News |5 min read

Is It Time to Take Action?

Real-World Insights by AADOM author - Denise Ciardello

I have a secret to share with you! There is something of great importance that as a dental office manager you may have overlooked.

We call it the GTS Playbook. A process manual or protocol book, this handbook tells your employees exactly how you expect things to be done every single time.

Many people scoff at the idea of needing it written down with the excuse, “We all do it perfectly every time.” Kudos to you! However, we have recently discovered the reason to have it written down.

Would you pass an audit?

We received a call from one of our clients that was going through an audit from a major insurance company. The representative came through the office and not only audited their patient charts, but also their OSHA & HIPAA binders. Before leaving, he asked to see their policy & procedure manual.

WHAT? Is that a requirement?

Apparently, it’s in the contract the office signed with this company. Lack of a written protocol manual could allow the rep to levy a fine against the office.

Fortunately for this office, theirs met the rep’s scrutiny perfectly. Would yours?

Creating a protocol manual

Now that I have your attention, let’s discuss how to create or update your policy & procedure manual. This is comprehensive, which means it won’t happen overnight. Ideally, the entire team will participate in creating the manual so it can be as accurate as possible.

A protocol manual is the guide for a manager or owner to fall back on in the event of operational questions.

It can also be a great source for a new employee to learn how this office “answers the phone”, “handles insurance processing” or “prepares for a crown prep”. It’s all in the book. You want to include everything that is to be done every single time.

Consistency is the name of the game.

How to document employee responsibilities

We suggest employees reflect on their individual responsibilities and document exactly how they go about completing their tasks. These may include, but are not limited to:


• Set up trays for all the procedures completed in the office
• Take pictures of the set-up
• Label each item on the tray
• Document the steps the doctor takes throughout the procedure

If there is more than one doctor, this may need to be completed for each doctor; but only if the steps taken are significantly different.

Another option is to list: “Dr. A does this…”, “Dr. B does this…”.


For the Prophy appointment:
• List each step taken during the appointment
• Opening questions: medical history, dental behaviors, personal habits, etc.
• X-rays taken
• How often is probing completed?

The clinical team can often look at the clinical notes to fill in the ‘how’ details.


• What financial policies are offered to patients?
• What is said during the financial conversation?
• How do you balance the end of day?


• What is included with specific insurance claims (crowns, root canals, etc)?
• When are outstanding claims tracked by the dental benefits coordinator?

Anything worth doing is worth doing right. This means being detailed and specific without being too wordy. It’s all about the ‘HOW’ rather than the ‘WHY.’

Additionally, confidential information should never be included in this community manual. Passwords, account numbers, PINs and such should be locked away in a private area.

Helpful tips

A few points to consider as you work on this project:

1. Walk through the process as though you were teaching it to someone for the first time. Write down every step along the way. Once you have completed the entire process, review it step-by-step to see if it makes sense to you. Finally, give it to someone who does not complete these tasks on a regular basis and see if they can follow the steps.

2. As you are listing the steps within the task, refer to the position of the person completing the task, not the person’s name. For instance: “The assistant will escort the patient to the treatment coordinator’s desk” (as opposed to “Becky will escort the patient to Mary’s desk”).

All protocols that you believe are the heartbeat of your practice should be included in this manual. Email to receive a copy of a list of major protocols.

If this seems too overwhelming, remember we recommend that everyone take responsibility for the tasks that they perform on a daily basis.

Use your downtime

Many hands make light work! It should not be something that interferes with daily operations of the office. A protocol can be created during downtime.

This is a project and cannot be completed overnight. However, it is valuable for cross-training and maintaining systems within the office. This manual is a living, breathing document that is to be changed whenever the process changes.

If you find that you need help getting started, give me a call.

Headshot of author Denise CiardelloMeet the Author

Denise Ciardello always knew she wanted to be an entrepreneur, and today she is Co-Founder of Global Team Solutions (GTS), a practice management consulting firm.

Denise is a professional speaker and published author who brings experience, insight, creativity, and a sense of humor to her consulting. She has served as president of ADMC and is a member of the National Speakers Association, Toastmasters International and Dental Speakers Bureau.

She can be reached at



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