during pandemic are no riskier than a drink of water Preventing Airborne Diseases in Dentistry with Michelle Strange CDC warns of bacteria in dental waterlines after children are infected Connect With Duane https://www.dentalcompliance.com/ toothcop(at)dentalcompliance.com On Facebook On Twitter On LinkedIn On Youtube
  • MCS Infection Control Solutions - Paul Saueressig

    MCS Infection Control Solutions - Paul Saueressig

    · Talking with the Toothcop

    Without question, the Covid pandemic had a large impact on the healthcare field. It highlighted monstrous changes that needed to occur in the infection control space. MCS put its resources into investigating standards of care in infection control.

    MCS came out with some new technologies that will transform the world of infection control. Paul Saueressig outlines the solutions they’ve created and how they can benefit your dental practice in this episode of Talking with the Toothcop. Do NOT miss this one!

    Outline of This Episode [2:12] Learn more about MCS Infection Control Solutions [8:01] Solution #1: Protective Coating Solutions [15:03] Solution #2: Rapid Testing Solutions [26:08] Two options for healthcare facilities [35:53] The problem with Healthcare-Associated Infections (HAIs) [39:56] Providing long-term proactive solutions for the healthcare space [41:09] How to get more information about MCS infection control solutions Resources & People Mentioned MCS Paul Saueressig Hygiena Connect With Duane https://www.dentalcompliance.com/ toothcop(at)dentalcompliance.com On Facebook On Twitter On LinkedIn On Youtube
  • How the No Surprises Act Impacts Dentists - Laura Diamond

    How the No Surprises Act Impacts Dentists - Laura Diamond

    · Talking with the Toothcop

    Have you heard of the federally implemented “No Surprises Act?” Were you aware that it applies to dentists? The No Surprises Act protects uninsured and self-pay patients from receiving surprise medical bills. So what does that mean for your practice? Find out in this episode of Talking with the Toothcop!

    How the “No Surprises Act” applies to dentists

    As of 1/1/2022, you need to provide patients an estimate of anticipated charges for dental services, i.e. “Good Faith Estimates” or GFEs. They must be provided upon request or upon scheduling an appointment—well in advance of the treatment plans and financial estimates you may be currently providing.

    Because you’re already providing financial estimates in advance of service, does that mean you’re exempt? NOPE. Sorry to tell you, that’s not the case. At this time, it applies to uninsured and self-pay patients. It may apply to insured patients in the future.

    What do you have to do?

    Here are the basics:

    You have to provide notice to your patients of their right to receive a GFE You must post a notice on your website You must post a notice in your practice where scheduling and service costs may be discussed (so a check-in desk).

    You need to implement a good faith form in your practice. You have to issue this to current and new uninsured and self-pay patients before you provide—or continue providing—services. This applies to anyone who even contacts your office. If they ask what you charge for a dental cleaning, you have to provide them with that estimate.

    What else do you need to know?

    Even if you provide a GFE verbally, it must also be provided in writing (mail, fax, or encrypted email). Before you give out this information verbally, it’s wise to tell a potential patient that you must follow up with this information in written form and ask for their name and address (and assure them this is federal law). It must be provided within a specific time frame (1–3 business days after an appointment is scheduled or 3 days after an inquiry) GFEs must be mailed to current patients before you continue with treatment You have to maintain the estimates that you provide in a patient’s charting and document in their progress notes that you’ve talked about the GFE They have to be maintained for six years (even GFEs for patients who never scheduled) A GFE is the cost of services that you anticipate providing for a patient over a year. If those costs change, you must issue a new GFE.

    None of this is difficult. But it is just one more thing you have to implement. That’s why we’ve created a toolkit for you to help you implement this in your practice.

    Why does any of this matter?

    If there is a difference of more than $400 between your GFE and billed charges, the patient can initiate a billing dispute that the HHS can investigate. Those decisions are reviewed by a third-party contractor. If the decision doesn’t go in your favor, you can lose out on legitimately earned fees. Secondly, this may become like HIPAA. A complaint may lead to your practice being audited and civil monitoring down the road.

    Outline of This Episode [1:23] The Federal No Surprises Act [3:35] What you have to do [7:03] When did this become effective? [8:04] Why does any of this matter? [9:52] Where this falls in order of operations [11:00] Q&A session with Laura [17:49] How to connect with Laura [19:46] Important compliance reminders OUR SPONSORS:

    ProEdge Dental Water Labs: https://ProEdgeDental.com/Toothcop

    Protective Dental: https://DentalCompliance.com/DrugKit

    Resources & People Mentioned The No Surprises Act implementation guide and toolkit Connect with Laura by email: ldiamond(at)dsedlaw.com Connect With Duane https://www.dentalcompliance.com/ toothcop(at)dentalcompliance.com On Facebook On Twitter On LinkedIn On Youtube
  • Protect Your Practice: Exclusions Monitoring + Compliance Programs - Justin Withrow

    Protect Your Practice: Exclusions Monitoring + Compliance Programs - Justin Withrow

    · Talking with the Toothcop
    Everyone needs a compliance program tailored to the needs of their practice. Justin Withrow jumps in when a compliance program is absent and things go horribly wrong. Perhaps a client was employing an individual that's excluded from participation in the Federal Healthcare Program that should have been caught.

    There is a multitude of things that could happen that could have been prevented by a compliance program. In this episode of Talking with the Toothcop, we dissect the importance of exclusion monitoring, the basics of the false claims act, self-disclosure protocol, and much more.

    The importance of exclusion monitoring

    Justin worked with a multi-location practice where the owner worked with walk-in and Medicaid clients frequently. He was doing criminal background checks and checking licenses with the dental board. But he didn’t know an exclusion list existed with the Federal Healthcare Program that could exclude providers from working with the Medicaid program. Unfortunately, one of his providers knew they were excluded and didn’t tell him. It resulted in a fraud investigation of his practice. He was looking at jail time for something that could easily have been avoided.

    It feels like science fiction but it’s the real deal. It’s as simple as running your licensed staff members’ names through a website. You need to know they’re authorized to work with your patients so you can get reimbursed for services rendered. If you don’t, they’ll take that money back—and then some. Justin dissects the basics of the false claims act and the fines you could be looking at if you were caught in this situation. Don’t miss it.

    The submission of “unclean” claims

    If you submit a claim for reimbursement by a provider who is excluded from a state Medicaid program, that claim is labeled as a false claim. Let’s say a practice employs someone who they knew was excluded and billed services as rendered by a credentialed provider. If it was determined the service was rendered by an excluded provider, that triggers a false claim. Any service rendered by an excluded provider and submitted for reimbursement to Medicaid is a false claim.

    If a provider has been excluded, that individual can’t have contact with any patient insured with Medicare or Medicaid. If they work on that patient that claim cannot be reimbursed. That’s why it is SO important to do exclusion checks. This applies to dental assistants, hygienists, and even administrative staff. Every member of your organization needs to be regularly run through exclusion databases.

    Defining self-disclosure protocol

    A compliance program helps you identify improper practices (something coded incorrectly, overpayment, etc.), catch them, and self-disclose or clarify that you made a mistake. You can let the governmental agency know a mistake was made and correct the mistake. Usually, you’re given a certain time period—60 days—in which to self-disclose. The government knows mistakes happen. That’s why this protocol exists.

    If you’re in the general ballpark of 60 days, it’s usually fine. Even if you’re outside of the 60-day window, doing nothing is the wrong approach. You will get in trouble down the road. It’s always appropriate to rectify your mistakes when they’re identified. Just work with a professional to do it appropriately.

    What a compliance program must address

    A compliance program must address the policies and procedures that an office uses to operate (i.e. OSHA, HIPAA, dental board regulations, state and federal regulations, etc.). You must properly and safely render care to patients while adhering to various laws of various agencies. It’s an all-encompassing document that dictates how you do everything in your practice. It’s who you are and how you operate. It has to be reflected in the day-to-day operation of your practice.

    People always say, “We’re too busy.” That’s NOT okay. It’s an excuse. These things can’t fall by the wayside. This has to be a staple of your business. There needs to be a compliance officer that is someone other than the dentist. They are your professional lifeguard. They stop the real cops from coming into play. If you’re “Too busy” it’s only a matter of time before you’re audited or investigated.

    Outline of This Episode [3:56] The importance of exclusion monitoring [6:30] The basics of the False Claims Act [11:56] Defining self-disclosure protocol [16:21] What a compliance program must address [24:12] Managing the merger and acquisition process [29:21] Possible reductions in fines and penalties [31:44] How to connect with Justin Withrow OUR SPONSORS:

    ProEdge Dental Water Labs: https://ProEdgeDental.com/Toothcop

    Protective Dental: https://DentalCompliance.com/DrugKit

    Resources & People Mentioned DENTAL COMPLIANCE RULES: NEW IN 2021 [PART II] DENTAL CHART AUDITING [WHY IT’S SO IMPORTANT] Connect with Justin Withrow Connect with Justin on LinkedIn Connect With Duane https://www.dentalcompliance.com/ toothcop(at)dentalcompliance.com On Facebook On Twitter On LinkedIn On Youtube
  • Dental Compliance Doesn't Matter Until It Matters. Then It Matters BIG TIME.

    Dental Compliance Doesn't Matter Until It Matters. Then It Matters BIG TIME.

    · Talking with the Toothcop

    When you’re in the midst of a busy day in your dental office, the details are the things that you typically let slide, right? But in the dental business, it’s the details that keep you on track and it’s the details that protect your office from huge fines and your Doctor from losing her licenses. This episode highlights some of the things I’ve seen recently that I think all dental office workers need to have top-of-mind. If you don’t take these things seriously, you’re going to have issues eventually.

    Online training or in-person training? Which do you need?

    Every dental office is going to be required to do Continuing Education from year to year. BLS, ACLS, and PALS are common certifications that need to be upgraded. Many times, compliance teams do their training through “approved” course providers through an online course. That’s OK, but you can’t assume that because it says “approved” or “certified” that it’s truly that across the board. Your STATE may have additional requirements that the course provider is not aware of. For example, for some of the CE requirements, you can do the didactic part online and the testing part online. But you must have a hands-on, in-person evaluation of skills to finish up the CE credit. Don’t get caught out of compliance because you didn’t finish a course as was required. If you discover that’s the case for you, simply fix the issue as soon as possible.

    Office Inspections: Things I’m seeing that you should consider

    As I do reviews at offices to help them get ready for State Board Inspections, I come across a variety of things that are of concern and should be addressed. One of the most common points where I’m finding errors recently is the Pre-Op Sedation/Anesthesia Checklist. State inspectors are fanatical about the form and want it to be used without exception. The title on your form must be exactly that: Pre-Op Sedation/Anesthesia Checklist. There is a lot of information on that form that is required to be ON the checklist. You will fail your sedation review if that is not the case. These are little things you need to make sure are properly in place to pass the inspection. You don’t want to be embarrassed or look bad in front of the board. If you are not 150% sure on your checklist, send me a copy and I’ll send you input on what you are missing (if anything).

    Compliance around drugs is a huge issue I’m seeing of late

    We all know there are compliance regulations in force surrounding the topic of expired drugs. But lately, I’ve come across offices that have terrible problems in this area. Many offices have their checklists but they are not accurate or up to date. In one situation I encountered, the NEWEST expiration date on drugs in their facility was dated 2016. That’s so problematic! You MUST be up to date by removing expired drugs from the premises, and by keeping accurate records. You’re playing a risky game if you’re not taking compliance issues like this seriously. Don’t just check the boxes on the forms, pay close attention to the reality of you drug inventory. Protect yourself and your patients. It doesn’t matter until it matters, and then it matters big time!

    Why office inspections are powerfully helpful for your dental practice

    The beauty of what I do and how I do it is that I’m able to do office inspections as a neutral 3rd party. That means I’m able to be entirely objective because I am not tied to the outcome in any way. I’m not so close that I can’t see the issues. This helps me identify what needs to be fixed, help the staff fix the issues, and move on. It really is that simple. There’s no need for panic or concern because you find something of concern. Just call and I’ll come out and assess everything, give you my recommendations, and point you in the right direction to fix any compliance issues I find.

    Quotes for this episode:

    “If you continue to think the way you’ve alway thought, you’ll continue to get what you’ve always got.” - Kevin Trudeau

    “Do all the good you can, by all the means you can, in all the ways you can, in all the places you can, at all the times you can, to all the people you can, as long as you can.” - John Wesley

    Outline of This Episode [3:58] Continuing Education requirements - changes, updates, clarifications [10:35] Office reviews and concerns that I’m seeing as I do these reviews [18:05] Best-practices for Dental office reviews (the article is linked below) [25:15] The quotes we’ve found helpful this past week Resources & People Mentioned

    OUR SPONSORS:

    ProEdge Dental Water Labs: https://ProEdgeDental.com/Toothcop

    Protective Dental: https://DentalCompliance.com/DrugKit

    Get the physical newsletter: The Dental Legal Update (Jeanine’s website) Dental IQ: Survivor: Dental office audit edition Connect With Duane https://www.dentalcompliance.com/ toothcop(at)dentalcompliance.com On Facebook On Twitter On LinkedIn On Youtube
  • Enforcement Activity Is Up! Do You Have A Legit Paper Trail?

    Enforcement Activity Is Up! Do You Have A Legit Paper Trail?

    · Talking with the Toothcop

    During the 4th Quarter of 2021 we saw a lot of enforcement activity, from the agencies that are announcing their fraud enforcement efforts to insurance companies that are initiating audits, etc. So whatever you’re involved with (Medicare, Medicaid, Indian Health Services, etc.), be sure you have an audit process in place that includes good records on the steps you’ve taken. You need to be able to prove your compliance should an audit or investigation comes your way.

    Narcotics charges against a Michigan Dentist, and lesson for all of us

    A Michigan Dentist was busted recently on narcotics charges, and it’s easy to sit at a distance and pass judgement. But regardless of the facts in this case, there are other things that happen along this line that are more common. For example: sometimes only one Dentist has a DEA license but the others in the practice may write scripts using the other Doc’s DEA number. That’s a dangerous habit to get into. This news story demonstrates that the powers that be are not looking the other way. Don't share your credentials and don’t allow other providers to use your credentials. Sharing is not caring in this situation.

    Are you considering the purchase of a dental practice?

    If you are considering buying a dental practice and the practice has been guilty of compliance issues, you will become liable for those issues the moment you buy the practice. So you need some kind of due diligence process that will assess the practice before you buy to ensure you’re not buying a piece of junk that you can’t get into compliance. But the good news is that not all things that look terrible are terrible. Duane has seen many situations where a practice was able to be easily fixed, then sold (like house flipping) for a profit. If you’re looking for support in the purchase of a dental practice, reach out!

    Outline of This Episode [3:06] Duane’s interest and belief in goals (and another puppy) [7:13] Regulatory action is taking place, so be sure your audit process is up to date [8:44] A Michigan dentist is guilty on narcotics charges brought by the DEA [14:38] The Self-Disclosure Protocols have been renamed [17:27] The DOJ reintroduces corporate compliance monitors [26:31] NEW SEGMENT: Inspirational Quotes Resources & People Mentioned Learn more about protectIt dental at https://dentalcompliance.com/drugkit or call them at 888-878-8916 and tell them that the Toothcop sent you! The Pro Edge Water team - www.ProEdgeDental.com/Toothcop (affiliate) Michigan Dentist busted by the DEA Self Disclosure Protocols renamed CIA's are back! The Justice Department's criminal fraud page

    “We don’t rise to the level of our expectations, we fall to the level of our training.”

    “Don’t practice until you get it right, practice until you can’t get it wrong.”

    “Most people never run far enough on their first wind to find out they have a second wind.”

    Connect With Duane https://www.dentalcompliance.com/ toothcop(at)dentalcompliance.com On Facebook On Twitter On LinkedIn On Youtube
  • An Important Announcement from the Toothcop

    An Important Announcement from the Toothcop

    · Talking with the Toothcop

    I started the Talking with the Toothcop podcast in December 2017. Andrea has been with me since early 2019. We love doing this podcast together. Sadly, it’s time for us to hit the pause button. We will be back—I promise! But we have a lot on our plates right now and it makes sense to pull back temporarily. If this podcast has been rewarding and educational for you professionally, take some time and go back to listen to our episode archive!

    Outline of This Episode [0:22] What’s happening in our lives! [4:18] Check out ProEdge Dental [7:01] Sharing some bittersweet news [9:07] Learn more about protectIt dental Past podcast episodes to check out!

    Check out some of our most popular and episodes packed with need-to-know information:

    Dental Unit Waterlines: the Good, the Bad, and the UGLY (with Mike Rust + Kellie Thimmes The 7 Elements of Dental Compliance Programs How a Compliance Program can Save Your Bacon Sedation Inspections + EPCS + Continuing Education The Importance of Sterilization Processes - Stephen Kovach

    We’re always here to answer questions, so don’t be afraid to reach out. Until we return, subscribe to our email list!

    Resources & People Mentioned Check out ProEdge Dental at https://proedgedental.com/toothcop! Learn more about protectIt dental at https://dentalcompliance.com/drugkit or call them at 888-878-8916 and tell them that the Toothcop sent you! Connect With Duane https://www.dentalcompliance.com/ toothcop(at)dentalcompliance.com On Facebook On Twitter On LinkedIn On Youtube
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