Talking with the Toothcop

Dentists face numerous regulatory and liability issues. Keep up with the issues can be daunting and best, career ending at worst. Host Duane Tinker (AKA the Toothcop) discusses the issues and helps make them easy to understand and apply in your dental practice.

Maximizing Dental Practice Success 04/09/2024

Maximizing Dental Practice Success Introduction: 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 /episode/index/show/dentalcompliance/id/30740613

Clinical Recordkeeping for Dental Assistants 10/06/2023

Waterline Safety – Amanda Hill, RDH, BSDH 02/28/2023

MCS Infection Control Solutions - Paul Saueressig 01/24/2023

How the No Surprises Act Impacts Dentists - Laura Diamond 02/08/2022

How the No Surprises Act Impacts Dentists - Laura Diamond 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 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: Protective Dental: Resources & People Mentioned The No Surprises Act Connect with Laura by email: ldiamond(at)dsedlaw.com Connect With Duane toothcop(at)dentalcompliance.com On On On On /episode/index/show/dentalcompliance/id/22055339

Protect Your Practice: Exclusions Monitoring + Compliance Programs - Justin Withrow 01/25/2022

Protect Your Practice: Exclusions Monitoring + Compliance Programs - Justin Withrow 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: Protective Dental: Resources & People Mentioned Connect with Connect with Justin on Connect With Duane toothcop(at)dentalcompliance.com On On On On /episode/index/show/dentalcompliance/id/21876191

Dental Compliance Doesn't Matter Until It Matters. Then It Matters BIG TIME. 01/18/2022

Dental Compliance Doesn't Matter Until It Matters. Then It Matters BIG TIME. 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: Protective Dental: Get the physical newsletter: (Jeanine’s website) Dental IQ: Connect With Duane toothcop(at)dentalcompliance.com On On On On /episode/index/show/dentalcompliance/id/21777242

Enforcement Activity Is Up! Do You Have A Legit Paper Trail? 01/11/2022

Enforcement Activity Is Up! Do You Have A Legit Paper Trail? 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 or call them at 888-878-8916 and tell them that the Toothcop sent you! The Pro Edge Water team - (affiliate) The 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 toothcop(at)dentalcompliance.com On On On On /episode/index/show/dentalcompliance/id/21672743

An Important Announcement from the Toothcop 09/21/2021

Instrument Processing Part I: The Proper Cleaning Process 09/14/2021

Instrument Processing Part I: The Proper Cleaning Process I work with dental offices and do a lot of dental inspections/consults. I help people identify what they need to do differently. We talk through OSHA, HIPAA, infection control, radiology, medications, state board compliance, etc. But I get really excited about infection control and sterilization. That’s my stage—my moment to shine. In this episode of Talking with the Toothcop, we’re going to talk about instrument processing and cleaning procedures. Find out what you could be doing wrong and what to do instead! Outline of This Episode [0:49] Time to redo the 75 Hard Challenge! [6:00] Check out ProEdge Dental at ! [7:16] What a sterilization room should look like [10:46] Don’t neglect monitoring your ultrasonic [14:37] Follow manufacturers instructions for use [16:45] Other things to note when using your ultrasonic [20:20] Learn more about protectIt dental at [21:46] Check out the 2021 Dental Compliance Bootcamp! What a sterilization room should look like I’ve seen thousands of sterilizations rooms. Some are great, some are poorly designed, and some just don’t shock me anymore. What should it look like? It needs to be physically segregated into different areas for instrument receiving and cleaning, decontamination, preparation and packaging, sterilization, and storage. There needs to be a “cleaned” area and a dirty area. I can’t tell you how often I see cross-contamination issues. When you bring the instruments into sterilization, the rest of the processes need to move in one direction. If you move in the opposite direction, you’re contaminating what’s supposed to be sterile. Don’t neglect monitoring your ultrasonic A sterilization area contains two major processes: instrument cleaning and sterilization. If you don’t do one part right, it impacts the entire process. There are monitors in place for the sterilizer, color-changing indicators on instrument peel-pouches, and indicator tape on instrument cassettes. They give us visual confirmation of whether or not the sterilization process worked. People often monitor the sterilization indicators but neglect the cleaning side of the process. You can’t just assume the instrument washer or ultrasonic is working effectively. Just because it sounds like it’s working properly doesn’t mean it is. You need a qualitative test—like a foil test—to make sure that it’s working properly. It needs to be done frequently. When those machines fail, they don’t sound any different. It is not obvious. I don’t love the foil test. What do I prefer instead? An ultrasonic cleaning monitor. It can be ordered through your dental suppliers. Get and use that weekly. Record in your records that it passes inspection. It gives you information on several data points: cavitation, enzyme concentration, and more. Follow manufacturers instructions for use (IFU) Are you using the correct concentration of enzymes in the ultrasonic? More than half of dental offices aren’t. Whatever product that you use for ultrasonic enzymes, make sure you follow the manufacturer’s instructions for use. People frequently use the wrong concentration, which is why I’m partial to tablets. It’s easier to calculate. Secondly, people don’t understand the water capacity of the ultrasonic. The box says “one tablet per gallon” so they drop one tablet in, not realizing they have a three-gallon unit. One tablet won’t cut it—you’re off by a lot. I was in an office last week that had a three-gallon ultrasonic and they were putting in one tablet. According to the IFU, they were supposed to be using two tablets per gallon. They should have been using six tablets total! What’s an easy way to track this? Buy a label maker and print the name of the product and the number of tablets/ounces required each time you fill an ultrasonic. Other things to note when using your ultrasonic What else do you need to focus on? Run the ultrasonic with the cover on. When the cover is not in place, you’re spewing aerosols of biohazards into the air. If you don’t have a cover, get a replacement. Anything that has moveable parts or hinges must be in the open position before it goes in the ultrasonic. If you’re not doing this, bioburden accumulates in the jaw or hinge. Those parts must be exposed to be adequately cleaned and sterilized. Cleaning time is important and it varies per dental instrument. Review the IFUs for each individual piece you have as well as peel-pouches and instrument cassettes. If you run the instruments and find when you’re rinsing them that they’re still dirty, what do you do? Run the cycle again. Fight the urge to manually scrub instruments. You will never do as good of a job as the instrument washer/ultrasonic. Tune in next week for part II—the sterilization process! Resources & People Mentioned Check out the Check out the ! Check out ProEdge Dental at ! Learn more about protectIt dental at or call them at 888-878-8916 and tell them that the Toothcop sent you! Connect With Duane toothcop(at)dentalcompliance.com On On On On /episode/index/show/dentalcompliance/id/20322776

Dental Infection Control Awareness Month 09/07/2021

Dental Infection Control Awareness Month It’s September! And it’s officially Dental Infection Control Awareness Month! We get you’re probably sick and tired of hearing about COVID and infection control. So guess what? Andrea and I will cover infection control without mentioning COVID, other than right now...We’ll cover getting a point-person in place and written policies and procedures. Check it out! Outline of This Episode [0:20] Dental Infection Control Awareness Month! [1:20] Check out ProEdge Dental at ! [3:02] Every office needs a point-person [6:17] Make sure you have written infection-control protocols [10:31] Learn more about protectIt dental at Every office needs a point-person This is an opportunity to use the time we have in Slowtember to review infection control protocols. Every office needs to have an infection prevention coordinator—or OSHA safety coordinator—to oversee all things related to employee safety and infection control. If more than one person is in charge, no one is in charge. Andrea points out that you don’t want to run into a situation where you’re saying, “Oh, I thought you were taking care of that.” Secondly, you want to make sure if that person leaves their role is reassigned to someone else. If you don’t know who it is, you probably don’t have someone in place. I promise you, there will be someone in your practice who wants to do the role. But if no one steps up, so be it. Someone has to lead the pack and you get to choose who that someone is. But make sure you give them the paid time to get it done. Make sure you have written infection-control protocols You need to have written policies and procedures that establish how you do things. According to the CDC, you need written procedures specific to the dental setting. This includes things like: Procedures for containing respiratory secretions Rules for sick employees Infection control education Policies for immunizations and vaccinations (Hepatitis B, Chicken Pox, MMR, Tetanus, Diphtheria/Pertussis) Safe injection practices for sharps/needles Rules for cleaning and sterilizing contaminated dental instruments Having instructions for use for medical devices and instruments (handpiece, sterilizers, x-ray machines, etc.) Cleaning and disinfection protocols for surfaces Cleanups of chemical spills or bodily fluids Testing dental unit waterlines + water treatment Protocols for the correct use of sterile water Rules for how to manage boil water advisories A tuberculosis exposure control plan (review the statistics for your country and state) Many dental offices that have a written set of protocols have never read them. That means practices are simply assuming their staff has been trained on these things. Not good. The dentist is expected to have the most knowledge and experience with infection control. Sadly, they’re often the least knowledgeable and experienced. Don’t let that be you! You also want to have a detailed conversation with your staff about these protocols. Does your staff know them? You’re only as strong as your weakest link. Mark your calendar for ! Bootcamp is all things compliance and risk-management related. It’s available to non-clients (even better, It’s FREE for current clients). Resources & People Mentioned Check out ProEdge Dental at ! Learn more about protectIt dental at or call them at 888-878-8916 and tell them that the Toothcop sent you! Mark your calendar for Connect With Duane toothcop(at)dentalcompliance.com On On On On /episode/index/show/dentalcompliance/id/20234105

The Toothcop’s Quick Tips for Emergency Preparedness 08/31/2021

The Toothcop’s Quick Tips for Emergency Preparedness Did you know that September is National Preparedness Month? So in this episode of Talking with the Toothcop, we share some quick tips your practice can follow to be prepared—for whatever may come. We also share a few ways you can take advantage of “Slowtember” and prep for the year to come. Outline of This Episode [0:22] Quick tips for emergency preparedness [6:00] Take advantage of Slowtember [11:57] Check out Compliance Bootcamp [12:45] Shoutout to some podcast listeners! Quick tips for emergency preparedness What are some easy things you can do to prepare your practice for emergencies? Check that emergency lighting (exit signs) are working properly if there’s a power outage. Check your fire extinguishers and make sure they aren’t overdue for inspection. The fire department can do—and will sometimes just walk in—fire extinguisher checks for you. Check your smoke detectors and change the batteries regularly. Make sure that you perform an annual emergency drill. Have your staff put their John Hancock on a sign-in sheet and keep documentation proving you completed training. If it ain’t written, it didn’t happen. Get out your medical emergency plan and review it with your staff. Make sure that you walk through every part of the process (except calling 911). Take advantage of Slowtember September is a slow month for many dental practices, so make sure—if you haven’t already—to get your compliance training knocked out. Cover bloodborne pathogens, HIPAA, cybersecurity, etc. If you participate with Medicaid/Medicare, you’ll also need to do your Fraud, Waste, and Abuse training. Take a few minutes to review everyone’s credentials and make sure they’re up-to-date. You should check CPR certifications, DEA registrations, sedation permits, even your driver's license and vehicle registration. Check anything that has an expiration date on it—both personally and professionally. What else can you do? Mark your calendar for ! Bootcamp is all things compliance and risk-management related. It’s available to non-clients (even better, It’s FREE for current clients). Resources & People Mentioned Check out ProEdge Dental at ! Learn more about protectIt dental at or call them at 888-878-8916 and tell them that the Toothcop sent you! Mark your calendar for Connect With Duane toothcop(at)dentalcompliance.com On On On On /episode/index/show/dentalcompliance/id/20233646

The Lowdown on the 2021 Dental Compliance Bootcamp 08/24/2021

The Lowdown on the 2021 Dental Compliance Bootcamp In this episode of Talking with the Toothcop, you get a glimpse into the “behind the scenes” of what recording an episode really looks like. From food pranks to our favorite Starbucks orders—every tangent that we usually edit out is on full display. Don’t miss a fun and quirky episode that also includes some important news about our Dental Compliance Bootcamp! Listening may even get you some FREE coffee! Outline of This Episode [0:21] Food pranks: Starbucks + Subway [6:10] Check out ProEdge Dental at ! [12:12] Dental Compliance Bootcamp 2021 [20:00] Record-keeping + Compliance Programs + Cybersecurity [27:48] Learn more about protectIt dental at Learn about Dental Compliance Bootcamp 2021 Bootcamp is coming up, November 19th-20th in Hurst, TX (in the DFW area) at the . The Hilton Garden Inn is attached to the conference center. We are going to have some hands-on medical emergency training. After attending, dentists will be able to facilitate training for their staff. Secondly, bring your team and run through some scenarios together. Justin Bonner, DDS Board Certified in Oral and Maxillofacial Surgery & Garrett Starling, MD Board Certified Anesthesiologist will be there! (the course instructors for our ) You’ll get some courses on insurance with (Pediatric Consultant). —a healthcare attorney—will be returning this year. She’ll be presenting in our risk-management and record-keeping course. The goal is to provide you hands-on clinical training that you can immediately put into practice. This years theme: Record-keeping + Compliance Programs Most of our presentations will center around: We will go in-depth on the nuts and bolts of a corporate compliance program for people who participate in Medicare/Medicaid. We will also complete a mock compliance committee meeting. You’ll learn what you need to talk about and cover in these meetings. Record auditing is a major element of compliance. We’ll cover what you need to audit/monitor, what it looks like, what records to create, and how to solve problems when you run into them. If you have any compliance responsibilities, come and immerse yourself in the experience. It’s not your typical conference. It is hands-on and immersive and you will get to experience everything with us. This is an opportunity to learn great things to apply to your organization. It’s also a chance for you to interact with our clients to decide if we’re a great fit for you. What’s your favorite drink from Starbucks? Let me know at toothcop(at)dentalcompliance.com and I’ll put you in a raffle for a gift card! Resources & People Mentioned Learn more about protectIt dental at or call them at 888-878-8916 and tell them that the Toothcop sent you! Mark your calendar for Connect With Duane toothcop(at)dentalcompliance.com On On On On /episode/index/show/dentalcompliance/id/20214725

The Backpack Rule: Giving Gifts in Dentistry 08/17/2021

The Backpack Rule: Giving Gifts in Dentistry Did you know there are specific rules from the Office of the Inspector General (OIG) regarding giving things of value (i.e. gifts) to solicit potential customers? In this episode of Talking with the Toothcop, Andrea and I talk about some of the specific rules on gifts and kickbacks. This is stuff that you need to be aware of so you don’t get hit with penalties and fines for breaking the law. Outline of This Episode [3:34] The OIG Backpack Rule [11:26] Texas Administrative Code Rule 108.58 [15:25] The anti-kickback statute (42 U.S.C. 1320a-7b) [20:34] Section 259.008 Dental Practice Act [23:03] “But everyone is doing it” [28:08] Dental Compliance Bootcamp 2021 The OIG “Backpack” Rule The OIG released a special bulletin entitled “Offering Gifts and Other Inducements to Beneficiaries.” This advisory from the OIG clarifies how the state interprets and applies the rules and statutes to giving things of value to Medicaid benefit recipients. While they understand the competitive market and desire of dental practices to differentiate themselves in the mind of potential patients, they must uphold the integrity and fairness of the Texas Medicaid program. Giving gifts may raise concerns among the community and other providers. The OIG reinforces Texas Administrative Code §371.1669, which prohibits a person “From transferring or offering any remuneration which the person knows or should know is likely to influence the beneficiary’s selection of a provider, practitioner or supplier of Medicaid payable items or services.” The state of Texas has announced that they will enforce more stringent rules than the HHS OIG, including: Providers are prohibited from offering items or services to influence health care decisions. The OIG presumes that any items that do not exceed $10 per patient were not provided to influence their decisions. Likewise, anything offered to a patient must be directly related to dentistry (i.e. a toothbrush, toothpaste, floss, etc.). You are NOT allowed to give patients backpacks and school supplies, even if your intentions are good. We get that it’s back-to-school time and people like to give out back-to-school supplies. Dental providers cannot do that. You may never offer patients cash or gift cards. Is it different for non-Medicaid providers? Non-Medicaid providers still have to adhere to the Texas Occupations Code Section 102: , which includes rules about not giving gifts to patients (though it doesn’t explicitly call out backpacks). Can non-Medicaid providers give gifts or do giveaways for current patients? Listen to learn more about Texas Administrative Code Rule 108.58 The anti-kickback rule (42 U.S.C. 1320a-7b) The Anti-Kickback Statute is a criminal law that prohibits the knowing and willful payment to reward patient referrals or the generation of business involving any item or service payable by the Federal healthcare programs (e.g., drugs, supplies, or health care services for Medicare or Medicaid patients). This includes things like rent, hotel stays, meals, excessive compensation, paying referrals, etc. Physicians or dentists who accept or pay kickbacks will be penalized up to $50,000 per kickback plus three times the amount of the remuneration. Dentists make attractive targets for kickback schemes because you are a source of referrals. Kickbacks in healthcare can lead to overutilization, increased program costs, corruption of medical decision-making, patient steering, and unfair competition. I hear of offices that offer free or discounted dental care for parents if they bring their children on Medicaid to the practice—which is clearly a violation of Federal law. Taking a kickback can never be justified, even if the service rendered was medically necessary. More of this is coerced in Texas Occupations Code . When people say “But everyone is doing it” Some dentists have pointed out to me that there is an unfair advantage because dentists in their community do these things. The temptation to get involved in a scheme like this is high because “everyone is already doing it.” Firstly, don’t do something that everyone else is doing. That’s not how you grow your business (especially with something illegal). Instead, find out what’s legal in your state (and federally) and then run tests to see what works. It can be as simple as focusing on giving your patients the greatest experience possible. You can make it a memorable and pleasurable experience. How can you take customer experience up a notch? Lastly, if people in your community are doing illegal things, perhaps they aren’t aware. If you have the gumption, you can talk to them about it. We cover a lot in this episode. Listen to the whole thing for all the nitty-gritty details! Resources & People Mentioned Learn more about protectIt dental at or call them at 888-878-8916 and tell them that the Toothcop sent you! Check out ProEdge Dental at ! Texas Occupations Code Section 102: 42 U.S.C. 1320a-7b - Texas Occupations Code Mark your calendar for Connect With Duane toothcop(at)dentalcompliance.com On On On On /episode/index/show/dentalcompliance/id/20157161

PMP Inquiries: Clearing up the Confusion 08/10/2021

PMP Inquiries: Clearing up the Confusion Are PMP inquiries required for sedation meds that are dispensed in the office? A listener read through the rules in January 2020 and spoke with a sedation officer and was advised that they did not need to do the PMP check if they were dispensing in the office. But the way the rule is worded makes it seem as though you do need to. So in this episode of Talking with the Toothcop, Andrea and I will cover Chapter 111 and spell out the PMP rule in detail. Hopefully, this will clear up any confusion you may have! Outline of This Episode [3:43] Rule 111.1: Additional Continuing Education Required [6:24] Rule 111.2: Self-query of Prescription Monitoring Program [7:43] Rule 111:3: Prescription Monitoring by the Dentist [10:51] Breaking down the PMP inquiry rule [12:54] Rule 111.4: Prescription Monitoring by the Board [14:12] Rule 111:5: Electronic Prescribing Waivers [16:51] Subscribe to our email list to stay up-to-date! Rule 111.1 Subsection B: Additional Continuing Education Required According to , effective September 1st, 2020 every dentist that prescribes controlled substances must complete two hours of continuing education “...related to approved procedures of prescribing and monitoring controlled substances.” This can be taken annually to count toward continuing education. Dentists have found this confusing because many have already taken the course. However, the requirement reset September 1st, 2020. So anyone who completed the two hours of continuing education on controlled substances before that date must retake it before September 1st, 2021. I know several thousand dentists have not yet taken this course. We offer this course on our —that you can complete at your own pace—so check it out. Rule 111.2: Self-query of Prescription Monitoring Program became effective Dec. 25th of 2016: “Each dentist who is permitted by the Drug Enforcement Agency to prescribe controlled substances shall annually conduct a minimum of one self-query regarding the issuance of controlled substances through the Prescription Monitoring Program of the Texas State Board of Pharmacy.” Many dentists don’t even have a login for the PMP. You need to do this. The state board of pharmacies can report you and you’ll have to answer for your failure to comply. You will face disciplinary action, which starts with paying a fine and lead to jurisprudence assessment. Rule 111:3: Prescription Monitoring by the Dentist became effective March 1st, 2020, and says: “(a) Prior to prescribing or dispensing opioids, benzodiazepines, barbiturates, or carisoprodol, a dentist shall access the patient's prescription drug history report through the Texas State Board of Pharmacy's Prescription Monitoring Program (PMP) Clearinghouse. Failure to do so is grounds for disciplinary action.” The rule goes on to say that an employee of the dentist can do the PMP check when directed by said dentist. The only exceptions? The PMP inquiry does not have to be completed if the patient is diagnosed with cancer or receiving hospice care and it’s noted in their record. If the dentist cannot do the inquiry due to circumstances outside their control—but has attempted—is not considered to have violated the rule. What circumstances might be outside of the dentist’s control? This would include something like the PMP website being down, your internet is down, etc. You need to get a process in place, look at the drugs you prescribe, and make sure that you check the patient’s drug history through the PMP before you prescribe opioids, benzodiazepines, barbiturates, or carisoprodol. Administering versus prescribing or dispensing: What Gives? The PMPinquiry rule doesn’t apply to administering these drugs but prescribing or dispensing. Dispensing is giving it to the patient to take it later. Prescribing usually entails the patient picking up the medication from the pharmacy. In both cases, the patient has possession of the controlled substances with the opportunity to take them. A PMP check is not required prior to administering to a patient in your chair immediately. Why? Because you are controlling how it’s administered and how much is administered. So if you're doing in-office sedation and giving it to the patient immediately from your office supply, you don’t need to do the PMP Check. If you prescribe the drug for the patient to pick up and you to administer, then you do need to complete the inquiry before doing so. We cover a few other pertinent rules in this episode so be sure to listen all the way through! Let us know if you have any questions at toothcop(at)dentalcompliance.com. Resources & People Mentioned Learn more about protectIt dental at or call them at 888-878-8916 and tell them that the Toothcop sent you! Check out ProEdge Dental at ! Connect With Duane toothcop(at)dentalcompliance.com On On On On /episode/index/show/dentalcompliance/id/20079686

The Texas State Board of Dental Examiners Newsletter [Important Updates] 08/03/2021

The Texas State Board of Dental Examiners Newsletter [Important Updates] In this episode of Talking with the Toothcop, I share some sobering news that recently happened in Kansas. I’ll also share some important updates that dentists need to be aware of that were highlighted in the Texas State Board of Dental Examiners Newsletter. Stay up-to-date on the latest dentistry compliance issues—don’t miss it. Outline of This Episode [0:21] 3-year-old boy dies during dental procedure [3:13] Get your dental unit waterlines tested through ProEdge! [4:30] Electronic Prescribing Waiver [6:03] Texas administrative code Rule 108.7 sub-section 16 [7:44] Tele-dentistry rule (HB2056) passed [12:50] Questions about Rule 108.7 sub-section 16 [14:33] Do dentists prescribe anxiety medication frequently? [15:26] Learn more about protectIt dental’s emergency medical kit [16:43] The Professional Recovery Network 3-year-old Boy Dies During Dental Procedure A 3-year-old boy in Wichita, Kansas went in for a simple procedure. He was sedated to have some teeth removed after a gum infection. Unfortunately, something went awry during the procedure and the boy passed away after being transported to a nearby hospital. The incident is currently under investigation though it appears there was no wrongdoing. However, incidents like these are a sobering reminder to have your dental office prepared in case of emergencies. You need a written protocol in place, your team needs to be aware of their role, and it needs to be referenced as often as possible. Electronic Prescribing Waiver As of January 1, 2021, the Texas Health and Safety Code 481.0755 dictates that “Prescriptions for controlled substances be issued electronically, except in limited circumstances, or unless a waiver has been granted by the appropriate agency.” The waiver applies to dentists that issue prescriptions for controlled substances—but don’t prescribe many at all. They can apply for a waiver to avoid setting up electronic prescribing. If granted, the waiver allows dentists to write up to 25 prescriptions for controlled substances per year. You can re-apply for your waiver up to 30 days before it expires (it lasts a year from when it’s issued). Please Note: Many drugs that you may not consider are classified as controlled substances. Do your research and don’t let yourself get caught off guard by this. Texas administrative code Rule 108.7 sub-section 16 Rule 108.7 sub-section 16 was the COVID rule. It’s now been replaced with what was sub-section 17: You must “Hold a Level 1 permit (Minimal Sedation permit) issued by the Board before prescribing and/or administering Halcion (triazolam), and should administer Halcion (triazolam) in an in-office setting.” Basically, if you want to treat patients with these meds, you must hold a Level 1 permit. In the newsletter, the featured a question a reader asked, “Can I prescribe or dispense a drug for sedation without a sedation permit?” The answer is no. You have to have a minimal sedation permit to prescribe sedation medications to patients (dosage recommendations in board rules 110.1 and 110.4). Texas Legislative House Bill 2056 Passes The bill passed on June 16th, 2021. But on August 11th at 1 pm, the Texas State Board of Dental Examiners will host a stakeholder meeting to address the specific rules for teledentistry. This is your opportunity to make your voice heard and shape these rules on the front end. What can you do? Look at other state’s regulations and see what they’re doing and what their recommendations are. Too often dentists don’t get involved when they have the opportunity. If you’re not involved, you can’t complain about it! I think we will see rules formed by March. Resources & People Mentioned Learn more about protectIt dental at or call them at 888-878-8916 and tell them that the Toothcop sent you! Get your dental unit waterlines tested through ! TWT Episode: Connect With Duane toothcop(at)dentalcompliance.com On On On On /episode/index/show/dentalcompliance/id/19985159

HIPAA: The Treatment, Payment, and Healthcare Operations (TPO) Exception 07/27/2021

HIPAA: The Treatment, Payment, and Healthcare Operations (TPO) Exception A lot of people get the Treatment, Payment, and Healthcare Operations (TPO) Exception wrong. So in this episode of Talking with the Toothcop, Andrea and I dissect what it is. We also talk about what to do if you need patient authorization and the importance of informed consent for treatment. Don’t miss it! Outline of This Episode [0:21] Coffee + Rom-Coms [4:07] Learn more about ! [5:24] The treatment exception [10:00] The payment exception [11:01] The operations exception [12:14] If you NEED authorization [13:25] Informed consent for treatment [17:49] Learn more about ! The treatment exception You can communicate with other healthcare providers (i.e. dentists/specialists) to care for a patient (consults, discussions, coordination of care, etc.). Under HIPPA you don’t need authorization from your patient to communicate with healthcare providers regarding treatment. Some state laws are more restrictive. For example, in Minnesota, this does not apply and you are required to get authorization. Federal HIPPA laws allow communication if your state does not have more restrictive requirements. The payment exception If Grandma stops by to pay a patient's bill, you may have to follow the minimum necessary principle (that a legal guardian is the only one allowed access to patient information). So you may not be able to close the date of service or the procedure but you sure can take payment. If it’s necessary to state a balance to get paid, it’s perfectly fine. The operations exception The operations exception allows dental offices to access and use/disclose their patient‘s information. You don’t need authorization from the patient or legal guardian. How does that look in practice? Duane is allowed to access a patient’s records without them being notified because it’s for compliance purposes. If you NEED authorization If you need authorization from a patient to disclose PHI to a third party, there is a form you need them to complete with specific elements that need to be on it. Most information release forms don’t have the necessary information. So what’s needed? It must clearly identify your entity and who you’re allowed to release information to What part of the patient’s record you’re authorized to use or disclose The explicit purpose for the disclosure A notice that informs the patient they have the right to revoke the authorization at any time (this is what most dental offices are missing) A signature on the form by the patient or legal guardian NOTE: Get familiar with your state's recommendations to make sure they don’t have specific requirements for authorizations. If you’re from MN hit me up at toothcop(at)dentalcompliance.com for a template for the form you need! Informed consent for treatment This seems like an ongoing issue I encounter regularly. Different states have different requirements for informed consent. Common sense dictates—to protect yourself and your practice—you should obtain informed consent from your patients. They should know the potential risks of a procedure and alternative treatments that could be appropriate (including no treatment). They should also be informed of the potential consequences if they choose not to have a procedure done. If you practice in multiple states, follow the most stringent standard in all of your locations. Then you’ll never run the risk of being out of compliance. In Texas, you need consent for everything that comes with a risk. In Texas, Medicare requires consent for every procedure on the date of service it’s being completed. If you don’t get consent, the insurance companies can recoup what they paid for the services. Have any good coffee bean recommendations? Send me an email with your suggestions! Resources & People Mentioned Learn more about protectIt dental at or call them at 888-878-8916 and tell them that the Toothcop sent you! Movie: Connect With Duane toothcop(at)dentalcompliance.com On On On On /episode/index/show/dentalcompliance/id/19834868

The Lowdown on Hepatitis B Vaccinations + Post-Vaccination Testing 07/20/2021

The Lowdown on Hepatitis B Vaccinations + Post-Vaccination Testing Recently, I’ve dealt with some level of confusion surrounding the Hepatitis B vaccinations (HBV) and post-vaccination testing requirements. So in this episode of Talking with the Toothcop, I’m going to cover what both OSHA and the CDC require for the HBV and post-vaccination testing. Outline of This Episode [2:03] Hepatitis B vaccination requirements in dentistry [5:08] OSHA requirements for post-vaccination testing [10:22] Hepatitis B vaccination recap Hepatitis B Vaccination Requirements When a dental office hires a new person, they need to determine if that person will have exposure to bloodborne pathogens. Front office staff may have exposure in one dental office and others won’t, whereas a clinical staff will have ongoing exposure. It all depends on the activities of your staff and whether or not they’re cross-trained. But it’s not like a bloodborne pathogen follows the rules and won’t cross into an area they’re not supposed to. If a new staff member will likely face exposure throughout their employment, they need to be offered the Hepatitis B vaccination. The employer must: Get a copy of the employee’s vaccination record If the employee declines the vaccination, they must sign a declination form. (i.e. they may have already had the vaccination). Dentists, you must show you offered the vaccination within 10 days of hiring the new staff member. Document your attempt to get the vaccination records. Include all of this in your new hire paperwork. The vaccination is a three-shot series given over six months. At the conclusion, your staff member’s blood needs to be tested to ensure they’ve developed antibodies for Hepatitis B. OSHA requirements for post-vaccination testing In a 2000 OSHA response to Christopher S. Taylor, M.D. (a flight surgeon), OSHA stated that: “The employer shall make available the hepatitis B vaccine and vaccination series to all employees who have occupational exposure, and post-exposure follow-up to all employees who have had an exposure incident." (Enforcement Procedures for the Occupational Exposure to Bloodborne Pathogens, [CPL 2-2.69]) In short, according to OSHA, the employer must pay for post-vaccination evaluation and follow-up at no cost to the employee (2 months after the vaccination series is complete). In 2015, Richard L. Raimondo, Jr. D.D.S, posed two questions to OSHA. Once my employees have completed the 3-dose hepatitis B vaccination series, is there a requirement to obtain a test for hepatitis B antibodies? OSHA responded that, yes, a test is necessary for antibodies (according to the ). Dr. Raimondo also asked if anyone hired before this standard was in effect must be tested for antibodies and offered the vaccination series. OSHA responded that at the time, they didn’t recommend further vaccinations or titer testing for anyone vaccinated before December 26, 1997. However, for anyone vaccinated after December 26th, 1997, they did recommend anti-HBs [titer] testing. Hepatitis B vaccination requirement recap What does this mean for dentists? Determine who needs to be vaccinated. Offer them the vaccination and prove you’ve made the offer (i.e. declination form and vaccination record). Document, document, document. If it isn’t written, it didn’t happen. Resources & People Mentioned Learn more about protectIt dental at or call them at 888-878-8916 and tell them that the Toothcop sent you! Check out for waterline testing! Connect With Duane toothcop(at)dentalcompliance.com On On On On /episode/index/show/dentalcompliance/id/19781624

Get to Know Duane Tinker + Andrea Baysinger 07/13/2021

Get to Know Duane Tinker + Andrea Baysinger This episode of Talking with the Toothcop is a two-parter! In the first half, you’ll get a look behind the curtain and get to know me—Duane Tinker—and my co-host, Andrea Baysinger. In the second half of this episode, we share an important reminder about nitrous oxide compliance rules. Don’t miss it! Outline of This Episode [3:01] How Andrea became my co-host [6:05] I’m an introvert—until I take the stage [8:09] Andrea is an introvert disguised as an extrovert [9:29] Country versus city living (who is who?) [12:22] Raising Australian Shepherds on a ranch [13:05] Dentists that administer nitrous oxide [14:31] How dentists get busted for lack of compliance I’m an introvert—until I take the stage I am an introvert. I’m like Sylvester Stallone (Hawk) in the Movie “Over the Top.” Hawk is a professional arm wrestler preparing for a national event in Las Vegas. At the end of the movie, Hawk is interviewed. He said that before he steps in the ring, he turns his hat backward and it’s like he turns his face and becomes a different person. That’s how I feel when I’m about to walk on a stage and speak. I’m a shy wallflower until I take the stage. Andrea is very talkative and is a self-proclaimed social butterfly. But she believes it’s just a different version of her. She has a degree in English and loves writing and being introspective. So she’s at her best when she’s chosen to be alone. She feels at peace. She recharges, then gets back out with people. Country living versus city living My wife and I have a ranch and sometimes I’ll go weeks without leaving it. We’ve got everything we need here (including fast internet). Andrea grew up in the country, too, in a small town of 1,500 people. She thought she was going to stay there for life but she followed her brother to Texas. She packed everything in her Maxima, got a part-time job within two weeks, and has been here for almost 8 years. She’d never in a million years thought she’d end up in a field close to healthcare and now she can’t imagine anything else (including living in the country again). My wife and I have 6 Australian Shepherds, five of which are related. We have a lot of livestock (sheep, goats, ducks, and geese) because my wife does competition herding with her dogs. Supporting my wife in training the dogs is my extracurricular activity. Plus, there are always things to do around a ranch. Dentists that administer nitrous Switching gears, I’ve been getting a lot of calls and emails from dentists who are shocked about rules that have been in place for three years now. Many dentists are way out of compliance and don’t know where to start. How are dentists getting busted for lack of compliance? The state only does inspections for those with level 2, 3, and 4 sedation permits. Those who are administering nitrous will never be inspected for that. But let’s say a new patient comes to see you for a second opinion. You prepare a treatment plan, make your recommendations, and the patient decides to go with you for treatment. Six months down the road, you get a letter from the state board. They want to copy the patient’s record and the dentist’s emergency plan, and the dentist has no idea what they’re talking about. Nine times out of ten, it’s a complaint against another dentist. That’s how dentists get busted for not having emergency plans. It’s how the conversation starts with me. Dentists who administer nitrous: What you should be doing What do you need to do? You need to have a written emergency plan in place and train your staff on that plan. You need an AED, stethoscope, blood pressure cuff, backup suction unit, and emergency oxygen unit. Most of the dentists that are calling me had no clue. Luckily, it’s an easy fix. The takeaway? Be in the know. Get the newsletter from your state licensing board. Visit their website frequently for important information and updates. Get on our email list. We’ll inform you of new rules and regulations. Something is always changing and impacting dental offices. Need help with compliance? Give me a shout! Resources & People Mentioned Learn more about protectIt dental at or call them at 888-878-8916 and tell them that the Toothcop sent you! with Sylvester Stallone More information on Connect With Duane toothcop(at)dentalcompliance.com On On On On /episode/index/show/dentalcompliance/id/19628918

Diving Deeper into the COVID-19 Rule Expiration 07/06/2021

Diving Deeper into the COVID-19 Rule Expiration In our last episode, we talked about how the Texas State Board allowed their COVID-19 rules to expire. We think it’s a good thing! But a lot of dentists are not happy about it. So in this episode of Talking with the Toothcop, Andrea and I dive a little deeper into the topic. We’ll share why we think it’s a good thing and what dentists can do moving forward. Outline of This Episode [2:51] The feedback on the COVID-19 rule expiration [5:22] You can continue what you were doing [8:10] Dentists are encouraged to follow CDC guidelines [11:00] Let us know if you have any episode requests! The feedback on the COVID-19 rule expiration I’m not entirely surprised dentists aren’t happy with the expiration of the rule. Many dentists want to know what they have to do—they like structure. I thought it was a beautiful thing that the state board was allowing dentists to take the reins again. But a large cross-section of dentists like the comfort of being told what to do. I don’t entirely understand. I get that you want to focus your energy elsewhere. But I like to be recognized for my ability to think, reason, and make my own decisions. Not everyone feels the same way as I do. Oddly enough, there were a lot of gray areas when regulations were first announced last year. Dentists wanted clarity. Now they’ve taken clarity away again and it can be overwhelming. So what can you do? Continue what you were doing We want to be clear. Just because the Texas state board allowed their COVID-19 rules to expire does not mean you have to stop following them. If you—and your patients—were comfortable with the level of safety it afforded you, then by all means stick with it. Work within your comfort level. However, I believe you need to get comfortable stepping outside of your comfort zone. It’s how you grow. You learn to trust your instincts and your ability to trust your own decisions. As a dentist, you’ve earned respect and you’re recognized as someone qualified to make tough decisions beyond the average person (when it comes to oral health). But everything that pertains to your patient’s health is your responsibility. Don’t be afraid to do your own research and make your own decisions. Dentists are encouraged to follow CDC guidelines The state board encouraged dentists to follow CDC guidelines but did not instruct them to. It sounds like this governing body understands it’s stressful, so if you want guidance, you can continue to follow the CDC recommendations. But they are giving you room to make your own interpretations. By the tone of the ruling, there is flexibility and forgiveness if you get something wrong. Any recommendations for requests for our next topic? Let me know at toothcop(at)dentalcompliance.com! Resources & People Mentioned Learn more about protectIt dental at or call them at 888-878-8916 and tell them that the Toothcop sent you! Connect With Duane toothcop(at)dentalcompliance.com On On On On /episode/index/show/dentalcompliance/id/19665575

The Expiration of the COVID-19 Rule: How Does it Impact Dentists? 06/29/2021

The Expiration of the COVID-19 Rule: How Does it Impact Dentists? The Texas dental board let the COVID-19 rule expire (rule 108.7 subsection 16). How does that impact dentists moving forward? What rules do some providers still need to follow? What procedures are still recommended by the CDC? We cover it all in this episode of Talking with the Toothcop! Outline of This Episode [3:20] The impact of the expiration of the COVID-19 rule [4:41] The OSHA Emergency Temporary Standard [9:25] 1910.504: The Mini Respiratory Protection Program [16:35] Subscribe to the podcast and sign up for our newsletter! The impact of the expiration of the COVID-19 rule How does this impact you? Maybe very little. There is no longer a Texas State Board rule that says you have to follow these specific rules. You don’t have to wear N95 masks. You don’t have to do twice daily temperature checks. You don’t have to screen patients and check their temperature. But many of you have gotten used to the process and feel like it’s best to continue. You absolutely can! You get to decide how to care for and keep your patients and staff safe—whatever that looks like for your practice. The OSHA Emergency Temporary Standard There is an OSHA standard—the “”—that was released a few weeks ago and was effective immediately upon release. That means it is an enforceable federal law. Who is impacted by this law? Those who work with people who are suspected of having or confirmed to have/had had COVID-19. This can include employees at: Hospitals Nursing homes Assisted living facilities Emergency responders Home healthcare workers Employees in ambulatory care facilities It does not apply to non-hospital care centers where non-employees are screened before entry and those with COVID-19 are not allowed to enter. So if you screen everyone that walks in the door, this rule doesn't apply to you. If it does apply, you must have a written safety plan, patient screening management, transmission-based precautions, PPE, physical distancing, and more. What qualifies as screening? Listen to find out! OSHA Standard 1910.504: The Mini Respiratory Protection Program When respirator use is required, the respiratory protection standard applies. This requires medical evaluations, fit testing, a written safety program, user seal checks, and training. What does the “mini” version require? User seal checks and proper training. 90% of dental offices are already here. CDC COVID-19 guidelines are still recommended The state board still recommends finding the : Postpone procedures if they aren't medically necessary Implement Teledentistry and Triage Protocols (doesn’t apply yet) Screen and triage everyone entering for signs and symptoms of COVID-19 Monitor and Manage Dental Healthcare Professionals (if you’re sick, stay home) Create a process to respond to COVID-19 exposures among DHCP and others Implement universal source control measures Encourage physical distancing Consider COVID-19 testing for patients and staff who don’t exhibit symptoms (we recommend you don’t do that) Do things to minimize exposure Implement universal use of PPE Familiarize yourself with this stuff! Resources & People Mentioned Learn more about protectIt dental at or call them at 888-878-8916 and tell them that the Toothcop sent you! Save the date for bootcamp: Nov. 19th and 20th Connect With Duane toothcop(at)dentalcompliance.com On On On On /episode/index/show/dentalcompliance/id/19629488

Don’t Neglect Your Sedation and Anesthesia Reviews 06/01/2021

Don’t Neglect Your Sedation and Anesthesia Reviews Are you doing proper sedation and anesthesia reviews? Are you making sure you don’t have drugs sitting in your office that expired pre-COVID? Are you checking with a patient’s primary care provider before administering anesthesia? Being busy and overwhelmed isn’t an excuse for not doing your due diligence. In this episode of Talking with the Toothcop, Andrea and I touch on the importance of doing a proper review. Outline of This Episode [4:09] Sedation and anesthesia reviews [8:49] Upcoming anesthesia course Check for expired drugs and equipment I’ve done a lot of sedation and anesthesia reviews in the last few months, and I can tell that some offices have been quite distracted. Those that have been quite busy aren’t staying on top of the things they should, like an annual inspection of the sedation process and equipment reviews. As a result, I’m finding a lot of expired stuff. They’re lucky I found it—not the state board. You need to be routinely checking to make sure you’re not storing expired drugs. Sedation and anesthesia reviews You also need to be diligent in your patient screening and selection for anesthesia. Don't overlook even the slightest detail. Get the proper medical consultations done versus just getting medical clearance. “Medical clearance” is not an absolution of viability for you. You can’t just exchange paperwork with their primary care physician. Take the time to document the conversation in your clinical notes (with great detail). Take your pride out of the equation. Even if you’ve done something 1,000 times, there may be one time something goes wrong. If you can’t prove you’ve done your due diligence and properly screened your patient, you won’t have a leg to stand on. Err on the side of caution. If a conversation happened—but it’s not in your records—it didn’t happen. Upcoming anesthesia course We have an anesthesia CE course coming up on June 5th from 8 am to 12 pm central, but open to anyone across the US. The course is “Principles and Practices of Dental Office Anesthesia,” taught by Dr. Justin Bonner and Dr. Garrett Starling. If you’ve done the same anesthesia course, change it up. Hearing the same thing from a different perspective might impact you in a more meaningful way. Learn more by clicking the link in the resources! Call to action: When you get to your office, check the expiration dates on your emergency drugs and all of your equipment. Make sure they aren’t expired. Resources & People Mentioned Learn more about protectIt dental at or call them at 888-878-8916 and tell them that the Toothcop sent you! Principles and Practices of Dental Office Anesthesia: https://dentalcompliance.com/products/live-anesthesia-principles-and-practices-of-dental-office-anesthesia Connect With Duane toothcop(at)dentalcompliance.com On On On On /episode/index/show/dentalcompliance/id/19275194

Death in the Dental Office: Avoid Tragedy with Proper Training 05/25/2021

Death in the Dental Office: Avoid Tragedy with Proper Training Last week, I read an article about an oral surgeon in North Carolina who got busted after a patient died. So in this episode of Talking with the Toothcop, we’re going to talk about what happened, why it happened, and how it could have been prevented. This isn’t to shame the dentist or staff involved, but to learn from the mistakes that were made. Tragedies in the dental office should never happen. Outline of This Episode [0:22] Death in the dental office [8:50] Get professional help before it’s too late [13:45] The Professional Recovery Network [18:21] Your patients may not trust you anymore [20:20] The current action being taken [24:15] Upcoming CE courses Death in the dental office According to the article , Dr. Mark Austin had his license suspended following an investigation by the State Board of Dental Examiners. The patient in question came in for an appointment to receive a dental implant. The doctor administered sedatives before and during the procedure. Unfortunately, the patient’s oxygen saturation dropped significantly, and after attempting to place an endotracheal tube, 911 was called. The patient died a few days later in intensive care. This prompted an immediate investigation by the dental board. The DEA and state board combed through this dentist’s practice. Even worse, in an earlier audit, the doctor couldn’t account for substances that were supposed to be maintained at his office, including Fentanyl. The investigation also alleges that he used illicit substances personally for two years while practicing. The patient was at 60-70% oxygen for 20 minutes. Brain death happens when it’s deprived of oxygen for 4–6 minutes. When EMS arrived, the patient didn’t have a pulse. The Dr. had not administered CPR prior to their arrival. His brain was deprived of oxygen for far too long, and he suffered irreversible brain injury and died 4 days later. Get help—or get busted If you or someone you know is struggling with a drug or alcohol problem, get help. It can be done anonymously before you impact your patient’s lives. Because when a dental board gets involved, they’ll issue an emergency suspension which creates a public spectacle. This situation is attached to Dr. Austin’s license for the rest of his life. Every insurance company he attempts credentialing with will know. Some won’t take the risk. If someone had recognized he had a problem it could all have been prevented. It’s hard to get help. But when you do, you go to a special rehab just for doctors. You’re there with other dentists or physicians in recovery. You avoid a public stigma while getting acceptance and support. This isn’t about shaming dentists, it’s about getting them help. It’s sad that a world-renowned cardiologist—someone who devoted his life to helping people—lost his life in a preventable situation. You have a moral obligation to protect your patients Someone had to have seen the signs in this doctor and did nothing. You can’t hide a drug addiction for over a year. If you work with someone who is struggling, you have an obligation and responsibility to report this behavior. You’re either part of the problem or part of the solution. The staff had a moral and ethical obligation to make a decision. They didn’t make the right one. The proper training and preparation for something like this could have prevented someone’s death. This is why we’re talking about this. Dental offices need to be taught the right way to do things. A reasonable person should ask, “What could I have done to prevent that?” Sadly, these staff members will carry guilt with them for the rest of their lives. The current action being taken The dental board received information that Dr. Austin had prescribed controlled substances for staff members—outside the scope of dentistry. The board also received evidence that he was unable to account for controlled substances and had been taking them for two years. In a nutshell, he agreed to a suspension of his license. Resources & People Mentioned Connect With Duane toothcop(at)dentalcompliance.com On On On On /episode/index/show/dentalcompliance/id/19199279

Where Are You Rusty in Your Dental Practice? 05/18/2021

Where Are You Rusty in Your Dental Practice? I recently realized it’s been so long since I’ve played my guitar that the strings have started to rust. It’s sad and embarrassing to realize I’ve let something I love that’s important to me get forgotten. But it made me question: Where do you have rusty strings in your dental practice? Where are you not putting in the energy and effort into things that you should be? Have you let the things that are important to you go to the wayside? In this episode of Talking with the Toothcop, our goal is to bring you back to your current reality. Outline of This Episode [0:22] Where do you have rusty strings? [2:23] You have to sweat the little things [6:22] Take a moment for self-reflection [8:26] Get on my schedule for a chat! Where are your rusty strings? We’ve had a lot of distractions with the pandemic. Because of this, I’ve seen a lot of “rusty strings” in dental practices. People are forgetting to do a step-wedge test for their x-ray machines. They’re forgetting medical emergency training and preparedness. Many people are just going through the motions. In every sedation inspection that I’ve done recently, everyone has had grossly expired equipment. These people are filling out their checklists but not really paying attention—which defeats the purpose of the checklist! Some of these things expired pre-pandemic. You have to sweat the little things Think about everything that happened in the last year. All of your energy and focus may have gone into keeping your practice afloat. It begs the question—is there something you can do to prepare for the next pandemic? When a crisis happens you focus on priority #1. With COVID, it was infection control. But you still have to focus on step-wedge testing and check for expired drugs. You still have to do your OSHA and HIPAA training. These things are basic and don’t require much effort to do. But all of the focus was on the pandemic. Maybe this won’t happen again in our lifetime, but other things will happen. You need to focus on the things that you still need to be doing and don’t forget the little things, or they will morph into bigger problems. It’s always the little things that fall through the cracks. Take a moment for self-reflection: mental checklist Take a moment to think through where you’re at right now. Did you do your HIPAA security risk assessment? Have you done your OSHA training? Have you done emergency training? What are the things you need to be doing regularly? Are you on top of everything? What are the things that you’re missing? Figure it out and get back on track. We aren’t bringing this up to shame anyone. But it’s easy to get caught up in the moment, and it’s important to take a breath and realign. Take a mental inventory, make a list of what you need to catch up on, and execute. Are you stressed and don’t know where to start? Head on over to and get on my schedule for a complimentary consultation. Just fill out a simple form, and Andrea will get you on my schedule for 30 minutes of my undivided attention. Then you can ask all of the questions you want. Resources & People Mentioned Connect With Duane toothcop(at)dentalcompliance.com On On On On /episode/index/show/dentalcompliance/id/19132559

Compliance Training Doesn’t HAVE to Be Boring 05/12/2021

Compliance Training Doesn’t HAVE to Be Boring Who says compliance training can’t be fun—or funny? In this fun episode of Talking with the Toothcop, we take a short break from our scheduled programming to hopefully share some laughs. Plus, we drop some important news about upcoming events. Don’t miss it! Outline of This Episode [2:08] Why OSHA training is dangerous [6:44] An intentional demonstration [12:19] Bootcamp is coming BACK! Why OSHA training is dangerous Those who know me know I LOVE public speaking. Recently, I was doing an in-person OSHA/compliance training (which was awesome). I was speaking in a movie theatre and this particular movie theatre had a short stage about one foot off the ground. Toward the end of the presentation, I was talking about medical emergency preparedness. I like to lean on things and decided to lean on a bar. Turns out, the bar was pretty low—a lot lower than I had anticipated. I ended up awkwardly squatting into a semi-sitting position to learn on the bar. But as I did, I slid back onto the platform and fell on my back. As I’m falling, I’m saying “It’s important to be prepared for unexpected emergencies.” Splat. The audience was confused and perplexed. I couldn’t figure out how to get back up without looking ridiculous. I managed to sit up and continue my lecture while sitting. I finally figured out a plan to get up and quickly hit the next slide, which said, “We don’t rise to the level of our expectations, we fall—HA—to the level of our training.” I walked off the stage and made a beeline for the door. People asked the hostess if I did it on purpose and she was like, “Yeah, he does that stuff all the time.” The takeaway? Come see me speak live! Need a speaker for an upcoming event? Throw my name in the hat! Bootcamp is coming BACK! Bootcamp is coming back in 2021! The planning is in motion. It will be a two-day event on the 19th and 20th of November. More details to come. Resources & People Mentioned Connect With Duane toothcop(at)dentalcompliance.com On On On On /episode/index/show/dentalcompliance/id/19065542

Walking Through a Corporate Integrity Agreement [CIAS Part III] 04/27/2021

Walking Through a Corporate Integrity Agreement [CIAS Part III] In the first episode of this series, we talked about what a corporate integrity agreement is. In the second episode, we covered focusing on compliance. In this episode of Talking with the Toothcop, we are going to walk through an actual corporate integrity agreement. If you’re caught in the OIG’s crosshairs, this is just one example of what you might expect. NOTE: These are NOT confidential and are public documents on the OIG website. Outline of This Episode [2:15] A pediatric corporate integrity agreement [9:27] Reach out to us for support [12:02] Compliance Bootcamp 2021 A pediatric corporate integrity agreement This CIA was executed in August 2016 with a three-year term (a CIA is typically a five-year term). The CIA stipulated that the dentist and all employees and contractors (including billing) had to establish a compliance program that included: Posting a notice in their office that patients could see—within 60 days of the effective date—that provides the OIG hotline number as a confidential means to report fraud or abuse. They had to include three hours of training and education for the practitioner and all covered entities within the first reporting period. That may only be satisfied by taking courses provided by the . It must include a billing, coding, and claims submission course and a medical record documentation course. New employees had to receive three hours of training within 45 days of being hired. An independent review organization was hired to conduct a review of the doctor’s coding, billing, and claims submission to CMS. Ineligible persons include anyone barred or suspended from participation with federal healthcare programs (this shows the importance of continued exclusions checks). Doctors had to prove that they had checked and tracked that their employees were not on an exclusion list. For the purpose of this CIA, an overpayment meant the amount of money a doctor had received in excess of the amount due and payable under any federal healthcare program requirement. If an overpayment was identified, they had to repay it to the appropriate payer within 60 days. They then had to take steps to prevent overpayment from happening again. Any paid claim had to be supported with proper documentation. This CIA didn’t even flesh out all seven elements of a compliance program. Even if the situation is over, it’s still a public record forever. Get the help you need—now Don’t wait until you’re in trouble to get help. Set up a compliance program to protect your practice so you don’t end up on the chopping block. The prevention is worth it. Just because it hasn’t happened doesn’t mean it won’t. If you’d like to schedule a call with me, call our office at 817-755-0035 to speak with Andrea and set up a Zoom call. Resources & People Mentioned Connect With Duane toothcop(at)dentalcompliance.com On On On On /episode/index/show/dentalcompliance/id/18845933

The OIG’s Focus on Compliance [CIAs Part II] 04/20/2021

The OIG’s Focus on Compliance [CIAs Part II] In the last episode, we talked about what a corporate integrity agreement is and what compliance programs should look like. In this episode of Talking with the Toothcop, we continue our series on corporate integrity agreements by looking at the OIG’s roundtable discussion. If you participate with Medicare or Medicaid, you HAVE to pay attention to this. Outline of This Episode [3:23] Corporate Integrity Agreements [5:21] The focus on compliance document [8:59] The board of directors [10:53] The role of the internal audit [11:26] Claims review requirements Corporate Integrity Agreements Just to recap, according to the , a corporate integrity agreement is “Part of the settlement of Federal health care program investigations arising under a variety of civil false claims statutes. Providers or entities agree to the obligations, and in exchange, OIG agrees not to seek their exclusion from participation in Medicare, Medicaid, or other federal healthcare programs.” A CIA usually remains in effect for five years. If you don’t agree to this, you lose the ability to participate in federally funded programs. If Medicare or Medicaid represent a large cross-section of your business, you could lose your business by losing the ability to work with them. It’s a large reason why organizations agree to CIAs. CIAs have evolved into what they are today. Focus on Compliance: The Next Generation of Corporate Integrity Agreements In 2012, the OIG held a roundtable discussion with stakeholders with entities and organizations that were under an active CIA to get feedback. The goal was to tweak CIAs to make them more effective to organizations. In this discussion, the CIAs required each participant to have a code of conduct setting forth their commitment to compliance. They also had to implement policies and procedures governing the compliance program and adherence to program requirements. A code of conduct is a great foundation for a compliance program and establishing policies and procedures. Your written policies and procedures should address each of your risk areas. The OIG now leaves it up to the organization to identify what topics you need further training on based on the CIA. So they’re moving away from an hours-driven training program to topic-driven. The government is responding to and taking feedback on some of their requirements. The board of directors involvement We do work with some dental partnership organizations and DSOs. CIAs require that the board of directors also receive training, reports from the compliance officer, and pass an annual resolution certifying the board is overseeing the compliance program. The board’s responsibilities result in more engaged board members, which assists in the allocation of resources to mitigate risk. An engaged board motivates executives and healthcare providers to commit more fully to compliance. I spend a lot of time working actively with boards and compliance committees and I see this. It takes a few meetings to see people get why it’s necessary. Once things click, I become more of a silent presence and less of the person leading the charge. This is how it should be. What is the role of an internal audit? Why is it so important? Listen to learn more! Claims review requirements Most CIAs require the provider to conduct a discovery sample of 50 paid Medicare claims randomly selected from those submitted by the provider during a specified 12-month period. If the error rate is 5% or greater, the provider must conduct a full sample systems review—which is far more involved. When an organization is under a CIA, they have to maintain an error rate of less than 5% in their audits. Based on my experience, this is difficult to accomplish. I’ve been doing record audits for over 10 years and the average error rate is north of 15%. Why? Because auditing processes aren’t in place and people don’t go back and check for mistakes. The average dentist thinks they don’t make that many mistakes, but unless you do audits and have definitive proof, you don’t know. If you’re playing the Medicaid/Medicare game, you’ve got to know that your error rate is below 5%. You’re not expected to have a full-time compliance officer in place—but you are required to have auditing and monitoring processes in place. So if you’re a small dental office, you must pull and audit at least 50 coding and billing records a year. Need help with this process? Send me an email and I’ll share some samples of overpayment lists. Resources & People Mentioned TWT Episode: HHS Connect With Duane toothcop(at)dentalcompliance.com On On On On /episode/index/show/dentalcompliance/id/18758624

How A Compliance Program Can Save Your Bacon 04/13/2021

How A Compliance Program Can Save Your Bacon This episode is the beginning of a series about corporate integrity agreements. One of the important elements that is part of a corporate integrity agreement is implementing a compliance program. Why is it so important to have a compliance program? What should it consist of? How can a compliance program save your practice? Find out in this episode of Talking with the Toothcop! Outline of This Episode [2:40] Corporate integrity agreements [4:41] Compliance program guidelines [6:48] Why you want to implement a compliance program What is a corporate integrity agreement (CIA)? A corporate integrity agreement addresses a specific issue while attempting to accommodate or recognize the elements of compliance programs. A CIA typically lasts for five years with a certain amount of requirements attached. What are those requirements? The organization must hire a compliance officer and appoint a compliance committee They have to develop written standards and policies They must implement a comprehensive employee training program Retain an independent review organization to conduct annual reviews Establish a confidential disclosure program Restrict employment of eligible persons Report overpayments, events, ongoing investigations, and legal proceedings Provide implementation reports to the OIG on the status of compliance activities A large part of demonstrating compliance is creating a compliance program. What should that consist of? Compliance program guidelines The OIG provides compliance guidance documents for the healthcare sector, including dental practices. Regardless of what sector of healthcare you’re in, these compliance guidelines center around 7 elements of compliance: Conduct internal monitoring and auditing processes Implement written policies and procedures Designate a compliance officer and compliance committee Conduct effective compliance training and education Respond promptly to violations and take timely corrective action Develop effective lines of communication Enforce standards through well-publicized disciplinary guidelines A corporate integrity agreement is agreeing to create a compliance program—with the added bonus of a babysitter, the independent review organization. The best way to learn is from others' mistakes, right? It’s less painful and less costly. Compliance programs are NOT cheap. The government wants you to feel the pinch. They expect you to invest time, money, and effort into compliance. Why you want to implement a compliance program Long before the OIG came out with guidance, the US Judiciary came up with federal sentencing guidelines that existed for different types of crimes. Chapter 8 deals with healthcare fraud. The OIG compliance guidelines come directly from these US Federal Sentencing Guidelines. If an organization gets busted for something—but has a reasonably effective compliance program in place—it can reduce fines and penalties up to 90%. When an organization is busted, the government's first ask after an audit is the highest amount. It can be millions of dollars. If you can reduce that by 90%, it can take $1 million down to $100,000. That’s a big deal. That is where your return on investment comes in. An effective compliance program will pay off. But it’s also my goal that our clients never realize this investment. These are systems that you need to implement. When it comes to compliance, there’s no such thing as “Set it and forget it.” Resources & People Mentioned TWT Episode: Connect With Duane toothcop(at)dentalcompliance.com On On On On /episode/index/show/dentalcompliance/id/18657770

The Genius of Protect It Dental Emergency Medical Kits - Scott Sankary 04/06/2021

The Genius of Protect It Dental Emergency Medical Kits - Scott Sankary Emergency medical kits are essential for dental practices—but most have a kit thrown under a cabinet that’s stocked with expired medications. Scott Sankary is the Co-Founder at Protect It First Aid & Safety, a company striving to change this unsafe practice. They supply emergency products and monitor expiration dates to keep customers in compliance. What do they offer to dental practices? How is their solution better than their competitors? Find out in this episode of Talking with the Toothcop! Outline of This Episode [0:35] Scott Sankary with Protect It Dental [5:47] Protect It Dental’s EMK series [8:11] How to become a customer [14:34] Their subscription-based program [21:58] How are they different? Protect It Dental’s Emergency Medical Kits Protect It Dental is best known in the dental world for their emergency medical kits—their EMKs. The kit itself is made of white metal, weighs approximately 9 pounds, is 15.5” by 6” by 10.5”, and has a handle. It’s well-marked as an emergency medical kit. It can be wall-mounted or stored on a countertop. They also have a grab-and-go magnetic wall mount. It’s well organized and everything has a customized slot. There is also a product key on the inside door. The kit is designed to bring order and calm to a chaotic situation. They have four kits to choose from, each with seven essential medications, consistent with ADA and GADA guidelines. EMK #1: This is the basic and most popular kit. It includes two diphenhydramine vials, two epi ampules, 1 albuterol, 1 adult EpiPen, 1 EpiPen trainer, 2 naloxone vials, nitroglycerin tablets, glucose, aspirin, ammonia inhalants, a CPR mask, and 2 syringes. If you don’t work with kids or seniors, this kit will work for your practice. EMK #5: This is the same kit, except the nitroglycerin tablets are replaced by nitroglycerin spray—which is best practice for elderly patients who have swallow reflex issues. If you work with seniors—but not kids—this kit could be a good choice for your practice. EMK #10: This is the same as kit #1, plus a pediatric epi pen. If you see kids in your practice but not seniors, this is the kit for you. EMK #15: This is the same as kit #1 + a pediatric EpiPen + nitro spray. If you see both kids and seniors, this is the kit for you. How to become a customer Protect It Dental allows you to buy a kit, onboard existing medications (using proprietary technology), or purchase individual medications a la carte. But to get the full benefit of their program, you need to sign up for auto-replenishment. The problem is that so few people are willing to commit to sign-up for auto-replenishment because they’re worried about cost. Those that don’t buy a kit and use the EMK onboarding wizard can ease into it. If you choose to onboard an existing kit, their site will walk you through the , which will only take 10–15 minutes. The drugs get entered into the Protect It system so you’re set to get replenished on the medications as they expire or are used. You’ll receive a notification saying it’s time to order and you simply pay as you receive replenishment medications. If you’re set up for auto-replenishment, you receive products 30 days before their expiration date. It comes with a postage-paid disposal bag to ship to their third-party destruction source. The subscription-based program Protect It Dental is now offering one-year or two-year subscription options. If a dentist chooses to continue to a second year after the first, they convert them to the two-year pricing and so on. When a customer purchases a kit, all meds and supplies are pre-loaded into their system and management is simple. The subscription program solves everything. They receive a new kit for a single monthly payment. As items expire, new ones arrive and old ones can be disposed of. Even if drugs are used—and not just expired—the replenishment is also included in the subscription program. They made it easy and cost-effective to acquire a new kit and enroll in the auto-replenishment program. You shouldn’t have to worry about expiration dates and constant monitoring—Protect It can do it for you. The solution makes it really easy for dental practices to say “yes.” The dentist’s investment is being protected. Patients are being protected. Some of these medications are life-saving. This subscription is eliminating apprehension and providing dentists with quality care. This is hard to compare to other options out there. What sets Protect It Dental apart? Protect It Dental is privately owned and there to serve the dental practice—not a shareholder. They’re small, innovative, and high-tech. They have in-house developers and custom programming to fit their business. What they do is driven by conversations with customers and prospects. They’re a small business supporting small businesses. Their pricing is customer-friendly and they have a genuine desire to help people. Resources & People Mentioned Scotts Phone #: 817-800-9541 Scott(at)ProtectItNow.com Connect With Duane toothcop(at)dentalcompliance.com On On On On /episode/index/show/dentalcompliance/id/18606242

Dental Compliance Reminders [Social Media, X-Rays, and Beyond] 03/30/2021

Dental Compliance Reminders [Social Media, X-Rays, and Beyond] Are you cultivating a culture of compliance in your dental practice? Are you careful about what you post on social media? Are you staying on top of X-ray machine maintenance? In this episode of Talking with the Toothcop, Andrea and I dive into some important compliance reminders you need to be mindful of—especially because OSHA is cracking the whip. Outline of This Episode [3:21] It’s time to create a culture of safety [4:59] A brief social media etiquette guide [6:22] OSHA is stepping it up [8:14] How to maintain your X-Ray machine [12:35] The topic of patient selection [15:18] What to do before administering Nitrous OSHA is stepping it up On March 12th, 2021 OSHA sent out a news release that said they launched a program to protect workers with safety concerns. OSHA is stepping up its enforcement efforts and protecting workers’ rights to a safe work environment. It’s time to take this stuff seriously and step up your game. Don’t look for loopholes—get this stuff done. We are seeing a shift under the new administration to enforce these things. If you get busted, it will be considered a serious violation. If you’re willfully negligent, it could be up to a $150,000 fine for a single violation. They are out for blood. A brief social media etiquette guide I’ve gotten some questions about whether or not practices should post specific photos on social media. Before you post photos on social media, make sure you get signed releases from patients. Secondly, make sure anyone in the photo is wearing the proper PPE based on what the situation looks like—not what it is. We are still in a pandemic, so you better be wearing your respirator and other PPE whenever required. Rember, anything posted on social media can be evidence for anyone to use against you. Maintain your X-Ray machine There are things you need to do regularly to maintain compliance with your office’s X-rays and to pass state inspection. I recently got a call from a client with an inspector in their office. I dropped everything to walk them through the situation. I talked directly with the inspector and directed her to the information that said what they were supposed to be doing. But it shouldn’t have come to that. The office luckily didn’t receive a fine but got slapped with a violation. You have to use a multi-dimensional device or commercial device (i.e. a phantom or step wedge) with every sensor. You must test every sensor on every machine. The distance with the sensor and the cone head must be consistent every time you do the test to control variables. You have to do the same test with the same equipment with the same settings every single time. What is the best way to do it? Listen to learn more! If you’re still confused, shoot me an email if you have questions! I’m happy to help. The topic of patient selection Just because someone walks into your office doesn’t mean they're your patient. They become your patient when you examine them and create a treatment plan for them (in Texas). If your first interaction is with the patient and some red flags come up, do not move forward. You can send them another dentist and go your separate ways. But once you plan their care and present them with a treatment plan, you can only dismiss them with proper mechanisms (so you’re not “abandoning” a patient). Listen to your gut feeling. These patients are the types that sue you or file state board complaints. You may have a huge compassionate heart—but you must protect it. Don’t take on patients that you shouldn’t. Listen to the whole episode for more tips on creating a healthy work culture and a reminder of what you should be doing before administering nitrous! Resources & People Mentioned (w/Laura Diamond) Connect With Duane toothcop(at)dentalcompliance.com On On On On /episode/index/show/dentalcompliance/id/18511436

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