Recommended Dental Clinic Reporting to Administration

Recommended Dental Clinic Reporting to Administration

Month: ______Clinic: ______

This form is an example of what a dental program might report to administration. It is a recommended format; however, dental clinic chiefs are encouraged to speak with their health directors to see what information they want. Where appropriate, I have listed the source of the information.

Clinical Workload:

1.  Number of dentist days for the current reporting month (compared with previous reporting month in parenthesis): Appointment schedule

2.  Number of dental hygienist days in the current month (previous month): Appointment schedule

3.  Total provider days, current month (previous month): Appointment schedule

4.  Number of patient visits, current month (previous month): 0000 + 0190 codes

a.  Scheduled patients, current month (previous month): 0000 + 0190 – 9170 or 0140

b.  Walk-in/emergency patients, current month (previous month): 9170 or 0140

c.  Broken appointment rate, current month (previous month): 9130/0000+0190+9130-0140 or 9170

5.  Number of procedures performed, current month (previous month): DANN or RDIR

6.  Number of relative value units produced, current month (previous month): DANN or RDIR

GPRA:

1.  Number of dental sealants applied, current month (previous month): 1351, SCOM

2.  Number of patients receiving topical fluorides, current month (previous month): 1203,1204, 1206, SCOM

3.  Progress toward meeting GPRA goals – what percent have you met annual goals, where should you be From ADO GPRA Report

Cost of Care Issues:

1.  Total CHS referrals made, current month (previous month): From your CHS clerk

2.  Total CHS referrals approved, current month (previous month): From your CHS clerk

3.  Total dental expenditures for the month (previous month):

a.  Dental lab fees

b.  Dental supplies

c.  Salaries (dentist and hygienist)

d.  Other

4.  Total dental collections for the month (previous month):

a.  Billed From your AR department

b.  Collected From your AR department

5.  Net profit/loss for the month (previous month):

Quality of Care Issues:

1.  Quality Improvement Projects during the month

2.  Results of previous QI projects from previous month

3.  Patient complaints and resolution

4.  Any other issues