Understanding Dismissal Statuses vs. Dismissed Patients

When a patient no longer requires treatment - whether they have completed care, declined treatment, or transferred to another practice- it’s important to update their chart accurately to reflect their current relationship with your practice.

In Tops, this involves two related but separate concepts:

1. Treatment Status (why the patient is no longer in treatment)
2. Dismissed Patient (archiving the patient record)

Step 1: Update the Patient’s Treatment Status

When a patient is no longer continuing treatment, update their Treatment Status accordingly:

• 13 - Tx Suspended Used when treatment is suspended (Oral Hygiene, non payment, etc.)
• 15 – Transferred Out Used when a patient moves or transfers care to another orthodontic practice.
• 16 – Dismissed Indefinitely Used when a patient has completed treatment (including retainer checks) and is considered finished.
• 17 – Tx Declined Used when a patient rejects the treatment plan and will not begin treatment.

The statuses listed above may be considered as a type of dismissal from your practice.

Step 2: Add a Dismissal Reason (Optional but Recommended)

When using a dismissal-type status, you can further document why the patient was dismissed by adding a Dismissal Reason, such as:

• Fee too high
• Scheduling conflicts
• Location too far
• No Patient Follow-up

Tops Tip: Dismissal Reasons can be customized in Tops Ortho>Practice Set-up>Labels

About the Dismissal Date

When a Dismissal Reason is entered, Tops automatically populates a Dismissal Date if one does not already exist.

The Dismissal Date typically represents:

• The date you were notified the patient would not continue treatment, or
• The date the patient stopped responding or following up

Step 3: Dismiss (Archive) the Patient Record

After updating the Treatment Status, the typical next step is to check the Dismissed box in the patient’s chart. Before doing so, it is recommended to review the chart to ensure all items have been addressed:

• Does the patient have an outstanding balance?
• Is there a future appointment or recall scheduled?
• Has all required documentation been added?
• Have all open claims been updated to a Closed, Voided or Paid status?

Marking a patient’s chart as Dismissed indicates the patient is no longer considered current. This action archives the patient and removes them from current-patient reporting.

Tops does not automatically dismiss patients; this step must be completed manually by the practice.

A dismissed patient (an archived patient) can still be searched using View>Patient Info (Command-I) and will continue to appear on financial reports, including reports that identify outstanding account balances, such as the Accounts Receivable report.

Why a Patient May Not Stay Dismissed

If a patient has:

• A future appointment, or
• A future recall

Tops will automatically uncheck the Dismissed box during system rollover.

Tops does not allow a patient to be archived while a future appointment or recall exists. As long as there is a future touchpoint, the patient is still considered current.

Clean-Up Tip: Finding Current Patients with Dismissed Statuses

You can easily identify patients who have a dismissal-type status but are still marked as current.

Recommended Report Setup

1. Go to Matrix > Patients.
2. Set filters to show Current Patients only.
3. Add the following columns:
   • Treatment Status
   • Total Balance
   • Next Appointment
   • Next Recall Date
4. Sort by Treatment Status.
5. Review patients with:
   • Treatment Suspended
   • Dismissed Indefinitely
   • Transfer Out
   • Tx Declined

If a patient has no balance, no future appointment, and no future recall, double-click their name, review the chart, and check the Dismissed box to archive the patient. They will no longer be considered a Current patient.

Treatment Status Definitions (Quick Reference)

• Tx Suspended Treatment is suspended and could be due to non payment
• Tx Declined Patient rejected the treatment plan and will not start treatment.
• Transferred Out Patient moved or transferred care to another orthodontist.
• Dismissed Indefinitely Patient has completed treatment (including retainer checks) and is considered finished.