The XLDent Suite is a completely mobile dental software system designed for the Tablet PC and wireless technology. This allows for flexibility in the delivery of patient care while enabling doctors and staff members to create an interactive patient experience. Developed with the latest software design methodologies, the suite features a robust, easy-to-use practice management system with a customizable patient screen, a dental appointment scheduler, a post-treatment screen, dental reports and patient history.

 XLChart is designed to leave no doubts about chart accuracy. Post a tooth code and everything related to the procedure will be documented.

 ImageXL integrates with most x-ray and camera systems, enabling clinicians to choose current and future technologies.

 Charts can be found on your wireless mobile PC, which means no more missing or lost paper charts. The paperless XLCheckIn eliminates scanning and shredding.

Fewer screens and clicks make the software easy for everyone in the office to use.

 Other suite products include XLTeach, XLNotify, XLHold, XLMobile, XLPortal, XLTimeclock, XLBackup and XLCharge. 

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The XLDent software suite in your practice

Recently the New York Times reported that President Obama is threatening to strip the insurance industries’ exemption to the antitrust laws because the insurance industry is using “deceptive and dishonest” advertisements to derail his health insurance reform. At the same time, the Senate Judiciary Committee is conducting hearings on the antitrust exemption for insurance companies. Senate Bill S.1681 has been introduced in the Senate to prevent insurance industry price fixing, bid rigging and market allocation. 

Trusts and monopolies are concentrations of wealth in the hands of a few. Trusts and monopolies are considered harmful restraints of trade which alter normal marketplace competition, and yield undesirable price controls. To prevent trusts from creating restraints on trade or commerce and reducing competition, Congress passed the Sherman Antitrust Act in 1890.

Many dentists, physicians and other health care professionals believe insurance companies have been treated more favorably under the antitrust laws. The reason for the alleged better treatment is the insurance industry has an exemption from the antitrust laws whereas dentists, physicians and other health care professionals do not enjoy any such exemption. Thus, certain activities that may be considered anticompetitive undertaken by dentists, physicians and other healthcare professionals would subject them to prosecution. At the present time similar activities by insurance companies, because of their insurance exemption, would not subject them to prosecution.

The exemption for insurance companies is found in legislation known as the McCarran-Ferguson Act. This provided that the federal antitrust laws will apply to the “business of insurance” only to the extent that such business of insurance is not regulated by state law…” The Act further provides that the “business of insurance and every person engaged therein shall be subject to the laws of the several states which relate to the regulation or taxation of such business.”

This language was clearly intended to preserve the extensive state regulation of the insurance industry, and consequently, exempt the insurance companies from federal antitrust laws. The “business of insurance” has been the subject of many court decisions including decisions by the United States Supreme Court. The Supreme Court has observed that the “business of insurance” should include the following: whether the practice has the effect of transferring or spreading a policyholder’s risk, whether the practice is an inherent part of the policy relationship between the policyholder and the insured and that the practice is limited to the insurance industry.

As a result, if the practice fell within this definition it was exempt from the antitrust laws. This means that except for certain egregious acts such as boycotts and intimidation, the insurance companies have enjoyed a robust exemption to the antitrust laws.

Because few businesses have an exemption to antitrust laws, Congress bills have been introduced almost every year to eliminate the insurance exemption. Year after year, the lobbyists for the insurance industry have defeated this legislation. However, at the present time, the Democrats in Congress along with the President may be able to overcome the lobbyists to eliminate insurance company exemption. If eliminated, there may be more competition within the insurance industry that in turn could level the playing field between the insurance companies and dentists, physicians and other healthcare professionals.  
	
	

Peter M. Sfikas was formerly the general counsel of the American Dental Association, and is a Fellow of the American College of Trial Lawyers. He practices law in Chicago and serves as the general counsel of the Chicago Dental Society. He has written, taught and lectured on dental law issues. If you have any comments or questions about the article he can be contacted at 

What dentists need to know about insurance exemption

An associate or hygienist you’ve worked with for years has decided to leave the practice, and not on the best of terms. This colleague may feel slighted or angry for one reason or another, and will use those negative feelings to justify trying to convince your patients to leave as well. This colleague may not even feel any animosity toward you or the practice, but still might feel entitled to the patients you’ve both worked with for years.

Patient stealing doesn’t happen everyday, but as a practice owner, you need to know how to protect yourself so it doesn’t happen to you.

“People tend to not think clearly sometimes,” said 

. “They can justify all sorts of things that aren’t right if they’re in a desperate situation and think it will help their pocket book.”

Although there’s no guarantee they’ll honor it, it’s a good idea to have associates-including hygienists, dental assistants, office managers and financial coordinators-sign an agreement indicating they understand the 

 belong to the practice and they cannot try to take them when they leave, Limoli said. Make sure they understand there will be consequences if the patient list is shared or transferred to another party. Let them know on the front end that they shouldn’t even think about it. A local attorney should be able to help you outline this agreement.

Making sure your team members are happy is also key to making sure they don’t want to steal from you when they leave, said 

. Most people leave because they’re not happy with the leadership, and that’s a role you have to take seriously in your practice.

“You need to be close to your people, close to your team,” Spiel said. “You have to know where their hearts are and be able to address issues that come up.”

Associate dentists typically sign noncompetes, Spiel said. Most dentists honor this and set up new practices outside the boundaries of the noncompete when a relationship ends and use billboards and other means of advertising to draw patients to their new practice. But Spiel said he has one client who opted to go against his noncompete agreement and thinks he’s getting around it by having his staff make the phone calls. In reality that doesn’t matter, Spiel said, and no matter how he tries to paint it, this doctor has compromised his integrity and the practice’s integrity.

“It’s a sad situation because it impacts every other decision that’s made in the practice,” Spiel said. “If you’re willing to compromise that type of clear agreement, how willing are you to compromise things that aren’t nearly as clear?”

If someone works with your software everyday, it wouldn’t be difficult for that person to grab a USB flash drive, make a backup of your practice database and then walk out the door with it, Limoli said. You have to keep your system as locked down and secure as possible so this doesn’t happen; don’t authorize every user to make back ups. Make sure only you and your office manager have access to certain reports. Don’t give everyone the ability to delete patients.

“It’s very easy,” Limoli said. “I could walk into a practice, run a patient report, take it with me and get on the phone and call patients for whatever reason I wanted. If I’ve been with a practice and I want more money, but the doctor says no and another dentist who is desperate for a hygienist says he’ll give it to me, how tempted would I be to get that list and call all those patients I’ve been treating for years?”

Also be cautious of team members who can log into the system at home, Limoli said. Make sure you limit what they can do; don’t give them the ability to transfer files or make changes.

If a patient mentions someone who used to be with the practice called and tried to lure him or her away, don’t use this as an opportunity to bad mouth the person who made the phone call, Limoli said. Thank the patient for telling you and for staying loyal to the practice. Write that patient’s name down. Keep a list of all the patients whose records you’ve sent to that hygienist’s or former associate’s new practice.

If you had a good relationship with this former employee or associate, Limoli said to go ahead and give him or her a call. Remind this colleague of the signed agreement and that making these calls is wrong.

If there are only a few patients on your list, Spiel said making a call to confront the person who is trying to harm your practice might help, but for the most part your best course of action is getting legal counsel right away. You can also write a stern letter asking the offender to cease and desist.

“If there’s a pattern, they’re clearly doing it under ill will,” Spiel said. “And it’s a sad place to be in. It’s really a situation that isn’t a fun place to be, but unfortunately what I’ve seen is the only effective way to deal with it is to pursue using legal resources.”

Your front staff will eventually get a call from patients who have decided to stay loyal to a person rather than the practice. Whoever answers your phones should be aware of the situation and know how to handle such a call. It might even be a good idea to give them a call yourself to thank them for being a patient with your practice and to let them know they’re welcome to come back whenever they’d like.

“You certainly don’t want to complain over the phone about that associate or hygienist who’s left,” Spiel said. “You thank them and express your gratitude for their loyalty to you and your practice and how you value them. Don’t go into details with them.”

The hygienist is the one team member your patients see the most. Good hygienists, over the years, establish relationships with their patients and often become like extended family members, Limoli said. These are the hygienists patients request for each visit, the ones who know their children’s names and birthdays. If you have a hygienist like this who’s been with you for 15 years and then decides it’s time to move on, there’s a good chance some patients will follow.

Patients also can develop feelings of loyalty for associates who have been with a practice for awhile. To avoid this, patients need to meet and actually have relationships with more than one associate, Spiel said. Each dentist in the practice should have the opportunity to develop a relationship with each patient.

“It’s also how the front desk and receptionist treats the patient. It’s the entire team,” Spiel said. “Everybody is involved in treating patients with exceptional care and warmth. If everyone achieves that uniformly, if one person leaves the chances patients will follow are slim. They’ll be loyal to the practice, not just one individual.”

Renee Knight is a senior editor for DPR. Contact her at rknight@advanstar.com.

dentalproductsreport.com-2009-11-01

The XLDent software suite in your practice

What dentists need to know about insurance exemption

Could former staff steal your patients?