Do you have a tough issue in your dental office that you would like addressed? Each week the experts on Team Troubleshooter will tackle those issues and provide you with answers. Send questions to [email protected].
QUESTION: We recently had new employers take over the practice. Some of their changes have been for the better. But there’s one change that’s becoming a negative issue. The dentist says nothing about this problem. He leaves it to the administrator, who is his wife, and another person she has hired to manage our existing office they recently bought.
Neither one of them is a hygienist. They insist that hygiene bill a full unit of polish for every client (that is seven minutes to 15 minutes). There are no half polishes because everyone loses the half billing. The administrators insist we write it up as five-minute polish and oral hygiene instruction.
The dental hygienists in the office have said no. We have explained to them that this is not ethical and it’s fraudulent. The wife/administrator becomes angry and says we’re wrong. We’re pretty sure based on our hygiene college rules that we are right. Can you please give us an explanation we can share with her?
We’re required to document in “minutes” vs. “units” of time for each procedure code that has a time representation. For example, a recare examination is a procedural code, whereas a scaling code is based on “units of time,” with a unit being 15 minutes. We are required to document the amount of time we have scaled. Under some terms of employment, an RDH would also be required to document the codes to assist the administrative team. The RDH is accountable for the codes being billed to be in accordance with the services provided and documented.
In today’s world it would be extremely rare to have a requirement for 15 minutes of polishing outside of someone with heavy black line stain, a heavy smoker, a drug user, etc. The code representing a half unit of polishing would be the customary code to use. If the polishing goes beyond the half unit (eight minutes or more), the code for the full unit can certainly be used. If oral hygiene instructions (OHI) are being provided, the code for OHI should be used. OHI would then need to be clearly documented and in accordance with the goals set for the client.
Either way, the services provided to clients must be specific to their needs and the billing must accurately reflect both the services as well as the time spent in the dental hygiene chair. This is done to protect both the practice and the dental hygienist or clinician providing treatment. The documentation serves as a paper trail should there ever be an inquiry or investigation.
If there are any questions regarding codes, a registrant is encouraged to inquire directly with the provincial dental association for further clarification. (The above is my opinion only.)
For the most current dental headlines, click here.
RECENT THURSDAY TROUBLESHOOTERS:
Dental assistant has no respect for RDH
RDH not paid for hours she spends preparing her schedule
Dental front office staff says angry patient out of line
Send your questions for the experts to answer. Responses will come from various consultants, many of whom are associated with Speaking Consulting Network, Academy of Dental Management Consultants, Dental Consultant Connection, and other expert dental support and human resources organizations. Their members take turns fielding your questions on DentistryIQ, because they are very familiar with addressing the tough issues. Hey, it's their job.
Send your questions to [email protected]. All inquiries will be answered anonymously every Thursday here on DIQ.
