Illinois State Rules of the Practice of Dentistry

Rules for the Practice of Dentistry in the state of Illinois

Dental patient record retention Illinois

I bought into my practice about 4 years ago and recently took over the storage of the practice’s paper charts; from my partner’s basement to mine.  They are elevated but flood damage is not an impossible scenario (neither is fire).  I suppose some people may keep them in professional storage.
Before having to carry the hundred or so boxes I decided to brush up on the rules regulating how long charts were kept.  Going purely of memory I knew it was 10 years but something different for minors.  I checked the ADA and they have a very thorough document on dental records   I called ISDS because ADA stated states regulate.
So the Dental practice act requires 10 years from last treatment (no different for minor or adult)
The malpractice act requires 4 years for discovery past 18 (in other words until they turn 22).  So if you treated a 2 year old just once you keep that one for 20 years.

ADA says that must be kept certain number years after adulthood of state so 18 in Illinois.

Even though we are totally digital,  I still have to keep all these records for 10 years and the minors for almost 22 years.

What can you charge for dental records in Illinois?

In 2016 it is $26.77 for handling and .50 per digital page or $1.00 for paper.  Each x-ray is a page.  Fee drops after page 25.  Have 30 days from time of written request, which can be email.  If can’t get in 30 then need to send letter explaining why and then have up to 61 days.

Email for Pam

In Illinois these rights are outlined in the Code of Civil Procedure 735 ILCS 5/ Art VIII Part 20. Inspection of Records. Basically the Code states:

1.      A practitioner (which includes a dentist) must provide copies of records upon a written request by the patient

2.      The practitioner has 30 days to produce the information once the request is received.  If for some reason the practitioner cannot produce them in 30 days, he/she must provide a written reason why they cannot provide the information within the 30 days and has up to a total of 60 days from the original request date to get the patient their copy.

3.      The practitioner must keep the original and can provide only copies of the record which includes but not limited to the diagnosis, treatment, prognosis, history, charts, pictures and plates, kept in connection with the treatment of such patient.

4.      The practitioner can charge a duplication fee which is set by the Illinois State Comptroller’s Office. It is adjusted every January. http://illinoiscomptroller.gov/agencies/statutorily-required-reporting/copying-fees-adjustments/

 

5.      A practitioner cannot refuse to release records if the patient has a  balance on services.  This is a billing issue and must be addressed as such. However, the practitioner can hold the records until the duplication fee is paid.

 

Inspection of Records

 

Rules from Illinois Practice Act

Free examinations or x-rays means visit must be free.

(4) Advertise or offer gifts as an inducement to
    
secure
dental patronage. Dentists may advertise or offer free examinations or
free dental services; it shall be unlawful, however, for any dentist to
charge a fee to any new patient for any dental service provided at the
time that such free examination or free dental services are provided.

How many dental hygienists can a dentist have working for him/her at one time?

4 – Answer is in Section 23

 14. Permitting more than 4 dental hygienists to be
    
employed under his or her supervision at any one time.

Dental Insurance issues that a dentist cares about

Collection of dental insurance issues I have seen come up and see asked again and again.

Is it legal to waive co-pays?

Well that depends. Never for government programs like Medicaid. My opinion is that it legal as long as you follow some of the rules. Here is a great dentaltown thread on the exact same question.

In network

You can waive the co-pay but you need to notify the carrier. Delta considers, emphasis on Delta considers, it fraud if do not notify the carrier that you do not attempt to collect co-pay. However, if you are in network it is likely against your contract so there would probably be some contractual issue. If the contract is silent on the issue then a waiver is permissible according to CDA.

Out of network

Do not advertise that you waive co-pays. Jason Wood’s opinion seems to be that OON can do what they want. Probably best practice to just put it in the remarks section.

 

Chris with ISDS says the Feds would consider ant fee not charged or waived to be unfair business practice. That consistency would be important in that as well. The Office of Inspector General can investigate anything they want at any time. So technically everyone should be charged same fee at all times no matter what. That means no senior citizen discount or professional courtesy to other doctors. This doesn’t sound right to me but may be technically accurate. He did say that he is not aware of any practice ever having an issue with this though.

 

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