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Schedule Sections:

All School of Dentistry Records | Clinic Operations | Curriculum | Clinic Financial Records

Accounting Reports from Outside Vendors

Accounting reports produced for the School of Dentistry by outside agencies, such as ProData, Strand, etc. May include Accounts Receivable, Aging Reports, Delinquent Accounts Report, Production Reports, etc.

Official Copy: Clinical Services: Accounting and Patient Accounts Office
Retention: 6 years after end of calendar year
Disposition: Shred

Other Copy: Any Clinic
Retention: Destroy when no longer needed
Disposition Method: Shred

Clinic Appointment Calendars

Provides record of patient appointments. May now be found in CMS (or current database).

Official Copy: Any Clinic 
Retention: 6 years after end of calendar year
Disposition Method Shred

Clinic Schedules

Tracks student and faculty assignment to individual clinics and provides clinic coverage information. May act as attendance record of students assigned to the clinic.

Official Copy: Any Clinic
Retention: Until end of quarter
Disposition Method: Shred

Continuing Dental Education Course Files

Provides a record of each continuing dental education course. May include course outline, income received for course, registrant list, credits awarded, advertisements for course, course evaluation, development files, contract with instructor, and financial statistics.

Official Copy: Continuing Dental Education
Retention: 7 years after end of calendar year
Disposition Method: Transfer to Archives for review

Other Copy: Any Clinic offering a continuing dental education course
Retention: 3 years after end of calendar year
Disposition Method: Shred

Daily Script Journal

An auditable summary of prescriptions filed each day, listed by drug and by prescribing doctor. Signed by the day's attending pharmacist. Maintained as per RCW 69.41.042.

Official Copy: Any Clinic
Retention: 6 years after end of calendar year
Disposition Method: Shred

Gold Slips and Logs

Provides record of gold inventory and amount of gold used in dental procedures. May include Gold Log, which includes student name, patient name, date and amount of gold used in procedure.

Official Copy: Any Clinic
Retention: 6 years after end of fiscal year
Disposition Method: Shred

Insurance Billing Records

 A record of all requests for payment submitted to Medicaid, DSHS, or insurance companies. May include copies of applicable patient chart notes, procedure coding sheets, patient bill, etc.

Official Copy: Clinical Services: Accounting and Patient Accounts Office - Explanation of Benefits
Retention: 6 years after end of month
Disposition Method: Shred

Official Copy: Any Clinic receiving insurance payments
Retention: 6 years after end of fiscal year
Disposition Method: Shred

Patient Billing Records

A record of patient charges. Used to generate patient billing for individual payment. May include copies of applicable patient chart notes, procedure coding sheets, patient bill, etc.

Official Copy: CMS Management
Retention: 6 years after end of fiscal year
Disposition Method: Shred

Official Copy: Pre-CMS- Any Office that mailed its own billing information
Retention: 6 years after end of fiscal year
Disposition Method: Shred

Patient Charts

Provides complete documentation of examination, diagnosis and treatment for each patient receiving dental care including: periodontal, orthodontal, oral surgery, endodontic treatment, or procedures such as dental implants which require long term tracking. Charts may include: Chart Routing Record, X-Rays logs, Admitting Record, Dental Insurance Questionnaire, Problem and Treatment Lists and Plans, Progress Notes/Treatment Record (UW-D-3), Health History Questionnaire, Fees Statement, Request for Radiographic Examination, etc.

Official Copy: Clinical Services: Patient Records
Retention: 30 years after last contact
Disposition Method: Shred

Other Copy: Any Dental Clinic sending patient charts to Clinical Services: Patient Records
Retention: Send to Clinical Services: Patient Records after last contact

Patient Payment Records

Provides a record of payment and adjustments for dental services. May include insurance statement, billing statement, photocopies of payment checks, credit card slips, write-off authorizations, etc. with all the backup attached to payments posted "batch."

Official Copy: Clinical Services: Accounting and Patient Accounts Office - Cashier Checkout Reports
Retention: 6 years after end of month
Disposition Method: Shred

Official Copy: Any Clinic posting a payment received directly from a patient
Retention: 6 years after end of fiscal year
Disposition Method: Shred

Patient Screening Records-- Not Accepted

Provides a record of questionnaires or preliminary screening examinations of patients not accepted for admittance to a clinic. May include Admitting Report, Health History Questionnaire, and Progress Notes. Screening records of accepted patients become part of Patient Chart.

Official Copy: Any Clinic
Retention: 1 year after patient not accepted
Disposition Method: Shred

Prescription Records

Provides record of each dispensed x-ray, prescription drug, set of dentures, etc. Includes Daily Script Journal.  Maintained as per RCW 69.41.042.

Official Copy: Any Clinic
Retention: 6 years after end of calendar year
Disposition Method: Shred

Official Copy: Restorative Dentistry and Prosthodontics- Lab Work Request Form
Retention: 6 years after end of calendar year
Disposition Method: Shred

Refunds

A record of refunds made for overpayment by dental patients or insurance companies.

Official Copy: Clinical Services: Accounting and Patient Accounts Office
Retention: 6 years after end of fiscal year
Disposition Method: Shred

Official Copy: Any Clinic requesting patient funds
Retention: 6 years after end of fiscal year
Disposition Method: Shred

Request for Radiographic Examination

This form is a request for an x-ray to be performed on a patient.

Official Copy: Any Clinic
Retention:File in Patient Chart once the x-ray is taken

Treatment Contracts

Contract outlining the treatment plan between the patient and clinician. Includes correspondence regarding treatment, payment plans, any notes, and all amendments to the contract.

Official Copy: Any Clinic
Retention: 6 years after termination of contract
Disposition Method: Shred