Frequently Asked Questions

Have a question about a pressing risk management issue? Our experienced Risk Management analysts have answers. From treating minors to retaining patient records to employee leaves of absence, chances are, your question has been asked before. The following is a list of frequently asked questions, along with practical solutions, that can help you avoid liability within your practice.

I have many patients who come to my office for emergencies, but go to other offices or less-expensive clinics for routine work and hygiene maintenance. Is there any liability in me treating these patients?

Patient Care

Dental patients may go to different general dentists for various reasons, including lack of adequate insurance or geographic convenience. You may experience problems when you agree to treat patients who only present on an emergency basis, but who actually consider another general dentist to be their primary care provider. As the “emergency” general dentist you may be treating the more difficult procedures, but are unable to ensure continuity of care, proper diagnoses, treatment and maintenance.

As the “secondary” general dentist, you may have more of a liability exposure than does the dentist who is only performing maintenance treatment for these same shared patients, as you may be performing the more complex treatment. Good communication between the dentist and patient and between the two treating dentists is essential to combat this problem. Explaining to the patient the importance of continuous care with one practitioner may go a long way to putting an end to the problem. If the situation continues, consider asking the patient to choose who will be his or her primary dentist.

If a minor patient’s parents are divorced but both have dental insurance, whose insurance covers the child first?

Treating Minors

If two or more plans cover a child of divorced or separated parents, benefits for the child are determined in this order: 1. The plan of the parent with custody of the child. When parents have joint legal custody, the parent whose birthday is earlier in the calendar year has primary coverage. 2. The plan of the spouse of the parent with custody, if that parent is remarried. 3. The plan of the parent not having custody of the child. However, if a court decree designates financial responsibility for the child’s healthcare expenses to only one of the parents, that parent’s plan determines the benefits before any other plan.

If we were to implement an alternative work week, how would we go about this and what forms do I need?

Employment

With an alternative work week schedule, there are guidelines that must be followed. In California, these include, but are not limited to, identifying employees affected by the schedule, an office vote, a written work week schedule and submitting the required documents to the Department of Industrial Relations, Division of Labor Statistics and Research within 30 days of the election. For California members, the California Dental Association has a valuable resource with additional information.

Many children walk to my office after school or their parents drop them off for their appointments. Should I be concerned about treating minors when their parents are not present?

Treating Minors

Ideally, parents or guardians should accompany their minor children to their dental appointments. However, this may not always be possible. The minor’s parent or guardian must at least accompany the patient to the initial appointment and go through an informed consent discussion about the diagnosis and treatment plan, including regular hygiene visits. At that time, written authorization can be obtained from the parent or guardian for future ongoing treatment, as discussed. However, if the treatment changes from what was covered in the informed consent discussion or complications arise, another informed consent discussion and authorization must take place with the parent or guardian before treating the minor. If you do not have a signed authorization, we recommended that you do not render any treatment. Document all conversations with the responsible adult and any consents, verbal or written, in the patient’s record. Understand that should you treat minor patients without their parent or guardian present, you are the responsible party for the minor from the time of treatment to the minor’s final destination (school, home, etc.).

One of my patients recently had hip replacement surgery. Do I have to pre-medicate him before treatment?

Patient Care

In all cases, it is best to consult with the patient’s physician as to whether pre-medication is indicated for your patient. TDIC has developed a Medical Clearance for Dental Treatment form you may use to obtain physician input specific to treatment recommendations. Document the physician’s recommendations and how you proceeded.

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The suggestions provided represent experience and opinions of TDIC. There are no guarantees that any particular idea or suggestion will work in every situation. The ideas and suggestions contained in this document are not legal opinion and should not be relied upon as a substitute for legal advice. For legal advice specific to your practice, you must consult an attorney. 
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