We believe that our business is ensuring the health of your business in every way. As the COVID-19 pandemic evolves and healthcare offices begin to reopen, BioHorizons field-based team members are looking forward to seeing you in person soon — and safely. To that end, we have developed the following guidelines for our field team to follow.

• Call ahead: All field-based TMs will contact you in advance of a visit. They will outline the purpose of the visit and ensure that you or your facility manager approve the visit before entering your office.
• Temperature checks: TMs will take daily temperature checks to ensure they are healthy before visiting your office. In addition, should your facility require a temperature check before visitors enter, they will be happy to participate.
• Masks during visits: TMs will wear face masks or face coverings at all times in your office. After completing a visit, they will wash their hands or use hand sanitizer before exiting your facility. Our TMs will also practice social distancing.
• No co-travels: TMs will not co-travel with other industry representatives in their vehicles.
• Clinical participation: For optimal patient care, we will make our TMs available to be present for critical implant therapy procedures at your request. In addition to following your required safety protocols, our TMs will come prepared with their own PPE, including a mask and face covering.
• Video calls: As an alternative to an in-person visit, you may request a virtual meeting with our staff. Each of our Territory Managers has the ability to send you and your staff a video link to conduct a virtual meeting.

Many healthcare providers may find telehealth to be an effective method of caring for patients as society recovers from COVID-19. The American Dental Association (ADA) released guidance to help dental practices code and bill for these appointments. Now, the association has updated the Frequently Asked Questions portion of this guidance. In this section, the ADA defines teledentistry and discusses how it can be conducted. Also included are questions and answers about various communications technologies such as Skype and Facebook Live in addition to information about insurance claims.

Learn more.

Aerosols are routinely created by dental procedures. In the aftermath of COVID-19, dentists may need to reconsider their infection control measures to ensure they are adequate in preventing the spread of various illnesses. In this article, Dr. Rella Christensen of the Clinicians Report Foundation addresses common concerns expressed by dentists.

Learn more.

As governments around the world begin to loosen restrictions put in place in response to the COVID-19 pandemic, many doctors are reopening or planning to reopen their practices. We know you are naturally looking forward to the day when your practice can resume providing patients with your full range of your services, and BioHorizons intends to be there for you throughout the process, just as we always are.

Join us for a complimentary webinar series with industry experts to discuss ways to accelerate the recovery of your practice.

The U.S. federal government created programs that offered loans through the Small Business Administration, but states also created their own programs. Qualifications for these programs vary by state. Use this listing to find out what is available in your state.

The Federal Communications Commission (FCC) currently limits its COVID-19 Telehealth Program to healthcare providers, but the American Dental Association (ADA) wants that to change. The ADA asked the agency to allow dentists entry into the initiative since many dentists face economic hardships with utilizing teledentistry to screen patients because of technology barriers. Screening patients via phone, text or video conference can help health dentists determine if the patient’s issue is an emergency and requires a visit to the office.

As governments around the world start to relax restrictions intended to flatten the curve, we appreciate that as a healthcare practitioner, you are beginning the process to reopen your practice and treat patients with your full range of your services. BioHorizons is there for you throughout the process, just as we always are.

This complimentary webinar series features industry experts discussing ways to accelerate the recovery of your practice.

Session 1: Practice & Patient Financial Considerations includes discussion on the following items and how they affect your practice:

• Paycheck Protection Program
• Emergency Injury Disaster Loan & Grant
• 120-day cash flow of a practice that was mandated to shut down

States are addressing the novel coronavirus crisis in different ways. From laws that require facemasks to be worn in public places to stay-at-home orders, find out what requirements you and your business are subject to.

Dentists can take advantage of Henry Schein’s new Thrive Practice Recovery Program to help get back to full operations more quickly. The program includes a cost-effective suite of solutions that include reconnecting with patients and accessing financial services.

The program offers a three-phase approach to guide practice readiness and a curated set of solutions ranging from practice safety and preparation, new protocol implementation, patient communications and financial assistance, among other options. It is available with all payments deferred for 90 days and the option to renew some program components after the three-month program ends. In addition, many solutions are available for purchase separately.

The Levin Group outlines five steps you can follow to get your practice back on track after the effects of the novel coronavirus. It all starts with developing an action plan and measuring each action item. Other important pieces are maintaining a strong team and streamlining expenses.

The American Dental Association (ADA) offers guidance to dentists to help them reopen their practices "while taking precautions to protect staff, patients and themselves." The toolkit includes:

• Sample "welcome back" letter to patients
• Pre-appointment screening guidance
• In-office patient registration procedures
• Reception area preparation strategies
• Chairside checklist
• Staff protection strategies
• Supplies shopping list

Under the U.S. CARES Act, several temporary programs were established to assist small businesses during the COVID-19 pandemic. Find out which loan or debt relief program is right for your practice.

The American Dental Association (ADA) encourages dentists to be sure coronavirus diagnostic testing kits have been thoroughly vetted for dentists before using them.

"The testing market is becoming a bit of the Wild West for companies right now," ADA Executive Director Kathy O’Loughlin said in an interview. "There is very little scientific evidence that the tests being marketed to dentists are reliable, so be careful when you see an offer that seems 'too good to be true.'"

"All dentists need a fast point-of-care test that accurately predicts the presence or absence of COVID-19 virus in real time," Dr. O'Loughlin said. "Unfortunately, very few tests have met a high standard for specificity and sensitivity, which means a potential for high rates of false negatives and false positives."

Because many healthcare institutions experience an ongoing shortage of personal protective equipment (PPE) such as N95 filtering facepiece respirators (FFRs), 3M has outlined new CDC guidelines on how to safely reuse the respirators up to five times.

Per the CDC: "The healthcare worker will wear one respirator each day and store it in a breathable paper bag at the end of each shift. The order of FFR use should be repeated with a minimum of five days between each FFR use. This will result in each worker requiring a minimum of five FFRs, providing that they put on, take off, care for them, and store them properly each day. Healthcare workers should treat the FFRs as though they are still contaminated and follow the precautions outlined in our reuse recommendations. If supplies are even more constrained and five respirators are not available for each worker who needs them, FFR decontamination may be necessary."

Recognizing that COVID-19 has changed the dental industry and how dentistry is practiced, many states have offered assistance and leniency related to licensing and Continuing Education (CE) requirements. This list compiles state-specific information from around the country.

After an extended closure, dental offices will have many things to think about. Many pieces of equipment will need to be treated with extra care and supplies may need to be restocked. Use Henry Schein’s Welcome Back Checklist to ready your business for resuming normal operations in the upcoming post-pandemic world.

Under a new executive order from Arizona's governor, dentists in the state can begin providing elective surgeries beginning May 1 as long as they meet preparedness criteria. Doctors must also get approval from the Department of Health Services before resuming elective surgeries. Preparedness criteria include:

• Demonstrating greater than a 14-day supply of PPE
• Ensuring adequate staffing and beds
• Testing patients prior to surgery and all at-risk healthcare workers
• Ensuring appropriate discharge plans for patients being transferred to nursing care facilities, including diagnostic testing for COVID-19
• Implementing a universal symptom screening process for staff, patients and visitors
• Establishing an enhanced cleaning process for waiting areas
• Prioritizing the restart of elective surgeries based on urgency

As states consider loosening restrictions in place that are focused on restricting the spread of the novel coronavirus, the Centers for Medicare & Medicaid Services (CMMS) released Phase 1 of its recommendations to “give healthcare facilities some flexibility in providing essential non-COVID-19 care to patients without symptoms of COVID-19 in regions with low incidence of COVID-19.”

Telehealth is strongly encouraged where possible. CMMS also acknowledges that careful planning is a necessity when considering resuming non-COVID-19 care. Considerations include:

• Availability of staffing, PPE, testing, facilities and supplies
• Coordination with state and local public health officials
• Prioritization of surgical/procedural care and high-complexity chronic disease management
• Establishment of Non-COVID Care zones

Dental offices have been greatly affected by the novel coronavirus pandemic, with many offices closing completely or at least drastically changing operations. While it’s still currently necessary to take proper precautions to ensure the disease is truly mitigated, make sure you’re ready for post-pandemic operations by thinking about it now.

The CDC released Interim Infection Prevention and Control Guidance for Dental Settings During the COVID-19 Response. Key concepts were updated and revisions made on April 7, 2020, include:

• Description of risk to dental health care personnel (DHCP)1 when providing emergency care during the COVID-19 pandemic
• Recommendations for contacting patients prior to emergency dental care
• Recommendations for providing emergency dental care to non-COVID-19 patients including engineering controls, work practices and infection control considerations
• Potential exposure guidance
• Contingency and crisis planning

The U.S. CARES Act allocated $349 billion to the Small Business Administration (SBA) to guarantee loans to small businesses, including dental and medical practices, that have been impacted by the coronavirus pandemic. Also included are provisions to help small businesses keep workers employed during the economic downturn. Known as the Paycheck Protection Program (PPP), the initiative provides 100% federally guaranteed loans to small businesses.

The PPP is a loan designed to provide a direct incentive for small businesses to keep their workers on the payroll. The SBA will forgive loans if all employees are kept on the payroll for eight weeks and the money is used for payroll, rent, mortgage interest or utilities (may be subject to other conditions). Loan payments will be deferred for six months. No collateral or personal guarantees are required. Neither the government nor lenders will charge small businesses any fees.

Use Henry Schein’s PPP loan calculator.

The loans offer:

• Forgiveness of up to eight weeks of payroll based on the employer maintaining or quickly rehiring employees and maintaining salary levels
• No SBA fees
• Loan payments will be deferred for six months
• The loan will be fully forgiven if the funds are used for payroll costs, interest on mortgages, rent and utilities (due to likely high subscription, at least 75% of the forgiven amount must have been used for payroll)
• This loan has a maturity of two years and an interest rate of 1%

Respiratory protection such as the N95 filtering facepiece respirator (FFR) can help reduce healthcare workers’ exposure to airborne particles, including disease-causing bacteria and viruses. No FFR will eliminate exposures entirely but learning how to use them correctly is important. 3M presents information to help answer some of the more frequently asked questions. Topics include:

• Respirator versus mask
• Types of respirators
• How respirators work
• How to use respirators
• Comfort considerations

Learn more.

BioHorizons is committed to providing information and education on the clinical, technology and practice-focused solutions we offer to help our customers improve clinical outcomes and operational success. We pride ourselves on partnering with world-renowned Continuing Education (CE) partners and key thought leaders to bring you ongoing, top-quality reconstructive dentistry education. Participate in engaging online lectures from the comfort of your home or office, anywhere in the world, led by a network of dental experts.

Live and on-demand webinar topics include:

• COVID-19 subjects such as:
  • Best practices regarding patient safety, HR guidance and more
  • Managing assets during a volatile market
  • What the U.S. CARES Act means for you
• Guided bone regeneration
• Mastering Leukocyte- and Platelet-Rich Fibrin (L-PRF®) in your practice
• Digital workflow
• Socket grafting
• Sinus augmentation
• Fully guided, full-arch, immediate-implant reconstruction

Watch now.

The virtual symposium presents best practices on a broad range of topics from experts across a spectrum of specialties and backgrounds, including:

• What's next with the outbreak?
• Enhancing team morale and maintaining emotional stability while working remotely
• Maintaining practice financial health
• Patient communications during and after COVID-19
• Improving patient care with telehealth using clinical decision support
• Maximizing time during office closings

Watch now.

Students from the Harvard School of Dental Medicine, Harvard Medical School and others worked on the COVID-19 Health Literacy Project toprovide key information about the new coronavirus in more than 30 languages. If you find yourself in need of help communicating in your non-native language, reference this resource for assistance.

Find fact sheets now.

Henry Schein presents an update on the new coronavirus in the community as well as forward-thinking scenarios to help you plan for getting your practice back to normal once the pandemic is over. Topics include:

• What is your cash flow like?
• How do you pay workers during the emergency?
• What does the U.S. CARES Act mean for your business?

Watch now.

Many healthcare providers, including dentists, are conducting appropriate medical services remotely via telecommunications. The American Association for Oral & Maxillofacial Surgeons provides a comprehensive listing of links to various telehealth guidance from many organizations including the Centers for Medicare & Medicaid Services; the U.S. Centers for Disease Control & Prevention; American Dental Association; American Medical Association and whitehouse.gov.

Learn more.

According to a social worker writing in Modern Hygienist, "the risk for mental health issues is skyrocketing right now." The article includes a plan to help people focus on what they can control and keep themselves centered in reality rather than minimizing the situation. Questions professionals can ask themselves include:

1. Am I staying in the present?
2. Am I exercising?
3. How many hours a day am I watching or reading about COVID-19?
4. Am I getting creative about communicating with others?
5. Am I overeating due to stress or boredom?
6. What is my shower and grooming situation like?

Read the full article.

Dental office closing checklist

Have you decided to temporarily close your practice? Follow this checklist to ensure your business is protected until you decide to reopen.

Learn more

Small business owners for more than 25 years, Drs. Robert & Bobbi Stanley review what is known about the U.S. CARES act so far and how experts are predicting it can impact dental small business owners. Find answers to questions such as:

• Is my business eligible for relief?
• How much can I qualify for?
• How do I apply?
• How much will I need?
• Will this loan be 100% forgiven?
• What are approved ways to use the money?

Watch now.

Earn 1 CE in this free webinar presented by Henry Schein Practice Services and led by Cirrus Consulting Group. Topics include:

• How to survive and thrive through the office lease
• Cash flow management: payroll and rent
• Landlord negotiation strategies
• Opportunities for new leases

Watch now.

Doctors' offices around the world on high alert for signs of the new coronavirus. Here's a quick refresher on what to look out for.
The CDC criteria for patients under investigation (PUI) for COVID-19 include one of the following scenarios.

Scenario 1:

• Fever (subjective or confirmed) OR signs / symptoms of lower respiratory tract illness (e.g., cough, shortness of breath) AND
• Any person, including health care workers, who has had close contact with a laboratory-confirmed COVID-19 patient within 14 days of symptom onset

Scenario 2:

• Fever AND
• Signs / symptoms of lower respiratory illness AND
• A history of travel from an affected geographic area within 14 days of symptom onset

Scenario 3:

• Fever with severe acute lower respiratory illness (e.g., pneumonia, ARDS) requiring hospitalization and without an alternative explanatory diagnosis (e.g., influenza) AND
• No source of exposure has been identified

Note: Fever may not be present in some patients, such as those who are very young, elderly, immunosuppressed, or taking certain fever-lowering medications. Clinical judgment should be used.

If you suspect the patient has COVID-19, immediately contact your local health department. Sanitize anything with which the patient came in contact.

Portions of this article originally appeared on https://www.visualdx.com/visualdx-blog/coronavirus-2019-ncov-what-you-need-to-know.

Learn more.

The American Dental Association (ADA) provides guidance on coding and billing for services provided in-office and via telecommunications services. The ADA notes that dentists may use teledentistry to triage patients and determine if the need is urgent. The guidance includes information on which billing codes to use as well as frequently asked questions regarding how to conduct teledentistry evaluations.

Learn more.

The American Medical Association (AMA) published this guide to help doctors continue to provide care via telecommunication systems (telemedicine). Get answers to questions like:

On March 27, 2020, Congress signed into law the CARES Act, which allocates $349 billion to the Small Business Administration. The loans are non-recourse and require no personal guarantees or liens on practice assets. You can apply if:

• You own a business with 500 or fewer employees, even if it is not shut down completely or partially.
• Your company was in business on February 15, 2020, and it had employees for which it paid salaries and payroll taxes.
• You are self-employed or an independent contractor.

Download Henry Schein's explanation of the legislation.

Delve even deeper into the topic with the American Dentistry Association’s free webinar. Presented by Michael Graham, ADA's senior vice president of government and public affairs, and Allen M. Schiff, CPA, CFE, managing member, Schiff & Associates LLC (S&A), the webinar covers:

• How the CARES Act has the most impact on dentists and their practices
• How you can have access to grant money on a first-come, first-served basis

Please note: You will need to register for a free ADA account to view the webinar. ADA membership is not required.

Watch now.

COVID-19 update

Dear Valued Customers,
Over the last couple of weeks, we have seen the world take numerous measures in an effort to contain the spread of COVID-19. It is increasingly evident that social distancing and other efforts to mitigate the spread of the virus will persist longer than anticipated.

The dental industry, in particular, has been significantly affected by recommendations from organizations such as the American Dental Association (ADA) that no non-emergency dental procedures should be completed until further notice. This includes routine dental procedures such as: initial or periodic oral examinations, cleanings, asymptomatic teeth extractions and esthetic procedures.

We understand the stress created by office closings and related uncertainty since no one is sure how long these measures will remain in place. As such, we are pleased to provide the following resources to assist you in responding to the challenges with which COVID-19 presents our industry:

• Web page dedicated to our response to the novel coronavirus, including resources to help doctors handle the COVID-19 crisis, such as messaging in the form of scripts to help your employees communicate with patients
• Virtual clinical learning curriculum in conjunction with the Oral Reconstruction Foundation

We continue to operate with most team members working from home but are shipping products per usual, and our U.S. production facilities are operating at full capacity. We will provide weekly updates to keep you informed of our activities so we all can make it through this crisis together. Please do not hesitate to contact me, your Territory Manager or Customer Care if you require any assistance. We sincerely hope that all of you, your friends and loved ones remain safe during this unprecedented time and that our world comes together to move past the challenges we currently face.

Best regards,

Steve Boggan
President & CEO
BioHorizons

Coronavirus protection for your team and patients

ProEdge provides a list of COVID-19 State by State Recommendations Regarding Dental Care statements made by state dental associations regarding the need to limit or postpone dental care due to the spread of COVID-19.

Putting public health first: Coronavirus Q&A with Dr. Brittany Seymour

Harvard School of Dental Medicine (HSDM) conducted a Q&A with Dr. Brittany Seymour, an associate professor and global health discipline director at HSDM. She recently shared her thoughts on the spread of the virus as well as the spread of misinformation.

How teledentistry can help during coronavirus pandemic.

It is crucial that dental health care providers provide the essential care necessary to their patients and communities through teledentistry, writes Dr. James Anderson in DrBicuspid.

ADA coronavirus coding and billing guidance

The American Dental Association's (ADA's) billing for teledentistry guide is intended to help dental offices navigate issues related to coding and billing for virtual appointments during the current COVID-19 pandemic.

Protect your practice financially during the COVID-19 pandemic

The Academy of General Dentistry provides five actions to take to protect your practice.

The Families First Coronavirus Response Act Signed into law - What this means for employers

On Wednesday, March 18,2020, President Trump signed the Families First Coronavirus Response Act into law. This law makes changes to an employer's legal obligations. For a summary of the final law, please click here.

Coronavirus protection for your team and patients

Earn CE during this free webinar that addresses what the implications of the new coronavirus are for dental practices, near- and short-term. Learn about what precautions your practice can take, OSHA regulations and more. Speaker Mary Govoni, CDA, RDA, RDH, MBA, is an internationally recognized speaker, author and consultant on clinical efficiency, ergonomics, OSHA & HIPAA compliance, infection control and team communication. Register for free to earn your CE. CE provided by Halyard Dental.

COVID-19 and other respiratory viruses: What every dental practice needs to know
Presented by: Mary Govoni, CDA, RDA, RDH, MBA
1 hour of CE credit
Watch now

Coronavirus protection for your team and patients

With the current Coronavirus pandemic, it's important to protect yourself, your team, and your patients. This is also an important time to communicate to your patients the plan for your office. Are you temporarily closing? Are you remaining open? And if you are staying open, you need to reassure them that your office is a safe place to visit.

Here are some things I will be doing in my office during this time, and that I suggest you do as well:

• Encourage patients and staff to wash their hands frequently. Have hand sanitizer dispensers located throughout the office to make it more convenient for staff and patients to use.
• If you use iPads or tablets for patient paperwork, be sure to sanitize them with a disinfectant wipe between each patient. It's important for patients to see you do this, as it will reassure them that you office is taking necessary precautions to protect their health.
• I also like to wipe down my office's computer keyboards, each computer mouse, and the telephones frequently. This is something I normally do on a regular basis anyway because these are areas the entire team tends to touch.
• Consider removing magazines and newspapers from the lobby as these tend to be handled by many people and could be contaminated. Also, if you have toys in your lobby for children, consider removing them during this time.
• Using Dentrix Communication Manager, you can create email newsletters. This is a good way to communicate with your patients. You can communicate with them if your office is open, closed, or is changing office hours.
• Email newsletters are also a good way to reassure your patients that your office takes their health and safety seriously. Explain to them that your team will (as always) be using universal precautions such as wearing gloves and masks, as well as being diligent with hand washing and the disinfecting of common areas.
• For your patients' confidence, have your clinical staff open sterilization packs in front of the patient in the operatory. This will help to reassure the patient that everything in your office is clean and sterile.
• And finally, if a team member isn't feeling well, make them stay home! Don't risk the health of other team members or your patients.

Stay healthy and safe! If you have questions, email me at vectordentalconsulting@gmail.com.

Charlotte Skaggs, Certified Dentrix Trainer
Charlotte Skaggs is the founder of Vector Dental Consulting LLC, a practice management firm focused on taking offices to the next level. Charlotte co-owned and managed a successful dental practice with her husband for 17 years. She has a unique approach to consulting based on the perspective of a practice owner. Charlotte has been using Dentrix for almost 20 years and is a certified Dentrix trainer. Contact Charlotte at vectordentalconsulting@gmail.com.

This article originally appeared on The Dentrix Office Manager blog http://thedentrixofficemanager.blogspot.com/2020/03/coronavirus-protection-for-your-team.html.

Are you still seeing patients?
Here are some tips on what your staff should say during the COVID-19 pandemic

No matter the procedures they need, every patient is likely concerned about visiting a healthcare provider's office. Communication is key to ensuring your patients remain committed to your practice during and after the pandemic. Your staff members can use the following suggested scripts and talking points when communicating with patients about COVID-19 concerns.

Appointment Confirmation: Confirming patient appointments presents an opportunity for assuring patients of your practice's dedication to cleanliness guidelines and for an informal screening to help ensure sick patients do not arrive at the practice.

If patient answers:
Good morning/afternoon, [insert patient name], this is Dr. ____'s office confirming your appointment for [insert date and time].

• We are getting everything ready for your appointment, which includes taking additional precautions with our cleaning routines to keep you safe during the coronavirus disease outbreak. We are also conducting patient screenings before and during appointments, which includes asking additional health questions and taking your temperature.
• How have you been feeling? Within the last 14 days, have you experienced a fever? Cough? Shortness of breath? Do you have any concerns to share with the doctor before your visit?
  
  [If patient describes flu-like or COVID-19 symptoms]
• I hope you feel better soon. Why don't we reschedule your appointment for a later date?
  [Reschedule appointment at one month later to ensure two weeks have passed after their symptoms end.]

If leaving a recorded message/recording automated message:
"Good morning/afternoon, [insert patient name]. This is Dr. ____'s office confirming your appointment for [insert date and time].

• To protect our patients and staff during the new coronavirus outbreak, we are taking additional precautions to keep you safe. This includes being more aggressive with daily cleaning in the waiting and clinical areas. If you are experiencing symptoms such as fever, coughing, shortness of breath or body aches, please reschedule your appointment for at least two weeks after your symptoms end. You will not be charged a cancellation fee for any appointments canceled due to illness until further notice. We are monitoring the situation at the national and local levels, and we will keep you updated with any changes.

If confirming an appointment rescheduled due to illness and patient answers:

• I know we rescheduled your last appointment because you were feeling ill. How have you been feeling? Within the last 14 days, have you experienced a fever? Cough? Shortness of breath? Do you have any concerns to share with the doctor before your visit?
  
  [If patient describes flu-like or COVID-19 symptoms]
  I hope you feel better soon. Why don’t we reschedule your appointment for a later date?
  [Reschedule appointment at one month later to ensure two weeks have passed after their symptoms end.]

If confirming an appointment reschedule due to illness and leaving recording message:
"Good morning/afternoon, [insert patient name]. This is Dr. ____'s office confirming your appointment for [insert date and time].

• To protect our patients and staff, we are taking additional precautions during the coronavirus outbreak. This includes being more aggressive with daily cleaning in the waiting and clinical areas. If you are experiencing symptoms such as fever, coughing, shortness of breath or body aches, please reschedule your appointment at least two weeks after your symptoms end. You will not be charged a cancellation fee for any appointments canceled due to illness until further notice. We are monitoring the situation at the national and local levels, and we will keep you updated with any changes.

In the office – Consider screening patients upon arrival by taking their temperature and asking if they have experienced fever, cough, shortness of breath or body aches. Attempt to screen them before they sit down in the chair. {Some practices are doing curbside or parking lot screening to reduce exposure to other patients}. If they have a fever, reschedule the appointment and sanitize anything they came in contact with. Consider mentioning this in your phone calls so they won’t be surprised by this additional step.

In waiting area (have a nurse stationed to assist with patient check in):
Good morning/afternoon, how have you been feeling? Within the last 14 days, have you experienced a fever? Cough? Shortness of breath? Let's go ahead and take your temperature. Do you have any concerns to share with the doctor before your visit?

• [If patient appears ill]
  • Be empathetic. "Are you feeling okay?"
    • If they mention they have experienced symptoms or if they have a temperature, ask them to reschedule their appointment with no penalty.

Appointment follow-up – Patients may be contagious before they present with symptoms. These patients may be harder to track down. Use patient follow-up to find out if they were satisfied with their appointment and to check on their coronavirus status.

If patient answers:
Good morning/afternoon, this is Dr. _____'s office following up on your appointment with us on [insert date/time].

• Was everything to your satisfaction? [pause for response] How are you feeling? Have you experienced any fever, cough, shortness of breath or body aches since leaving our office?

[If they have experienced symptoms]

• I hope you feel better soon. Have you visited a doctor about your symptoms? What did they say?

[If no symptoms]

• Wonderful. We look forward to seeing you next time. Have a great day!

If leaving a message/automated system:
"Good morning/afternoon, [insert patient name]. This is Dr. ____'s office confirming your appointment for [insert date and time].

• We hope everything was to your satisfaction. Since leaving our office, if you have experienced any fever, cough, shortness of breath or body aches, or been diagnosed with any illness by a doctor, please call our office back at xxx.xxx.xxxx and let us know so we can keep our patients and staff safe. We look forward to seeing you next time. Have a great day!

Talking points to help you answer potential questions before, during and after appointments

• Are you cleaning the office more than usual? Has the waiting room been cleaned lately]
  • Before the outbreak began, we cleaned our waiting area every night. Now, we're even cleaning it through out the day and paying special attention to wiping down chairs, armrests, and the coffee station and other things patients frequently touch.
    *This could change practice by practice. Please adjust according to your unique cleaning practices.
• Have any of your patients tested positive for the coronavirus?
  • If you have had a positive case: "We did have a positive case, and the office has been thoroughly disinfected, local health authorities contacted and we are following their guidelines, and other patients alerted who visited on the same day."
  • If you have not had a positive case: We have not. We are screening each patient before treating them. If anyone tests positive for the virus in our office, we will follow WHO guidelines, which could include entering quarantine.
• Do any of your staff members have the virus? Are any of them sick?
  • No staff member presently in the office is ill and, as a rule, if a staff member is ever ill, we require that individual to stay home, in keeping with WHO guidelines. Now, we’re being especially careful and recommending that anyone with fever, cough, shortness of breath or body aches and chills sees their doctor as soon as possible and stays home for the WHO-recommended time, which could be up to 14 days after symptoms subside.
• My kids are sick, but I'm not. Can I still come in? OR I'm sick but my kids aren't, and they have an appointment.
  • Out of an abundance of caution to protect the welfare of patients and staff, we would prefer to reschedule your and/or your children's appointments. Thanks so much for your understanding. When are you available in one month?
• How do you know what's going on?
  • We are monitoring the situation locally and nationally. We will strictly follow WHO guidelines to keep you and our employees healthy.

If your office must close because of local outbreaks or other WHO guidance, let patients know via email, social and phone calls.
Automated message:

Good morning/afternoon, this is Dr. ____'s office.

• We are calling to let you know that due to local outbreaks of COVID-19, the disease caused by the new coronavirus, our office will close until [insert date], at which point we will look at the local situation and evaluate reopening or extending our closure. Thank you for patience and understanding. We hope you and your family and friends stay healthy and safe during this outbreak.

Additional recommendations:

• Quarantine cities and towns may require additional or altered talking points and actions. WHO guidance should be considered to supercede these recommendations.
• Recommend adding sign to door: PLEASE STOP. To protect everyone’s health, please do not enter this office if you are experiencing fever, cough, shortness of breath or body aches. You will not be charged for missed appointments due to illness. Simply call the main office number [XXX.XXXX] to reschedule. Stay healthy and safe!
• Recommend no cancellation penalties due to any illness until further notice.
• Include COVID-19 screening questionnaires as part of paperwork to be filled out in waiting area. Ensure the questionnaire meets all HIPAA requirements.
• Remove pens from office so patients are encouraged to use their own. Provide one if asked.
• Remove magazines and toys from the waiting area. If patients ask why, let them know it's to prevent the spread of germs during the outbreak. The toys and reading materials will be sanitized and returned once it's safe to do so.
• Spread out the chairs or remove some so they are farther apart.
• Recommend doctors send email and social media messages that outline more aggressive cleaning methods during the outbreak.
• If a patient asks whether the doctor can spare any masks for personal use, recommend replying as follows: I'm sorry, but at the urging of the WHO, protective masks are only for use by health care professionals and those who are ill or caring for the ill.

For additional guidance, consult the World Health Organization World Health Organization and the Henry Schein Education Center

General messaging for the COVID-19 pandemic

Tips and messaging guides to help patients understand your COVID-19 policy and reschedule their appointments:

COVID-19 has forced us to change how we conduct our daily business and even how we interact with each other. During times of uncertainty, it's critical we have a plan to effectively communicate with our patients to help deal with any disruption to their dental care schedules, while continuing to provide a quality patient experience.

Below are some best practices for using your patient communication tools to send messages that ease patient concerns, clarify your COVID-19 policy, provide dental care information, and reschedule appointments for when your practice is ready. Also included are sample messages to help you communicate practice closure and reopening.

Steps for properly communicating to patients during a crisis:

1. Establish your office’s COVID-19 policy utilizing national, state, and local board guidelines.
2. Ensure the proper team members have access the office's Practice Management and Patient Communication software remotely and securely. Reach out to the manufacturer’s support team if you need help.
3. Notify patients regarding a closure, limited hours, or special precautions using your communication tool's mass email communication feature.
4. Disable or modify reminders and confirmation communications (email, text, voice, etc.).
5. Disable or block ability for patients to book appointments online during a closure or limited hours.
6. Add copy to your website and social media pages regarding your COVID-19 policy, closure, precautions, or limited hours.
7. Add contact information and policy for dental emergencies to your website, voice mail, emails, social media pages, etc.
8. Quickly notify patients that are already scheduled for appointments of office closure or limited hours utilizing a Notify All Scheduled Patients email or text messaging feature of your communication service
9. Utilize Two-Way texting feature for communicating one on one with scheduled patients regarding closure or limited hours.
10. Ensure team members can continue performing collection-related tasks (insurance management, billing, payment posting, etc.)
11. Ensure you have a team member monitoring the phone and/or returning phone calls to patients.

Messaging guides for communicating to patients about your COVID-19 policy:
For automated emails announcing: Office Closure
As novel coronavirus (COVID-19) diagnoses continue to increase around the world, we are committed as always to providing a safe and hygienic environment for our patients and team. Updates may change day-to-day but currently, individual state dental associations are recommending for dental practices to suspend nonessential or non-urgent dental care for the next two weeks to help with social distancing efforts in order to help slow the spread of the virus. If you have a dental need and are unsure of the next steps, please do not hesitate to give us a call so we can help you! Our phone lines will be staying open and appointments will be available on an as-needed basis. We will keep in touch if current guidelines change and will let you know of any updates. Thank you for your trust in us, and we look forward to helping you with your dental care in the future.

Messaging guides for communicating to patients about your COVID-19 policy (continued):
For automated emails announcing: Office Open
As novel coronavirus (COVID-19) diagnoses continue to increase around the world, we are committed as always to providing a safe and hygienic environment for our patients and team. Updates may change day-to-day but currently, our doors are still open and we are maintaining business as usual. We do kindly ask, for the health and safety of patients and our staff, that only the patients receiving dental treatment come into the office. We will continue to use precautions with every patient we interact with in order to keep you safe! If you have a dental need and are unsure of the next steps, please do not hesitate to give us a call so we can help you! Our phone lines will be staying open and appointments will be available on an as-needed basis. We will keep in touch if current guidelines change and will let you know of any updates. Thank you for your trust in us, and we look forward to helping you with your dental care in the future.

For automated voice messages announcing: Office Closed
Good morning/afternoon, this is Dr. ____'s office.
We are calling to let you know that due to local outbreaks of COVID-19, the disease caused by the new coronavirus, our office will close until [insert date], at which point we will look at the local situation and evaluate reopening or extending our closure. Thank you for patience and understanding. We hope you and your family and friends stay healthy and safe during this outbreak

For automated voice messages announcing: Office Open
Good morning/afternoon, [insert patient name]. This is Dr. ____'s office confirming your appointment for [insert date and time].
To protect our patients and staff during the new coronavirus outbreak, we are taking additional precautions to keep you safe. This includes being more aggressive with daily cleaning in the waiting and clinical areas. If you are experiencing symptoms such as fever, coughing, shortness of breath or body aches, please reschedule your appointment for at least two weeks after your symptoms end. You will not be charged a cancellation fee for any appointments canceled due to illness until further notice. We are monitoring the situation at the national and local levels, and we will keep you updated with any changes.

Tips for using Henry Schein One Patient Communication Software:
If you are a user of Henry Schein One North America patient communication systems, such as Demandforce, Lighthouse360, Dentrix Patient Engage, Sesame, or Communication Manager, you can use these features now:

• Email Campaigns or Newsletters
• Two-way Text Messaging
• Appointment Cancellation and Rescheduling Messaging
• Family Messaging
• Facebook Integration

Helpful "How to" tips:
Visit these help pages for steps on how to use your specific software features to communicate to your COVID-19 policy and reschedule patients.

For Patient Communication users, visit:

• Demandforce
• Lighthouse360
• Patient Engage
• Dentrix Patient Engage
• Sesame Communications
• Communication Manager

For website users, visit:

• Sesame Communications
• Officite
• Website manager

If you have any questions regarding how to reach your patients, best practices, or how your business can adjust to the evolving situation, please reach out to our support team at 833.471.2273.

If you do not use Henry Schein One patient communication tools, feel free to use these recommendations in your own practice. And if you would like to learn more, we’re here to help, at 833.471.7253.

COVID-19 update

Dear Valued Customer,
Thank you for your support of BioHorizons and for the important role you play in protecting and improving public health. Our society is facing unprecedented challenges due to the threat of COVID-19 and, as such, I wish to inform you of the proactive measures we have implemented in consideration of this global concern.

We are taking the following steps to continue our excellent service to you:

• Our Territory Managers (TMs) will call prior to any appointment to verify if you still desire a personal visit or if you prefer for us to serve your needs over the phone or online.
• If you have other needs, please contact us at 1.888.246.8338 or register for our online store at store.biohorizons.com/register.
• All of our titanium implants and abutments are manufactured in the U.S., so our supply chain remains intact.
• We are taking additional measures to protect and ensure the continuity of our manufacturing and shipping operations to help you deliver quality care to your patients.

We are taking several precautions to ensure safety and minimize transmission of the virus:

• We are following guidance from the U.S. Centers for Disease Control & Prevention and the World Health Organization.
• Our teams are now working from home (with the exception of critical functions).
• Visitor access to our facilities is restricted.
• Company-sponsored events such as the Oral Reconstruction Foundation's Global Symposium are postponed.
• Employee travel is restricted.
• We have increased the frequency and degree of cleaning and sanitization throughout our facilities.

We stand ready to support you during this difficult time. We hope you and your family remain healthy and unaffected by this outbreak. Please do not hesitate to contact me or your TM if we can be of additional service.

Best regards,

Steve Boggan
President & CEO
BioHorizons