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Page Title: PATIENT CONTACT REPRESENTATIVE
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Figure 2-4.—Daily DIRS form
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Dental Volume 1 - Dentist training manual for military dentists
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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 person’s 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   command’s   annual assessment  for  the  Quality  Assurance  (QA)  Program. Follow  BUMEDINST  6010.13  and  your  clinic’s 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- sentative’s  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 command’s 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 individual’s 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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