The billing of a dental hygiene appointment demystified
The hygienist I see told me I should be seen every 3 months
, is this legit? and what am I being billed for at these appointments?
In the past it was customary to fall into the trap of dental insurance dictated "once a year", or "once every 6 months" frequency of dental cleanings. Often patients will state "I can onlyhave a cleaningevery 9 months, because that is what my insurance covers"well you can actuallygo as often as you want, insurance won't cover every visit, but you can go as often as you wantif you hate flossing you couldgo tosee the hygienistevery few days but seriously you have other places you need to be so Floss!
Due to the status of the health of your gum tissues and bone levels, the hygienistmay recommendthat you are seen every 3 months for plaque and calculus removal, or 4 months, or 6 months, or 9 months.you get the picture. Everyone's health is different, and so are the dental hygieneneeds of each patient. I would be more concerned if the dental hygienistyou see doesn't customize your hygiene frequency to your specific needs. Hygienistsuse information such as the amount of calculus that forms in your mouth, the depth of the periodontal pockets measured (yes, all that poking and number calling..3, 2, 3.is useful), bone levels, amount of tissue bleeding, as well as your overall health and risk factors to decide what is going to give you the best chance at achievingtop-notch oral health , and the benefit of keeping yourteeth for life!!
What does that mean in terms of dental insurance? Well get to know your coverage. A dental "cleaning" is actually a very general term because your dental hygiene visit will likely include scaling and or rootplanning, polishing and application of topical fluoride, diagnostic radiographs to assess bone levels, or areas of cavities and a dental check up exam by the dentist.That is why your invoice when you leave a dental hygiene appointment has a list of individualprocedures.
And what does all of that dental lingo mean? Scaling and rootplanningin Canada are billed in time units.
1 unit of scaling = 15 minutes of removing deposit (or as my friend likes to call it "scraping the teeth")
Polishing involves paste, removes daily sins like coffee, tea and red wine stain
Fluoride can be gel, foam, varnish or rinse applied topically to teeth
Insurance Plans usuallyhave limitations such as 1 polish per 9 monthsor 1 dental check up exam and x-rays per 12 months)
Insurance coverage for scaling units mayinclude 16units per calendar year, or if you have a great plan unlimited scaling units per year or less units per year *This may be a combination of root planning and scaling..you have to ask questions of your insurance provider if it is not clear.
The good news is (yes, good news and dentistry all in the same discussion) that you probably require scaling, rootplanning at these 3, 4 or 6 month hygiene visits, but don't necessarily need polishing, fluoride, xraysand a check up exam every visit. So what the dental hygienistis recommending may actually fall within your dental insurance limits, good news!! Be thankful you have any dental coverage at all, as there are many people without .
Bad news and its not really bad news- if it doesn't fall within your dental insurancefind out how much it would cost you? 2 units of scaling may not cost quite what you think in terms of dollars, and may mean that if you visit the hygienist4 times a year and you are willing to pay for 2 of the visits you get to have healthy gums, healthy mouth,which contributes to overall health.
The billing of a dental hygiene appointment demystified
By: SALLY LLOYD
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