Clinical audits can play a critical role in ensuring the success of a dental practice, according to Barry Lyon, DDS.
Dr. Lyon, a chief dental officer for the division of orthodontics and pediatric dentistry for Dental Care Alliance, recently spoke with Becker's about the benefits of performing clinical audits.
Editor's note: This Q&A is part of a weekly series featuring Dr. Lyon focused on topics in the dental industry and DSO field. This response was lightly edited for clarity and length.
Dr. Barry Lyon: Performing clinical audits for a dental practice can be tedious and time consuming, but the effort is clearly worthwhile.
Audits serve a great purpose. They tell a practice owner what is working well clinically and what is not. It helps demonstrate ethical practices and can provide a sound defense in the event the dentist is asked to handover charts to an insurance company or a regulatory agency. Insurance companies perform utilization audits, and it is essential that dental practices perform their own audits to confirm the practice’s doctors are using clinically sound and indicated procedures. Often, dental offices are the subject of "random" audits, but are they really random? Dental practices are closely monitored for significant changes in the volume of claim submissions for those codes that are often misused.
Audits are performed by DSOs to monitor clinical quality performed by their doctors and to ensure that compliance standards are being met. Clinical due diligence, by way of chart audits, is an essential part of the practice affiliation process. Further, the audit results of recent grads and newly hired dentists can identify potential problems early and help determine if further training is warranted.
Audit criteria should include anything that could expose the dentist to malpractice, reveal over-utilization of certain insurance codes or expose the practice to HIPAA violations. Dentists should strive to perform audits before an outside organization decides to do it themselves. It’s the old saying, "an ounce of prevention is worth a pound of cure." In the case of a dental practice and the owner dentist’s license, it’s worth a ton of cure.