Notes: Dentrix Enterprise North East Users Group Meeting
From the meeting on August 18, 2011, taken by Greg Gibson
Attendance at NYU ::
Michelle Herter, Children’s Dental Associates, New London, CT
Gloria Regan, Children’s Dental Associates, New London, CT
Donna Bunnell, Dedham Dental Associates, Dedham, MA
Donna Brock, Dental Associates, Newtown, CT
Barbara Quinell, Dental Associates, New Milford, CT
Philip Artenberg DDS, Institute for Family Health, Kingston, NY
Paula Hinners, Institute for Family Health, New Paltz, NY
Amy Latch, Institute for Family Health, Kingston, NY
Clara Ruiz, Institute for Family Health, New Paltz, NY
Greg Gibson, New Haven Dental Group, New Haven, CT
Ken Fauerbach, NYU, New York, NY
Ira Beresnoy, NYU, New York, NY
Tykieyen Moore, NYU, New York, NY
Barbara Thompson, NYU, New York, NY
Jeff Fahnoe, UPenn
My Voice & PST Requests
MyVoice is an on line forum. Users of Dentrix Enterprise can make requests here for new features to the software. There is also a voting system. We did a run through on MyVoice and then showed the new forum for PST requests. PST requests will follow the old format. They will be sent to Dentrix first. Dentrix will then post them into this new PST forum for comment on by other users. Clients of Dentrix Enterprise can then team up to share the cost of a PST request.
Electronic Forms and Insurance claim payment imports
NYU has requested that Dentrix Enterprise add the ability to import payments from insurance 835 remittances, specifically from a file of medicade payments that New York State sends back to NYU. A similar request has been made to import a data file of patient payments (not insurance payments, but rather guarantor payments) that might come back from a bank lockbox service.
Dentrix is adding to Enterprise, at no cost to the user base, the ability to import claim payments that flow back through e-claims. Dentrix is still planning to have their clients pay a fee for the ability to import a data file of payment information whether that file holds data regarding state medicade / medicare payments, the file is from a private insurance company, or the file is from a bank lockbox service.
Update cycle for Dentrix Enterprise
It was proposed that software updates to Dentrix Enterprise occur twice per calendar year. After some discussion, everyone agreed that this would work. We discussed other companies, like Patient Now that do many small updates to their software almost monthly or every other month. These upgrades are done remotely by Patient Now. Clinics at the meeting were a little leery of this method but for the fact that these updates are generally very small, so they are easy to get used to quickly.
Testing upgrades / Dentrix Enterprise in the cloud
The issue of testing upgrades to Dentrix Enterprise and the QA process was brought up. We agreed that an easier way to test an upgraded database would be to do so “in the cloud”. We think that this would increase participation in beta testing and would make QA easier and faster to do for Enterprise clients. It was noted that better, more complete documentation of what has changed in an update would be appreciated and would also help to “role out” newer versions of Dentrix Enterprise more quickly, even in a test environment.
Several clinics agreed that searching in the appointment book could be improved. Searching in the appointment book is done by clinic or view and operates over the operatories clicked off. Searching for appointment could be improved by:
· Allowing for a link between provider and operatory, such that searching for a provider, shows only open appointments in a particular operatory or group of operatories used by that specific provider.
· Allowing for searches that involve appointments across multiple clinics
· Allowing views to show operatories in different clinics
· Allowing for searches that are specialized for family needs which may include
- An appointment with a hygienist followed by one with a dentist
- Two appointments with hygienists at the same time
Orthodontic enhancements to Enterprise
A couple of clinics suggested that using an add on feature of Dolphin Imaging called the “Orthodontic Treatment Card” might serve as a solution for clinics feeling that Dentrix Enterprise needs to do more for Orthodontics. This is an inexpensive add on module of Dolphin.
In addition to this it was noted that another filter option could be added to the chart to only show orthodontic procedures; D8XXX. The chart already has a bunch of check boxes to filter items, so this is seen as only a minor change to the software.
Filtering the ledger and chart
Many clinics think that if the ledger had more information, that patient billing calls could be handled more efficiently. At the meeting, the follow improvements to the ledger were discussed:
· Rows can be filtered:
by date range, by tooth, by provider, by clinic,
by procedure code or by a range of procedure codes
· Add column(s) for aggregate payments, aggregate credits and balance remaining to each procedure row. Possibly add a column for any deductible owed.
· Users can choose what columns to have the ledger display from the proc_log table fields
· All columns, like amount, can be sorted by double clicking on the label of that column
· Users can hide certain information, like special adjustments, regular adjustments, primary payments, and secondary payments
Almost universally, clinics miss the functionality of “show transaction links” and everyone wants it back. In response to this, the group discussed having an automatic “show transaction links” feature. When clicking on rows in the ledger with a procedure, or on a row with claim information like primary sent, primary received etc., all other procedures and claim data rows attached to it would highlight automatically. It was suggested that for performance reasons this might not always be wanted. Each user should therefore be able to set this feature to always be on, to always be off or to ask the user each time a different patient is called up. The “show transaction links” menu option should do this when the automatic feature to do so is turned off.
We discussed moving the adjustments on the bills up from the bottom so that they are in the section for each patient and next to the insurance payment to which they are attached.
Upgrading to Newer Versions of Dentrix Enterprise
Clinics updating to version 5 :
Clinics updating to version 5 should be aware that there is a “back-date transaction” right that is turned off for all users by default.
Regarding security, a proposed enhancement request is to change how new security rights are handled during upgrades, so that each clinic can choose when and how to deal with security changes during an upgrade.
· Allow clinics to set new security rights as fully permissive or least permissive.
(This might help clinics in test mode because the first test upgrade could be done
in a fully permissive mode.)
· For new security rights allow clinics to set a default for all users of either on or off.
· Have a “group permissions” system, so that default permissions for “groups” of employees can be set and managed. For instance, a group for “assistants” rights could be created, the security set for that group and then all the assistants could be put into that group.
Clinics updating to version 6 :
In version 6 all access to any patient by any employee is recorded, but this feature can be turned off. If this feature is left on, it is important that the IT department is aware that the database will grow much more quickly than it has in the past. It was suggested at this meeting to make an enhancement request to separate the audit logs into a separate database instance. Among other improvements, this would make restoring the database from tape or disk after a crash much faster.
Version 6 now has multipage support in the document center for .pdf files and maybe for .tiff files. I do not think .jpg files can be multipage, so therefore it is unlike the document center supports multipage .jpg files.
Also in version 6, there is a virtual printer driver which allows Dentrix users to store any document that can be printed to paper directly in a specific patient’s document center area.
We discussed the need for an indicator in the ledger that alerts the user to the fact that there is a document stored in the ledger. As document center is used more, some users feel that this indicator will always be “on” because most patients will have a document stored. It was therefore suggested that an indicator could light up if there is NOT a document in the document center, or that the latest document in the document center is older than some time frame. A possible use of this indicator light would be to alert staff to scan the latest insurance card into the document center.
There is a new feature in 6.0 that allows scheduling events in the appointment book such as the closing of an Operatory. We think there is already a security right to limit the staff that can change these events and if not then we should submit this as an enhancement request.
A question was asked about a HIPAA requirement to make looking at audit logs easier and how can this be done? The feeling is that the audit log reports are too cumbersome to be printed and reviewed routinely and that this is an area of Dentrix Enterprise that could be improved.
The following discussion was left open for another meeting :: Do any clinics need the ability to change history? Is the invalidate flag enough? Can historical items be changed? In core there was a utility called dxhist. The invalidate f