87 episodes

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.

Talking with the Toothcop Duane Tinker

    • Business
    • 5.0 • 8 Ratings

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.

    MCS Infection Control Solutions - Paul Saueressig

    MCS Infection Control Solutions - Paul Saueressig

    Without question, the Covid pandemic had a large impact on the healthcare field. It highlighted monstrous changes that needed to occur in the infection control space. MCS put its resources into investigating standards of care in infection control. 
    MCS came out with some new technologies that will transform the world of infection control. Paul Saueressig outlines the solutions they’ve created and how they can benefit your dental practice in this episode of Talking with the Toothcop. Do NOT miss this one!
    Outline of This Episode [2:12] Learn more about MCS Infection Control Solutions [8:01] Solution #1: Protective Coating Solutions [15:03] Solution #2: Rapid Testing Solutions [26:08] Two options for healthcare facilities [35:53] The problem with Healthcare-Associated Infections (HAIs) [39:56] Providing long-term proactive solutions for the healthcare space [41:09] How to get more information about MCS infection control solutions Resources & People Mentioned MCS Paul Saueressig Hygiena Connect With Duane https://www.dentalcompliance.com/ toothcop(at)dentalcompliance.com On Facebook On Twitter On LinkedIn On Youtube

    • 45 min
    How the No Surprises Act Impacts Dentists - Laura Diamond

    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 toolkit for you to help you implement this in your practice. 
    Why does any of this matter? If there is a difference of more than $400 between your GFE and billed charges, the patient can initiate a billing dispute that the HHS can investigate. Those decisions are reviewed by a third-party contractor. If the decision doesn’t go in your favor, you can lose out on legitimately earned fees. Secondly, this may become like HIPAA. A complaint may lead to your practice being audited and civil monitoring down the road. 
    Outline of This Episode [1:23] The Federal No Surprises Act  [3:35] What you have to do [7:03] When did this become effective?  [8:04] Why does any of this matter? [9:52] Where this falls in order of operations [11:00] Q&A session with Laura  [17:49] How to connect with Laura [19:46] Important compliance reminders OUR SPONSORS:  ProEdge Dental Water Labs: https://ProEdgeDental.com/Toothcop 
    Protective Dental: https://DentalCompliance.com/DrugKit
    Resources & People Mentioned The No Surprises Act implementation guide and toolkit Connect with Laura by email: ldiamond(at)dsedlaw.com Connect With Duane https://www.dentalcompliance.com/ toothcop(at)dentalcompliance.com On Facebook On Twitter On LinkedIn On Youtube

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

    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

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

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

    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 c

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

    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 https://dentalcompliance.com/drugkit or call them at 888-878-8916 and tell them that the Toothcop sent you! The Pro Edge Water team - www.ProEdgeDental.com/Toothcop (affiliate) Michigan Dentist busted by the DEA Self Disclosure Protocols renamed CIA's are back! The Justice Department's criminal fraud page “We don’t rise to the level of our expectations, we fall to the level of our training.”
    “Don’t practice until you get it right, practice until you can’t get it wrong.”
    “Most people never run far enough on their first wind to find out they have a second wind.”
    Connect With Duane https://www.dentalcompliance.com/ toothcop(at)dentalcompliance.com On Facebook On Twitter On LinkedIn On Youtube

    • 34 min
    An Important Announcement from the Toothcop

    An Important Announcement from the Toothcop

    I started the Talking with the Toothcop podcast in December 2017. Andrea has been with me since early 2019. We love doing this podcast together. Sadly, it’s time for us to hit the pause button. We will be back—I promise! But we have a lot on our plates right now and it makes sense to pull back temporarily. If this podcast has been rewarding and educational for you professionally, take some time and go back to listen to our episode archive! 
    Outline of This Episode [0:22] What’s happening in our lives! [4:18] Check out ProEdge Dental [7:01] Sharing some bittersweet news [9:07] Learn more about protectIt dental  Past podcast episodes to check out! Check out some of our most popular and episodes packed with need-to-know information: 
    Dental Unit Waterlines: the Good, the Bad, and the UGLY (with Mike Rust + Kellie Thimmes The 7 Elements of Dental Compliance Programs How a Compliance Program can Save Your Bacon Sedation Inspections + EPCS + Continuing Education The Importance of Sterilization Processes - Stephen Kovach We’re always here to answer questions, so don’t be afraid to reach out. Until we return, subscribe to our email list! 
    Resources & People Mentioned Check out ProEdge Dental at https://proedgedental.com/toothcop!  Learn more about protectIt dental at https://dentalcompliance.com/drugkit or call them at 888-878-8916 and tell them that the Toothcop sent you! Connect With Duane https://www.dentalcompliance.com/ toothcop(at)dentalcompliance.com On Facebook On Twitter On LinkedIn On Youtube

    • 11 min

Customer Reviews

5.0 out of 5
8 Ratings

8 Ratings

Dental Compliance Nerd ,

Thank you!

I appreciate your podcasts and information so much. You and your guests are informative and I learn so much. Compliance is my passion, and i take every course available, although I am still working chair side as an RDH. Thanks for increasing awareness of all of us dental peeps out there. You all are my spirit animal!

The original DA Rockstar ,

DA Rockstars loves Talking with the ToothCop🤩

I recently met Duane in person at the Voices of Dentistry and was floored with his extensive knowledge in so many things practice related. I have learned so much already probably because I’ve been binge listening for the last two days! This podcast is a must listen for every member of the dental team. Keep up the great work and thank you so much for this podcast.

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