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Back Figure 2-4.—Daily DIRS form | Up Dental Volume 1 - Dentist training manual for military dentists | Next Figure 2-5.—Patients' Bill of Rights and Responsibilities |
to voice and document how they are treated and are
able to report any unsatisfactory or satisfactory
complaints or compliments concerning the treatment
they have received.
can be found in the Dental Treatment Record Manual
dated December 1997. This manual will eventually be
incorporated into MANMED, Chapter 6.
PATIENT CONTACT REPRESENTATIVE
In all Navy dental clinics, a patient contact
representative is appointed in writing by the
commanding officer. This persons picture is posted in
the front desk or reception area and should be visible
for all patients to see. All patient complaints or
compliments are channeled through the patient contact
representative and then up the chain of command for
action. Validated patient compliments and complaints
are incorporated into the commands annual
assessment for the Quality Assurance (QA) Program.
Follow BUMEDINST 6010.13 and your clinics
instruction for follow-up actions and reporting
instructions.
PATIENTS BILL OF RIGHTS AND
RESPONSIBILITIES
Post the Patients Bill of Rights and
Responsibilities next to the Patient Contact Repre-
sentatives picture in the reception area. Figure 2-5
illustrates the Patients Bill of Rights and
responsibilities.
PATIENT SURVEYS
Patient survey forms should also be located at the
front desk area. These forms are originated at each
clinic and ask the patients different questions
regarding their visit. These forms will also ask for any
suggestions that might improve the services provided.
Completed forms are turned into the front desk
personnel or may be placed in a suggestion box located
in the reception area. Surveys are compiled and
submitted with the commands annual assessment of
the QA Program per BUMEDINST 6010.13.
PREPARATION OF THE DENTAL
RECORD JACKET
A Dental Record Jacket, (NAVMED 6150/21-30)
should be established for every individual receiving
dental care in a Navy DTF, except when dental care is
limited to participation in a group preventive dentistry
program.
Dental records prepared for eligible
beneficiaries should be placed in the custody of the
DTF responsible for the individuals dental treatment.
The following procedures for establishing dental
records apply to all eligible beneficiaries receiving
outpatient dental care. Figure 2-6 is a sample of the
front cover of a dental record jacket (NAVMED
6150/21-30). Refer to figure 2-6 for guidance for
preparing dental records using the specific instructions
discussed next.
Use an indelible, black, felt-tip pen, black ink, or
pencil, as indicated to record all patient identifying
data sections.
Social Security Number (SSN)
The second to the last digit of the SSN is preprinted
on the dental record jacket. The preprinted digit also
matches the last digit of the form number (e.g., the
preprinted digit on NAVMED 6150/26 is a 6). The
color of the treatment record jacket corresponds to the
preprinted digit as follows:
Preprinted Digit
Jacket Color
1
Green
2
Yellow
3
Gray
4
Tan
5
Blue
6
White
7
Almond
8
Pink
9
Red
0
Orange
DENTAL TREATMENT RECORDS
An essential part of the receptionist or clerical
duties of a dental assistant is preparing and
maintaining the dental record jacket and associated
forms. Please note that the old Dental Treatment
Record (NAVMED 6150/10-19) is being replaced by
the new dental record jacket (NAVMED 6150/21-30).
Instructions for completing the NAVMED 6150/21-30
Jacket Selection and Entries
Select a prenumbered NAVMED 6150/21-30
jacket matching the second to last number of the
2-9
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