American Dental Association

Managing Patients: The Patient Experience Guidelines for Pratctice Success


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an implant. My name is Jane. May I have your name?”

      Patient: “Ms. Doe.”

      Front Desk Staff: “Thank you, Ms. Doe. The fee for an implant will vary from $________ to $________ based on your specific needs and the materials used. We understand that many patients are concerned about cost. May I schedule a consultation for you to meet Dr Cook and have her examine you and take any necessary X-rays? Once we have that information, we can provide you with a specific fee for your treatment. We are happy to do this at no charge! When would you like to come in? I can fit you in today at ________.”

      image USE THIS LANGUAGE IF THE CALLER EXPRESSES CONCERN ABOUT FEES:

      Patient: “The fees are so high.”

      Front Desk Staff: “Thank you for sharing your feelings. In [practice name], we are proud to provide the best dental care we possibly can. The fees are based on the materials used, the time, skill and advanced technology used to provide you with the level of care you can expect from Dr. Cook and her staff.”

      Or

      Front Desk Staff: “Dental treatment is an investment in your health. Perhaps I can assist you. We have several payment options available; may I review them with you to see which would works best for you?”

      Or

      Front Desk Staff: “Is it possible for you to stop in today or one day this week? We’d like to schedule an initial appointment so the doctor can assess your oral health needs and develop a customized treatment plan that fits your specific needs. We can discuss treatment costs once we know what your needs are. At the same time, we can review ways for you to fit the treatment you need in your budget. In the meantime, do you have any questions about the practice that I can answer briefly over the phone?”

      image USE THIS LANGUAGE TO SCHEDULE APPOINTMENTS FOR PATIENTS OF RECORD:

      Patient: “Good morning, Susie. It’s Ms. Doe. I’d like to schedule an appointment.”

      Front Desk Staff: “Hello, Ms. Doe. How are you? How can I help you today?”

      • For longstanding patients who honor regular appointments, respond to their request for an appointment with “Let me try to get you in as soon as possible.” And work to get them into the practice as soon as the schedule allows.

      • For patients of record who frequently cancel or miss appointments, respond with “I will try to get you in as soon as possible. The next available opening is [insert a date and time convenient to the office]. Are you available then?” Once they’re scheduled, respond with “We’ll contact you with a reminder of the appointment [insert timeframe]. We look forward to seeing you.”

      image USE THIS LANGUAGE TO END CALLS:

      Front Desk Staff: “Thank you for calling us today, [insert name]. We’ll see you [restate appointment date and time and the reason for the appointment]. Have a great day!”

      FOR OFFICE USE ONLY:

      Date:___________________________________________________________________________________

      Patient name: ______________________________________________________________________________

      Parent or legal guardian’s name: _______________________________________________________________

      Address:__________________________________________________________________________________

      Email: ____________________________________________________________________________________

      Cell phone: ___________________ Home phone: _________________ Work phone: __________________

      Contact Preference:image Cellimage Textimage Home phoneimage Work phoneimage Email

      How did you hear about our office?

      image Referralimage Websiteimage Signageimage Couponimage Other: _________________________________

      Referral Source: ____________________________________________________________________________

      Are you experiencing any dental problems or have any dental concerns?

      image Pain? Where?_______________________image Constant?image Occasional?

      image Swelling?Where?________________________

      Are you under the care of a physician?image Yesimage No

      When was your last dental visit?_____________________ Are x-rays available? ______________________

      Name of previous dentist: __________________________ Phone number: ___________________________

      Address: __________________________________________________________________________________

      Do you have a dental benefit plan?image Yes image No

      If Yes:

      Member ID number: _______________________________Group number: ___________________________

      Name of policy holder: ______________________________________________________________________

      Policy holder’s relationship to the patient: ______________________________________________________

      Date of birth:______________________________________________________________________________

      Policy holder’s employer: ____________________________________________________________________

      Insurance company: _______________________________________________________________________

      Address: __________________________________________________________________________________

      Phone number and/or insurance company website: _____________________________________________

      Scheduled appointment date: ________________________________________________________________

      Verification