Best Practices for Accepting and Transferring Orthodontic Patients
Patient transfers are a routine part of orthodontic practice, but they also come with significant clinical, legal, and ethical responsibilities. Whether you’re accepting a transfer patient or facilitating a patient’s departure from your care, how you manage the transfer process can protect you from potential claims and ensure continuity of care.
Accepting a Transfer Patient
While a transfer patient may seem like a continuation of treatment, they should always be treated as a new patient from a diagnostic and documentation standpoint.
Here’s what should be included when accepting a transfer patient:
- Request complete records from the previous provider: diagnostic records, progress notes, treatment plan, radiographs, and informed consent documentation.
- Take your own full records, including updated x-rays, intraoral and extraoral photos, periodontal charting, a new health history, and a treatment plan you create independently.
- Obtain new informed consent based on your revised treatment plan.
Just as important: Understand why the patient is transferring. If they’re moving across the country, the handoff is usually smooth. But if they’re transferring across town, it’s worth asking: Was there a conflict with the original doctor? Financial issues? Noncompliance? Unmet expectations? Personality clashes can follow the patient to your office—and so can treatment complications.
You’re inheriting someone else’s work. Do you agree with what was done? Is it clinically sound? Can you build a plan you’re confident in from where they left off? If not, you’re under no obligation to accept the case.
Your updated records serve as a line of demarcation between the previous orthodontist’s treatment and your own. This distinction is critical if a claim arises later. Document thoroughly and clearly.
Transferring a Patient Out
When a patient leaves your care, your role doesn’t end the moment they walk out the door. Follow these best practices:
- Use the AAO Transfer Form to clearly outline the current status of treatment, appliances in place, and any concerns for the new orthodontist.
- Send all requested records directly to the new provider, including diagnostic records, progress notes, and treatment summaries.
- Maintain availability for emergency care only for 30 days, giving the new provider time to assume full responsibility.
- Make note of the reason for transfer. Some, like relocation or job changes, are straightforward. Others—such as family conflict or dissatisfaction—can signal future issues. When emotions are involved, a greater level of care and caution is often needed.
- Document the status of your treatment. If there is a problem after the patient transfers, you need to be able to prove the condition of the patient at the time they left your care. At least take complete intraoral and extraoral photographs and preferably a panorex to document your progress with the patient’s treatment.
Also, keep in mind that communication with the new provider may not always be smooth. Be professional, clear, and cooperative in correspondence, but also keep detailed records of all communications—especially if treatment issues or conflicts arise during the transition.
Transfers Are a Common Source of Claims
Improper handling of transfers—especially when patients feel lost in the shuffle—can lead to malpractice claims. Incomplete records, lack of clear informed consent, or inadequate handoffs are all avoidable risks. Following a standardized protocol helps protect both your patients and your practice. AAOIC recommends reviewing and updating your patient transfer procedures regularly and ensuring your team understands the importance of documentation and communication at every step.
Protecting your practice starts with doing things right from the start—even when someone else started the case. AAOIC is committed to protecting orthodontists and their practices. Stay informed and proactive about your insurance coverage to ensure continuous protection as you navigate different stages of your orthodontic career. Learn more about how AAOIC can help![SS1]