Update to Office Procedures During COVID19

The Kansas Department of Health and Environment (KDHE) and Kansas State University Pollution Prevention Institute (KSU PPI) have partnered to help dentists prepare for the upcoming compliance date of the EPA's new amalgam rule. 

More information on compliance in Kansas is available on the KSU PPI web site

*Dental offices who do not discharge to a publicly owned treatment work (POTW) with a pretreatment program must submit a one-time compliance report to the Kansas Small Business Environmental Assistance Program by October 12, 2020. 

Check here to see if your city has a pretreatment program and who you would need to contact for further information. 

The EPA requires amalgam separators to achieve at least a 95% removal efficiency. The EPA final rule on amalgam separators went into effect on July 14, 2017, and the date for compliance is July 14, 2020. 

The report can be submitted online, emailed to amalgamrule@ksu.edu,or mailed to 2323 Anderson Ave, Ste 300 in Manhattan, KS 66502.

The ADA Center for Professional Success has additional resources for dentists available at ada.org/recycleamalgam. 

Contact information for KDHE and our local EPA office is listed below.

KDHE Industrial Programs Section
Bureau of Water
Steve Caspers, Pretreatment Specialist
785-296-5551
steve.caspers@ks.gov

Environmental Protection Agency
Region 7 (KS, NE, IA, MO)
Paul Marshall, Pretreatment Specialist
913-551-7419
marshall.paul@epa.gov

Collecting payment is literally the bottom line of your practice. Developing and implementing a workable financial system is critical to ensuring that patients pay their bills promptly. While this is important for dentists at all stages of their careers, it’s especially important for new dentists who may be personally managing the financial aspects of the business rather than delegating that function to someone outside of the practice, such as an accountant.

A workable financial system should include a written financial policy, information about the financial payment options available in the practice, details on financial arrangements established in advance of treatment, and a protocol that describes the time and place to have private consultation with patients to discuss private clinical and financial matters.

Having a formal financial program and policy can be a win-win scenario for your practice and for your patients. This information can make it easier for patients to finance and receive the treatment they want and need, and you’ll be able to perform the clinical work that you enjoy with fewer headaches relating to managing accounts with open balances.

Remember to discuss your financial policy in full with each patient. It’s also helpful to have patients of record review and sign your current financial policy on a regular basis, since it’s likely that they don’t recall every form they saw or signed when they first came in for treatment.

Also, every patient should sign a treatment form, with informed consent or informed refusal where applicable. More information about informed consent/refusal is available in the Managing Patients module of the ADA’s Guidelines for Practice SuccessTM; please see the Informed Consent/Refusal article in the Policies section of that module.

Make sure your financial policy clearly expresses what payment is due at the time of service, even for cases involving routine care. You’ll also want protocols to validate patients’ eligibility, coverage and remaining benefits for the plan year for those patients who qualify for some level of coverage or reimbursement through a third-party dental benefit plan. If applicable, your policy should clearly state that any remaining deductibles and estimated copayments are payable at the time service is provided.

Financial responsibility for healthcare costs, such as dental treatment, provided to children whose parents are divorced is typically outlined in the divorce decree. Since it’s not uncommon for parents to share responsibility for taking children to these types of appointments, it’s a good idea to have the parent who is not financially responsible for any out-of-pocket dental costs to agree, in writing, that he or she will pay for care if the former spouse fails to cover those expenses.

The patient should know the full cost of treatment, including the amount he/she is responsible for after any estimated payment by their dental benefits plan.

They should also be aware of the practice’s financial policies. Once you’ve confirmed the patient understands, remind them when payment is due at the time of service and advise them of the amount that will be due on the first date of treatment.

Having a system in place and following procedures consistently will reduce the amount of staff time spent on collections. This will help avoid uncomfortable, unpleasant, and sometimes even contentious, back-and-forth conversations with patients who might question whether your fee is “really worth” the work you’re doing. Surprisingly, this happens more than you might think, even with patients who seem to share your philosophy about maintaining good oral health.

There are many options for developing a financial policy. Some practices develop their own, others work with a financial or business advisor to develop one, and others ask colleagues for suggestions and other resources. Regardless of your approach, it’s advisable to have your lawyer review your policy to ensure that it’s in compliance with any applicable federal and state laws and regulations.

Additional Resources:

• A Dentist’s Guide to the Law: 228 Things Every Dentist Should Know [ADA Catalog]
• Sample Financial Policy Statement 

In August 2019, the American Dental Association (ADA) released a statement in response to a recently published study linking maternal ingestion of fluoridated water during pregnancy to lower IQ scores in children. 

The ADA remains committed to fluoridation of public water supplies as the single most effective public health measure to help prevent tooth decay.

This commitment is shared by many national and international organizations, including the World Health Organization, US Public Health Service, the Centers for Disease Control and Prevention, the American Medical Association, and the American Academy of Pediatrics.  

Public health policy is based on a collective weight of scientific evidence. The ADA is aware of a new study conducted in Canada in which its authors reviewed maternal exposure to fluoride in pregnancy.

We welcome this and further scientific study of the issue to see if the findings can be replicated with methods that demonstrate more conclusive evidence."

Read the full news release at ada.org. 

If your patients have questions or concerns regarding community water fluoridation, helpful information for the public is available at mouthhealthy.org. 

Additional Resources:

• The American Dental Association's Fluoride and Fluoridation website
• The Centers for Disease Control and Prevention Community Water Fluoridation website
• Campaign for Dental Health

As dental offices look to store greater amounts of their practice information electronically, a reliable backup method is crucial.

The HIPAA Security Rule, which took effect in April 2003, addresses electronic protected health information (e-PHI). It established national standards to protect individuals’ e-PHI and requires the implementation of administrative, physical, and technical safeguards.

All HIPAA-covered dental practices must have a data backup plan as part of their contingency plans. The data backup plan must include “procedures to create and maintain retrievable exact copies of electronic protected health information.” A covered practice must also be able to fully restore any loss of data. It is recommended you find a service that encrypts your backup data.

Although encryption is not mandatory, it must be implemented if “after a risk assessment, the entity has determined that the specification is a reasonable and appropriate safeguard in its risk management of the confidentiality, integrity, and availability of e-PHI.” If you choose not to encrypt data, you must implement a solution that is both reasonable and appropriate.

Storing a backup offsite can help ensure that, in the event of a natural disaster (fire, tornado, flood, etc.) or theft, electronic dental records will be recoverable. Online backups with automatic incremental backups can assist with maintaining records. If a dental office needs to recover data, the process can be quick and secure and the office can resume normal operations with minimal disruption to your patients or practice.

If you are covered by HIPAA, written procedures must be in place related to your data backup and recovery plan. In addition, a covered dental practice is required to implement procedures for periodic testing and revision of contingency plans.

Penalties for failure to comply with HIPAA standards can be severe. Penalties for noncompliance penalties are based on the level of negligence and can range from $100 to $50,000 per violation (or per record), with a maximum penalty of $1.5 million per year for violations of an identical provision.

Consult with your provider and make sure that they are maintaining HIPAA-compliant standards. More information on Health Information Privacy can be found on the U.S. Department of Health & Human Services website. You can also view their security risk assessment tool.

In addition, the American Dental Association endorses The Digital Dental Record for HIPAA Compliant online back-up and patient forms created specifically for the dental practice. 

The Digital Dental Record Offers:

• DDS Safe: HIPAA compliant online back-up system that provides dental offices triple the protection of traditional online back-up products.
• Medic Talk DentForms: Software that allows patients to electronically complete their forms and capture their signature’s electronically in office.
• Other solutions include industry leading dental forms and charts - Whether you need electronic PDF forms for your website or paper forms for your office, The Digital Dental Record has it all.

ADA Member Value:
ADA Members receive 1 month FREE of DDS Safe, online data back-up, $200 off of DentForms, paperless software package, plus multiple other ADA member discounts.

Contact The Digital Dental Record at 800-243-4675 or visit dentalrecord.com. 

Have questions about dental benefits, billing, or coding? Contact the ADA's Third Party Payer Concierge!

Members get one-on-one support for your dental benefit issues, including third party payer, provider contracts, coding and dental plan issues. Email or call the ADA’s Third Party Payer Concierge™ to speak directly to an expert for advice.

• Third party payers
• Dental benefits
• Provider issues
• Coding issues
• Dental plans

Get expert advice by calling 800-621-8099 between 8:30 am – 5:00 pm CT or email your benefit questions to dentalbenefits@ada.org and your coding questions to dentalcode@ada.org.

A variety of articles and webinars are also available at ada.org/dentalbenefits.

Previous Action

On July 11, 2019, the American Dental Association announced it sent a complaint letter to the Federal Trade Commission’s Bureau of Consumer Protection, raising concerns over aspects of SmileDirect Club’s marketing and direct-to-consumer sales of plastic teeth aligners.

The letter, sent on June 27, comes about two months after the Association filed a citizen’s petition with the U.S. Food and Drug Administration, stating that SmileDirect Club is placing the public at risk by knowingly evading the FDA’s “by prescription only” restriction the agency has placed on teeth aligning materials.

“The ADA took these actions out of concern for patient safety and to enable consumers to take action when negative treatment outcomes occur,” said Dr. Jeffrey M. Cole, 2018-2019 ADA president.

“Moving teeth without knowing all aspects of a patient’s oral condition has the potential to cause the patient harm,” Dr. Cole said. “Orthodontic treatment, if not done properly, could lead to potential bone loss, lost teeth, receding gums, bite problems, jaw pain and other issues.”

In both communications the ADA sent to the FDA and FTC, the Association also underscored that SmileDirect Club requires customers to hold the company harmless from any negative consequences.

“The ADA considers it our duty on behalf of the public to make the relevant regulatory agencies aware of what’s going on so they can consider whatever actions they deem appropriate,” Dr. Cole said.

DIY dental treatments can affect the gums, bone, ligaments that support the teeth, or the teeth themselves. Depending on the oral health issue being addressed and the nature of the treatment, there may be risks for long-term issues including jaw problems, abnormal bite, tooth decay and loss, as well as gum disease. If teeth are improperly aligned, gum tissue may be impinged or stripped.

According to a 2017 survey by the American Association of Orthodontics (AAO), about 13% of its member orthodontists are seeing patients who have tried do-it-yourself teeth straightening, with some of those attempts causing irreparable damage. AAO attributes the DIY trend primarily to social media, citing YouTube tutorial videos on how to straighten one’s own teeth. The AAO found that 70% of DIY patients seen by its members who took part in the study were between the ages of 10 and 34.

Additional Resources

The FDA’s MedWatch voluntary reporting form may be used by both consumers and health care professionals to report poor clinical outcomes associated with medical devices, including plastic teeth aligners. The FTC also offers consumers an online form to report complaints about unfair and deceptive business practices on its website.

For more patient information about direct-to-consumer dentistry, visit the ADA’s consumer website MouthHealthy.org/DIYdentistry.

For dentists interested in sharing do-it-yourself dentistry stories, contact adanews@ada.org.

You and your dental staff may need to act quickly to safeguard yourselves, your patients or your community following a natural or man-made emergency. Emergencies are mainly local in nature and can result from mudslides, earthquakes, fires, hurricanes, avalanche, floods, and tornadoes, or from non‑natural incidents involving transportation accidents, power failure, gas leaks, structural collapse, detonated bombs, chemical spills, radiation release from a nuclear power station, or from bodily harm and trauma caused by workplace violence.

The basics of an Emergency Action Plan

The Occupational Safety & Health Administration (OSHA) is a federal agency that was created by Congress in 1970 to protect workers from hazards in the workplace. OSHA specifically requires employers with 11 or more employees to have a written Emergency Action Plan for individuals involved in providing fire prevention, emergency medical or evaluation assistance.  In an emergency, all personnel should know their role and where to go if shelter must be sought, as well as escape routes and shutdown procedures.  A written Emergency Action Plan according to OSHA should include (OSHA 1910 Subpart L, Fire Protection):

• An alarm system that is audible within the work environment
• Escape procedures and routes (include a map, if necessary)
• Procedures to account for all employees when evacuation is complete
• Rescue and medical duties of employees who perform them
• Identify likely hazards (hazard assessment/risk evaluation)
• How to report fires and other emergencies
• Whom to contact for more information

Update the plan at least annually and communicate changes to employees.

Other key points

• New employees should be made aware of the plan
• In general, all employees should be alerted when their duties under the plan change and whenever the plan changes overall
• The written Emergency Response Plan should document all training and review sessions, but it’s not required
• Drills and interactive training that reference the plan are a great way to teach employees about their responsibilities and what to do in actual emergencies
• After initial training, there should be periodic retraining
• Remember to check the functioning of emergency equipment according to a schedule

New York University College of Dentistry has developed an action plan for tornado disasters. The emergency preparedness documents will give you tips and advice to prepare for and recover after a disaster:

• Tornado Disaster Preparedness

The ADA has compiled the following resources for our members affected by hurricanes, tropical storms, and floods:

• Tips for Retaining and Caring for Staff after a Disaster  [PDF]
• Flood Water after a Disaster
• After a Hurricane: Key Facts about Infectious Disease [PDF]
• Mosquitoes and Hurricanes
• After the Flood: Mold Specific Resources [PDF]
• Hurricane Resources at Your Fingertips
  
• Data Backup and Recovery
• Practical Advice for Weathering Pay and Leave Issues Following a Hurricane

Emergency management is the process of preparing for, mitigating, responding to and recovering from an emergency. Take the time to keep your patients, yourself and your staff safe in the event of an emergency.

For additional information necessary training for and documentation of Emergency Preparedness, visit the OSHA publication “Principal Emergency Response and Preparedness Requirements and Guidance.”

You may also download the ADA publication, Emergency Planning and Disaster Recovery in the Dental Office.

Fraud is the misrepresentation of material facts that causes harm through deception, and can be either civil or criminal. Most cases of civil fraud are filed on behalf of someone, either a person or a business, who claims they were damaged by the purported misrepresentation. Cases of criminal fraud are usually brought by local, state, or federal prosecutors who believe they have sufficient evidence to prove the misrepresentation occurred, was intentional, and was committed for material gain.

For example, in dentistry, a charge of fraud, either civil or criminal, can be brought against a dentist who signs off on notes in a patient’s record that inaccurately claim procedures that weren’t performed. The best way to prevent this from happening is to carefully review and confirm the information in each patient’s chart before signing off on it.

Fraud can also be committed against the practice itself by unscrupulous staff. While you may believe you can trust your staff and that you’ve hired or inherited honest employees, ultimately it’s up to you to be sure that all financial aspects of your practice are accurate and current. Taking preventive steps to keep fraud out of your office is also preferable to discovering it and having to resolve it.

It’s a good idea to establish and maintain hiring practices that include screenings, references, and background checks for each member of your team. The time it takes is worth it. Every prospective employee, even relatives, should complete an employment application.

Fraud can take the form of theft of money, drugs and/or supplies, skimming the payroll, padding expense reimbursements, embezzlement, submitting false claims, etc. An internal compliance program can help a dental practice defend a claim that arises out of an inadvertent error or employee misconduct.

One way to safeguard your accounts is to have one employee process only accounts payable and another process only accounts receivable, with neither involved in the other side of the money trail. Allowing one person to handle both functions makes it easier for them to juggle the books and hide the details of any money they’ve siphoned from the practice. 

Your practice should have a professional and up-to-date employee manual that clearly details staff duties and office policies and procedures.

That resource should also clearly explain the possible consequences of not following established protocols. For more information on hiring and training dental staff, read the Guidelines for Practice Success™ module on Managing the Dental Team.

If an unscrupulous staff member commits fraud against a government program like Medicaid, a dental practice with a compliance program in place will be better able to defend itself.

The U.S. Department of Health and Human Services Office of Inspector General (OIG) provides the following PDF titled Health Care Compliance Program Tips. 

The Seven Fundamental Elements of an Effective Compliance Program:

1. Implementing written policies, procedures and standards of conduct.
2. Designating a compliance officer and compliance committee.
3. Conducting effective training and education.
4. Developing effective lines of communication.
5. Conducting internal monitoring and auditing.
6. Enforcing standards through well-publicized disciplinary guidelines.
7. Responding promptly to detected offenses and undertaking corrective action.

More information is available through the hyperlink to the OIG Compliance Program for Individual and Small Group Physician Practices.

Additional Resources

• The ADA Guide to Protecting Your Dental Practice From Fraud
  
• The ADA Practical Guide to Leading and Managing the Dental Team [ADA Catalog] 
• The ADA Practical Guide to Creating and Updating an Employee Policy Manual [ADA Catalog] 
• Dos and Don’ts If You Suspect Fraud 
• The ADA Guide to Protecting Your Dental Practice From Fraud [ADA Catalog]

Studies have shown that patients with a dental plan are much more likely to seek dental care and accept treatment plans.

Under such a plan, the patient pays the doctor or dental office a fixed amount of money on a monthly or annual basis. In return, the patient generally receives preventive services at no charge, with other procedures offered at a discounted fee.

The ADA Council on Dental Benefit Programs has developed a toolkit to help dental practices evaluate whether an in-office dental plan option is right for them.

An on-demand webinar, "Increase Value in your Practice! How? Start your own Dental Plan," is also available to help dentists gain a basic understanding of how in-office dental plans work, how to create a plan for your office, and the advantages/risks of implementing a plan.

Learn more in the Decoding Dental Benefits segment from the ADA News.

On April 16, 2018, the Centers for Medicare and Medicaid Services (CMS) published a final rule that revises Medicare Advantage program (Part C) regulations and Prescription Drug Benefit program (Part D) regulations, and implements certain provisions of the Comprehensive Addiction and Recovery Act.

Among other things, the new rule rescinds a proposal that would have required dentists who provide dental care and prescriptions for Medicare Advantage patients and Part D beneficiaries to be enrolled in Medicare, or to have opted out in order for their services to be covered.

More information about the rule is available in the ADA News and on the ADA's Facts and FAQs on Medicare page.

Additional questions may be directed to the American Dental Association at dentalbenefits@ada.org.

Despite sharing your philosophy about the value of maintaining good oral health, patients can still fall behind on their payments.

If your staff reports that collecting fees is requiring more time or becoming more difficult, make it a point to review your internal financial policies and protocols as well as the written information you give patients about those policies. It could be time to update or even rewrite those documents so patients fully understand their responsibility for paying for services prior to, or at the time of, treatment. While you’re doing that, also make sure your financial policy accurately details the procedures staff should follow when collecting fees from overdue accounts for treatment already provided, including complete documentation of any patient promises to pay the balance.

If you accept assignment of benefit from patients with some type of dental benefit coverage, make sure you collect the anticipated amount that the patient is responsible for at the time of service.

Don’t wait to collect the private pay portion of the bill until after the third-party payment has been received. Try to make it a standard operating procedure that you receive payment of benefits from any third-party dental benefit administrators within 7-10 days of submitting the claim. All claims should be paid, with funds deposited, within 30 days. Submitting your claims electronically will greatly help in reducing the payment cycle.

Sometimes, there might be a balance due from patients after you receive the payment of benefit, even though patients have paid their estimated portion of the bill at the time of service. When that happens, immediately send the patient a statement indicating the balance due. If this happens frequently, consider amending your financial policy to have patients sign a pre-authorization form that allows you to charge their credit card for any balance due after receiving payment from a third-party.

Practices that store patients’ credit card information should comply with the Payment Card Industry Data Security Standard (PCI DSS). It requires maintenance of a secure environment, including data encryption, firewalls, anti-virus protection, as well as other requirements.

A dental practice that does not comply may be subject to financial penalties and be vulnerable to payment card data breaches.

Dental practices that accept credit and debit cards should review their credit card service provider agreements and review their network security requirements for their individual situations.

Generally speaking, the best way to manage accounts receivable is to issue and mail weekly statements to all patients with balances on their accounts; this would include those who have a balance due following payment of a dental benefit. Each statement should include a due date. Past due statements should include a tactful message letting the patient know that his or her account is in arrears.

Accounts that are more than 30 days past due require extra attention. In these cases, the best approach is to have your financial coordinator, business administrator or office manager contact the patient by phone to request payment. No one likes to make – or receive – this type of call. But this approach usually works well because patients are talking with someone they’ve met and connected with in real life. One of the ways to make this phone call more successful is to be pro-active. Inform the patient who is establishing a payment plan how you handle the balance in the event that the expected payment does not arrive as planned. Let the patient know that a phone call will be made five days after payment is due.

Ideally, these types of calls should be made by someone who has had communications training and is familiar with federal and state collections laws. That person also should have the skills to balance a friendly and concerned demeanor with a commitment to resolving the situation. This isn’t as easy as it sounds. There needs to be kindness and courteousness, blended with a firmness that accomplishes the collection.

Even when you choose the right team member for the task, that person still needs time and resources to perform these important duties effectively. Make sure your collections person is able to make these calls in a private setting so the conversation isn’t overheard by other patients or staff. Also make certain that team members has enough time to make calls, prepare and mail any follow-up letters, and document the effort. Consider providing this staff member with training, such as a CE course, video or webinar that is specific to successful collections.

Never let accounts with outstanding balances become dormant. If you haven’t been able to collect a payment after mailing a statement and making a friendly phone call, you’ll need to try other approaches. Some practices find it helpful to send a series of collection letters which, while friendly and professional in tone, escalate in intensity the longer the past due amount remains unpaid. Issue these letters on a predetermined schedule, such as every two to three weeks. Follow up on the initial statement and reminder phone call with a reminder notice. After that move to a negotiation process and then a final letter detailing what steps you will take in order to receive payment. Again, make sure every communication is professional and nonjudgmental. Each should simply be a dated, factual recounting of the collection process with notation as needed.

While you might be tempted to hire a collection agency or file a complaint in small claims court, consider the possible ramifications of either action. Never make these types of decisions in haste or in anger and never threaten action you might not be willing to take. Keep in mind that suing a patient or sending an account to a collection agency could become a public relations nightmare that could tarnish your practice’s image and hurt your reputation in the community (also consider, for example, the possibility of an aggrieved patient disparaging your practice on social media).

Consider all of the costs, including legal fees and time away from the practice for court appearances; it could be in the end that it’s better to write-off the debt and then terminate your professional relationship with that patient. Each state has its own rules regarding patient dismissals so refer to your state’s dental practice act and consider consulting a knowledgeable attorney in your jurisdiction before taking that action. More information on dismissing patients is available in the GPSTM module on “Managing Patients,” please see the article titled “Dismissal” in the Patient Relations section.

Be aware that collection efforts by the office might result in a patient seeking refuge from paying behind a license complaint to the state licensing agency. The start of an investigation tends to focus the dentist’s attention on the defense of his or her license and away from collecting monies due. All patient records should be impeccable and able to withstand scrutiny.

In many cases, it’s possible that this type of situation could have been avoided if the appropriate policies were in place and properly communicated. While developing and abiding by a financial policy can be time-consuming, it’s an investment worth making up front. Make sure that the practice abides by all appropriate state and federal collection laws, such as the Federal Trade Commission’s Fair Debt Collections Act, which prohibits the use of specified abusive, harassing, and unfair practices in the collection of debts.

Additional Resources:

• Sample Telephone Scripts Notifying Patients of Past Due Accounts
• Sample Letter to Collect Patient Balance Due 30 Days 
• Sample Letter to Collect When the Dental Benefit Carrier Did Not Pay
• Sample Letter to Contact Delinquent Payers
• Sample Letter to Dismiss a Patient for Nonpayment of Fees
• Dismissal, ADA GPSTM on “Managing Patients,” Patient Relations
• The ADA Practical Guide to Dental Letters: Write, Blog and Email Your Way to Success
• Tips to Safeguard Your Practice from Computer Hackers, ADA Center for Professional Success
• Federal Trade Commission’s Fair Debt Collection Practices Act
• Payment Card Industry Data Security Standard (PCI DSS)

In February 2016, the Hollywood Presbyterian Medical Center in Los Angeles was forced offline after cybercriminals shut down their computer system with ransomware. Hospital staff members have said that the system was hacked and being held for a ransom of $3.6 million.

Employees were unable to gain access to some documents, patient data, and emails. Staff was instead relying on pens and paper to keep track of work. The LA Times reported they eventually paid $17,000 in ransom. 

Ransomware is aptly named. It is a type of software that prevents access to a computer system by encrypting that system’s data files.  The system owner is asked to pay a ransom to retrieve the encryption key that will remove the lock.  Often the hacker states there is a limit on the amount of time to pay the ransom.  After the time expires, the encryption key is no longer available. 

HIPAA requires providers to maintain access to health records, in addition to protecting data from breaches. The HIPAA Security Rule is designed to protect the confidentiality, integrity, and availability of health information.

Because ransomware is designed to deny access to data, there could be HIPAA implications for a dentist office that falls victim to it.

There are multiple defenses against ransomware. Training your staff on basic data security can help reduce the chances of your staff being susceptible to attacks that will arrive via email and other methods.

Additional ways to protect your office:

• Backup your data regularly and keep a copy off-site: Backing up your data regularly and keeping a secured copy offsite can help protect you from ransomware, and would also be useful in the case of a disaster like fire or flood.
• Be wary of email attachments: Opening attachments or clicking on web links from unknown sources is what many hackers are relying on to infiltrate your system. If you are not absolutely sure of the sender or the attachment, don’t open it. Better safe than sorry.
• Maintain your cyber defenses: Make sure your anti-virus and anti-malware software is updated on a daily basis. Apply software patches for operating system, browser, and browser add-ins like Flash and Java as soon as they are available.

Read more "Tips to Safeguard your Practice from Hackers."

In addition, the American Dental Association endorses The Digital Dental Record for HIPAA Compliant online back-up and patient forms created specifically for the dental practice. 

The Digital Dental Record Offers:

• DDS Safe: HIPAA compliant online back-up system that provides dental offices triple the protection of traditional online back-up products.
• Medic Talk DentForms: Software that allows patients to electronically complete their forms and capture their signature’s electronically in office.
• Other solutions include industry leading dental forms and charts - Whether you need electronic PDF forms for your website or paper forms for your office, The Digital Dental Record has it all.

ADA Member Value:
ADA Members receive 1 month FREE of DDS Safe, online data back-up, $200 off of DentForms, paperless software package, plus multiple other ADA member discounts.

Contact The Digital Dental Record at 800-243-4675 or visit dentalrecord.com. 

Radiation has been a hot topic among KDA members over the past year, due to increased dental office inspections and new requirements regarding handheld X-ray units that took effect on September 1, 2019. 

In an effort to help our members, the KDA sat down with representatives from the Kansas Department of Health and Environment (KDHE) Radiation Control Program to discuss ways we could better inform dentists of the responsibilities in their dental offices, pertaining to radiation.

If you have questions about radiation regulations or an inspection, contact the KDHE Radiation Control Program at 785-296-1560 or kdhe.xray@ks.gov.

Regulations on Handheld X-Ray Devices

Effective September 1, 2019, KDHE will ​enforce regulations that ban the use of handheld X-ray units without proper protection and a waiver granted by KDHE.

Kansas Radiation Protection Regulations may be found at kdheks.gov/radiation. 

Any manufacturer or vendor who wishes to sell handheld X-ray units in Kansas must apply for and be granted a waiver. In addition, each individual X-ray facility wishing to possess and use a handheld X-ray unit must apply for their own waiver and be approved by KDHE before the unit is used to image patients.

Click the link below to view the full information notice from KDHE.

Information Notice 2019-01 Handheld Dental X-ray Units

KDHE is aware there are several handheld dental X-ray units are the market. These are the four (4) handheld dental X-ray units that have requested and been granted a waiver to be sold and used in Kansas:

• KaVo Nomad Pro
• KaVo Nomad Pro 2
• Digital Doc, LLC XTG MiniX-S
• Maxray Cocoon

If the purchase of a handheld dental X-ray unit is being considered by your facility, please contact the KDHE Radiation Control Program at 785-296-1560 or kdhe.xray@ks.gov to determine if the device is in compliance with state regulations and obtain information on the process to obtain a waiver for use of these units in your facility. 

Click the link below to download the Request for Handheld X-ray Waiver.

KDHE RH-92 Handheld Dental Unit Waiver

Dental Office Inspections

One suggestion from our members was to help dentists understand what inspectors are looking for when they evaluate an office.

KDHE was able to provide the KDA with a list of the “noncompliance” issues most commonly found in dental offices over the course of the last several years.

The list does not include everything they inspect; however, it will give dentists a good sense of what areas of their office to assess prior to KDHE inspectors showing up.

Click the links below to download the noncompliance lists.

2016 Dental Noncompliance List
2017 Dental Noncompliance List

If your office uses x-ray equipment, you are responsible for knowing and following KDHE Radiation regulations.

We understand that reading regulations and statutes is confusing and sifting through 178 pages of regulations to find those that pertain to dentistry is tedious and time consuming. Therefore, KDHE staff has combed through all radiation regulations and created a regulatory document that pertains to dental offices.

Click the link below to download this document.

2018 Dental Regulations and Explanations

What's taxable in your dental practice? The KDA sat down with representatives from the Kansas Department of Revenue to find an answer to this question. 

Sales Tax and Compensating Use Tax Handouts

• Sales Tax for Dental Industry
• Sales Tax and Compensating Use Tax
• Exemption Certificates

If you or your staff have any additional questions after reviewing these materials, please contact Kansas Department of Revenue Tax Specialist, Carl York, at carl.york@ks.gov or 785-296-1048.