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Dental Consultant Advice: HIPAA

Dental Consultant Advice: HIPAA

Welcome to the first in an ongoing series on HIPAA compliance for dental practices. As many of you know, HIPAA rules and regulations have completely changed the ways that dental offices need to operate. There are a number of problems, however.

First and foremost, the sheer volume and complexity of the rules can be overwhelming. There are literally hundreds and hundreds of pages of rules, many of them well beyond what a dentist can achieve. Related to this, there are unfortunately a number of companies and sales reps whose sole focus is to sell products and services, quite often based on a perceived need which isn't factually correct.

The goal of this series is to educate dental offices on the main rules, what exactly they require, and how offices can achieve compliance without spending a fortune to get there. For this first article, I wanted to review the main components of the HIPAA rules, so that practices are at least aware of the "view from above".

While HIPAA can be overwhelming, it's important to understand that the concepts behind the creation of the rules actually make a lot of sense. Patients are entrusting dentists with very private information, such as health history, social security numbers, and credit card numbers. As such, they have a reasonable right to expect that dental practices will keep that information private and secure. That's really the gist of what HIPAA is all about. The problem, of course, is exactly how that mandate has been implemented. More than half of all HIPAA rules are administrative in nature, things such as risk assessments, policies and procedure manuals, incident reports, etc.

There are two components to the HIPAA rules. The privacy rule was finalized in the year 2000 and while it does include some rules related to electronic information, it applies to many other aspects of a dental practice, such as handling of paper charts, what information is discussed around other patients, and what information can be disclosed to third parties. The Security Rule, conversely, only applies to electronic Protected Health Information (ePHI). If your IT people have been talking to you about encryption, antivirus software, and firewalls, then that's because they are trying to get you compliant with the Security rule.

There have been two other major updates to the HIPAA rules. The HITECH Act was passed in 2009 and it set up a tier of fines and penalties for non-compliance to these rules. These rules were then made final with the Omnibus Rules, which gave further clarification to the penalties. Of all the penalties out there, the most damaging one is the Breach Notification rule, which in my opinion could easily cause a practice to go out of business immediately.

In the next article, we will look at the need for a contingency plan, what exactly it says, and how easy it is for dentists to develop a HIPAA compliant disaster recovery system.

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There is the good, the bad and the ugly of dental practice management, but many dentists will still tell you the probability is your dental consulting will work if you and your consultant are on the same page. It stands to reason that if a dental consultant had little value, worth or benefit that consultant could not stand up to harsh economic realities for long.  A veteran dental consultant is also a "personal coach" who shold bring management wisdom based on "in the trenches" experience along with systems and protocols to that have been successfully implemented in other practices. Top dental consultants talk and network with each other. They pay attention to what systems work and don't across many dental practices. 


New Patient Phone Call

Insurance Processing

New Patient Experience and Patient Education

Financial Arrangements



Unscheduled Treatment 


Daily and Weekly Checklists

General Policy Manual 

Staff Accountability

What gets monitored, gets managed. It is as simple as that. The only way to monitor what gets done is with daily stats especially for your weak areas. For example, one employee should be specifically responsible for calls to patients who are unscheduled, overdue for re-care or need reactivation. Other staff can and should help in coordination with the accountable employee.


What most practice owners are lack in knowledge is not how to book an appointment, but rather how to be an effective leader. The best systems in the world are useless if the staff do not comply. Good leaders know how to get staff to willingly follow through and comply. 

Questions To Ask 

  1. Do you and/or your staff have to travel or does the consultant come to you?

  2. Is the program mostly one on one consulting versus seminars or courses with multiple clients in attendance?There are advantages to both.

  3. If the dental consulting is one on one who will actually deliver the consulting? I recommend knowing who your specific dental consultant will be prior to signing on the dotted line.

  4. Is program based on a specific dental practice management system? You want to avoid cookie-cutter programs. Ensure the program will be tailor-made to fit your practice's specific needs.

  5. The cost (including travel expenses and downtime) is certainly not the only factor, everything else being equal, it is still a major factor to consider. It's unwise to pay too much, but it's worse to pay too little.  


Top Dental Practice Mangement Consultant

Shane Blake DDS Coudersport, PA

My name is Kevin Tighe. Consultant. Coach. Mentor.

My mission is to advise, recommend and help implement proven systems to grow your practice . 

Before joining the Cambridge team I was in charge of setting up workshops for large nonprofits throughout the United States and Canada. During that time, I was fortunate to receive mentoring from several world-class business consultants, including a dental practice management guru, which led to a position at Cambridge as their seminar organizer. In time, I began crisscrossing the country delivering seminars myself for the better part of a decade. Subsequently, I moved up to senior consultant and eventually partner and now sole owner. 


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