Clinic Encounter Form Monitoring and Compliance Policy
University of Texas Dental Branch - Houston
December 14, 2000

The Dental Branch clinic Encounter Form is a vital patient accounting and student activity/performance document. The form is generated by Patient Services from the CIS at patient check-in. This document describes policy, monitoring and compliance with the return of Encounter Forms to Patient Services for patients seen in all in-house Dental Branch clinics.

All Encounter Forms must be completed and turned in to a Patient Services Reception Desk the same day they are generated.

Monitoring

Encounter Forms are electronically monitored by the CIS. Patient Services will review the CIS Encounter Form Report daily to identify missing forms. A Patient Services staff member will contact appropriate students, faculty, and staff to recover missing forms and to obtain information to complete forms which are incomplete.

1. Dental and Dental Hygiene Students

Dental and dental hygiene students who fail to return an Encounter Form the same day the form is generated, or return an incomplete form the same day, will be given a grade of "one" (1) by the Associate Dean for Clinical Education or designee on the "Clinical Evaluation" portion of the form. If, however, the Encounter Form is turned in on time but is incomplete due to faculty unavailability, the student will not receive any reduction in grade or credit. In this circumstance, the student must write the faculty member’s name/I.D. # and "unavailable" in the "Comments" section of the form. (Note: A list of faculty names and I.D. #’s is posted in clinical hallways.)

On the 15^th of each month or first business day following the 15^th if a weekend/holiday, Patient Services will identify all students with missing/incomplete Encounter Forms. Any dental or dental hygiene student whose name appears on the report will be blocked from clinic until all forms are accounted for. Students who have outstanding Encounter Forms at the beginning of new semesters will also be blocked from clinic, and graduating students will not be cleared for graduation if any of the student’s Encounter Forms are unaccounted for.

Forms that are returned incomplete due to "faculty unavailability" will be logged by Patient Services and reported to the Associate Dean of Patient Care and appropriate Department Chairperson on a regular basis.

2. Dental residents

Each graduate program will designate a staff member who is responsible for:

1. ensuring that all Encounter Forms for the program are accounted for and submitted to Patient Services on a daily basis.
2. assisting Patient Services with locating program’s missing Encounter Forms.
3. completing program’s "incomplete" Encounter Forms that are returned to programs from Patient Services due to missing information.

Compliance reports will be provided to programs on a regular basis. Residents who are habitual offenders are subject to suspension from clinic by the Associate Dean for Patient Care.

3. Clinical Faculty

On an occurrence basis, individual faculty members will be notified by Patient Services of any student forms returned incomplete and/or marked as "faculty unavailable". Faculty are required to correct and/or complete forms in a timely fashion and return to Patient Services. Similarly, faculty will be notified of missing forms for patients treated by the faculty member. Periodically, Patient Services will report incomplete and missing Encounter Form activity by faculty to clinical department chairs and Associate Dean for Patient Care.

 

Approved:                                                                                   Date:

John A. Valenza, D.D.S., Associate Dean, Patient Care

Approved:                                                                                   Date:

Ronald Johnson, D.D.S., Dean