New Dentists FAQs

So, you just started your first job as a new dentist and, while you know your stuff, you have just a few questions about practice management. Well, here are some answers!

How long should I keep clinical records?

You should keep active patient records forever. There are several reasons to maintain a patient’s clinical record:

• For clinical use. Continuity of care requires that a dentist have access to a patient’s record, sometimes even after the patient leaves the practice.
• For legal reasons. Patients have a right to obtain a copy (not the original) of their records.
• For malpractice defense. A dentist’s records are a vital part of their defense should a patient bring a claim of malpractice or a Board complaint.

For inactive patients, we generally recommend keeping clinical records for adult patients for 10 years past the date you last saw the patient. Your state has a statute of limitations defining the timeframe in which a patient has the right to bring a claim. In general, a patient has two to three years after the care has been rendered to bring a claim. However, some circumstances may act to lengthen the statutory limits, such as a claim that the alleged negligence was not discovered until much later.

For minors, we recommend keeping records for either 10 years or until 3 years after the patient reaches the age of majority (18), whichever time period is longer. The statute of limitations does not begin to run until the minor has reached the age of majority.

I have a patient posting bad reviews on social media sites. What do I do?

It is always unsettling when patients post bad reviews on social media sites, but it’s important to deal with the issue correctly. A specific response about the complaint could potentially result in divulging information that would be subject to a HIPAA claim about confidentiality. It is a good idea to respond, but you can do it in a way that reflects well on you and your office.

We suggest something like, “Because of privacy regulations, we can’t discuss any specifics about your comments. However, we are committed to providing high quality care, and we take your feedback very seriously. Please contact our office directly. We are happy to discuss additional details to resolve this matter with you.”

I received a credit dispute on payments by credit card company. How do I handle that without violating HIPAA?

First, review the office financial policy or contract with the requesting entity for their legal right to information. If need be, the office may require the entity to provide an authorization signed by the patient. HIPAA allows doctors to disclose protected health information as necessary to obtain payment for health care and does not limit to whom such a disclosure may be made.

What is said next depends upon the specifics of complaint. Services were charged that weren’t delivered? Services delivered that were not authorized? Services were quoted at a lower figure and charged at a higher figure? Dentist did not apply an adjustment that was promised?

Once the credit card company has the authorization to discuss the facts, you should be prepared to explain the circumstances of how the charges were incurred. It can be important to show that the patient accepted the treatment plan, the services were delivered within the standard of care, that consent was obtained without guarantee of any specific success or longevity, and, if applicable, a change in conditions or outside trauma affected the treatment and changed the plan. You can show invoices and receipts, any agreements the patient signed, and any documented customer service interactions (e.g., emails or texts), among other proof.

You do have a duty to keep the disclosed health information to a minimum, so share only what you need to prove that the transaction was authorized by the cardholder and the goods or services were delivered.