Donated Care Reporting Form
Donating Care? “Write it Up!”
In an attempt to track the amount of free dental care that is provided by Maine dentists, the Maine Dental Association has developed a reporting form that members can complete and return to the MDA.
The MDA Executive Board urges all MDA members to keep a master of this form available and report donated care on a regular basis. The information is used in advocacy and awareness efforts, to demonstrate the commitment of Maine dentists to provide care for those in need. Information is used on a collective or anecdotal basis, without the use of any names.
Whether you participate in a local free clinic, volunteer at the local nursing home, offer screenings at your community’s school, make mouthguards for the local high school athletes, or offer free care to your own patients, let us know. A few things to remember:
• Don’t report donated care that already has a formal reporting mechanism—i.e. Donated Dental Services (“DDS”) or the Cole Family Foundation Orthodontic Project. Report only those services that aren’t tracked another way.
• If you treat MaineCare patients, you should report MaineCare write-off amounts as the last entry—don’t include these amounts in the itemized list. Be sure to indicate the time period represented by the write-offs.
• Keep a master copy of the reporting form and send in a report on a regular basis, i.e. one per month, once per quarter, etc.
Donating Care? Write it Up!
