dental cleanings

Just bill my dental insurance. Why Not?

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There is high administration cost for dental hygiene clinics to directly bill dental insurance companies ins claim

Dental Hygiene clinics are still a relatively new concept, despite the fact that legislation was changed in Alberta several years ago to allow Registered Dental Hygienists to achieve this. You could say it is still an unknown concept by the majority of Canadians even.

Lifetime Smiles Dental Hygiene Clinic wants to make it as easy as possible for individuals to arrange treatment, and handle the financial process. Therefore we do directly bill to dental insurance companies, when provided with valid dental insurance information, and to companies that will reimburse the hygienist. Some dental insurance companies require that the individual pays up front and submit a claim for reimbursement.

We make every effort to ensure all the forms submitted are processed efficiently. The are only a few companies that allow dental hygiene clinics to submit claims electronically – remember this is still a new concept and it has involved changes for insurance companies as well. Unlike dental clinics, the majority of our claims are made by paper and carried by snail mail.

As you can see in the photo- we have had so many issues with dental insurance companies paying the patient instead of our clinic- we have resorted to attaching a “flag” to the claims. There are still problems. Dental insurance companies still make mistakes- and send a cheque to the patient, or directly deposit the money into the patient`s bank account despite the fact that the submitted claim clearly states the subscriber has assigned payment to the hygienist.

What does this mean for us?  We have to make phone calls when payments don`t come in on time. The privacy act limits the information the insurance company will disclose. We have to resubmit forms to insurance companies by snail mail, phone patients, and do our best to track down payments. This takes time to process and correct , adding to the cost of doing business. This drives up fees.

Why do I write this?  in the hopes that more individuals will understand the effort we make to directly bill a dental insurance company, and understand why clinics need financial policies. Unfortunately, all it takes is a few individuals who are reimbursed by the insurance company incorrectly – and who do not then forward payment to the hygienist owed- to ruin it for everyone. And there are individuals who are “upset” when we have to make several calls to achieve payment from them. They feel we have somehow not been competent in handling their paperwork.

This is why many dental clinics will not directly bill – they do not want this extra work, and as a business that also have staff and overhead costs, can`t carry the high accounts receivable typically associated with this way of doing business.

We are happy to extend this courtesy to our patients, and keep in mind if the insurance company makes a mistake- extend a courtesy to us and clear up outstanding balances as soon as possible.

Thanks, and feel free to discuss payment policies with us. Our goal is that the cost of dental hygiene treatment not be a barrier to oral health. We did not raise our fees this year, and do not plan to do so next year. Please help us in achieving this.

Put your money where your mouth is…

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Do you think the cost of a dental cleaning in Calgary is expensive? outrageous? or could you care less about the cost because your health and teeth are worth it?

If you think the cost of a dental cleaning is high, then you will find the cost of treating gum disease by a periodontist, or having one cavity repaired with a filling outrageous!!

For some of you reading this- you are going to question  “who would not spend money having their teeth cleaned?”   This blog is not for you –  you already get it. Your teeth and overall health are important, you would go without cable tv if you had to in order to afford dental cleanings. You probably drink your coffee through a straw so your teeth do not become stained. You take the Dr.Oz quiz “ How clean is your mouth” and you ace it!! You brag to co-workers about the wonderful flossing grade your dental hygienist gives you at your appointments. Or maybe you have dental insurance and have never given a second thought to the cost of a dental cleaning.

This blog is for those that value their oral health but don’t believe they can afford dental cleanings, or it is for those for those that don’t get it – yet. I want to highlight how the cost of dental cleanings can be viewed as an investment in oral health, and since your mouth is attached to the rest of the body – an investment in overall well-being. Who wants destructive mouth bacteria travelling the blood highway through the body? Yes- it is true the bacteria in your mouth causing bad breath, disease, bleeding gums loves to travel- where? to your heart, to the site of your knee replacement, your new hip – everywhere. It has been linked to pre-term delivery of babies (1).

 I suggest looking at the cost of preventative dental cleanings over a year, rather than on a  per visit basis.

 If you neglect your oral health, your teeth and your gums – you will pay for it at some point. Perhaps it will be in terms of bad breath, bleeding gums, decayed teeth, tooth abscesses, loss of teeth, time missed from work due to dental pain and emergency dental appointments, or maybe you will end up struggling with ill-fitting dentures and not being able to chew your food properly. Does this sound horrible? it should…and I haven’t even touched on the overall health conditions that are linked to gum disease. Hygienists provide oral cancer screenings. When was the last time your medical doctor checked the tissues inside your mouth?

Why do I say this? I hear comments and concerns from public that the costs of basic dental care, including examinations, xrays and dental cleanings can be prohibitive.  Dental Hygiene Clinics can help to ease the financial cost of prevention and treatment of gum disease, and keep healthy mouths healthy! You see the same Registered Dental Hygienists at Lifetime Smiles Dental Hygiene Clinic that you would see in dental clinics. You can also keep your diet in mind for an outcome of oral health. Inflammation plays a keey role in both gingivitis and periodontitis – read more about nutrition and inflammtion.

We answer many questions about the cost of dental cleanings. The cost generally works out to $35 month for 2 professional dental cleanings a year. There are those that do such a great job with their home care that the cost is less ( yes, it is true some people do actually floss daily- it is not a myth). This is without any type of reimbursement from your dental insurance or health spending account (if you have either). Obviously treating active gum disease is going to cost more, as is treating cavities and other dental conditions. The cost for childs dental cleaning is less.

 I see patients that are wearing implant supported dentures for dental cleanings. No teeth remaining. I unscrew the denture attachments- remove the dentures and then clean the build up from around the implants. So even people with out teeth remaining still need to see dental hygienists!  These patients could tell you what teeth are worth- or sorry, I should say they can tell you what the cost is to replace ill-fitting dentures that floated around in their mouths. One woman told me she has spent the equivalent of 2 automobiles on achieving dentures that fit well ( attached to dental implants), that allow her to chew properly, eat and speak in front of others with confidence knowing that her dentures are not going to move around or make a clicking noise.

 What could you trade each month that costs $35, to cover the cost of 2 dental cleanings a year? What are your teeth worth? What is your overall health worth? I would love to hear from you. I could easily go without Sushi..well maybe not easily.

Want a payment plan at our clinic? no problem- just ask. What if $35/month is still not feasible? There is assistance for low-income groups in Alberta for dental treatments, for children, and emergency dental treatment resources. Lifetime Smiles Dental Hygiene clinic sees children under 3years of age for their first visit at no cost. Ask us if your need dental help – we are a very resourceful group.

Journal Reference:

    1. Y. Fardini, P. Chung, R. Dumm, N. Joshi, Y.W. Han. Transmission of Diverse Oral Bacteria to Murine Placenta: Evidence for the Oral Microbiome as a Potential Source of Intrauterine Infection. Infection and Immunity, 2010; 78 (4): 1789 DOI: 10.1128/IAI.01395-09

 

Can good oral hygiene save your life

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Dr Oz sees the connection now is the time for you to see it.

Our mouth is the opening into the rest of our body and it is important that you
understand when we are asking you about your “medical history” we are
doing this to understand your body.  “Research shows that individuals
who have moderate or severe tooth decay and gum disease tend to have a
higher incidence of systemic health problems. According to the U.S.
Department of Health and Human Services, research has indicated a
potential link between periodontal disease and lung infections,
stroke, diabetes, heart disease, low birth weight in children, and
premature labor. For example, individuals with diabetes and
periodontal disease are faced with increased difficulty in achieving a
good blood glucose level.” Bacteria in our mouth enter our circulatory
systems through the blood vessels. Your Mouth is a gateway to your
body” It very important to keep good oral hygiene to help prevent the
spread of bacteria to the rest of our body. KEEP your mouth cleaned
through dental cleaning and proper home care.

follow the link for more information:

 http://www.doctoroz.com/videos/can-good-oral-hygiene-save-your-life

disclaimer: please note that this information was taken off the doctor oz show. This infromation was not made by us and is property of the DR OZ show we are just providing the link

Home is where the heart is….and the toothpaste, and the floss..

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 I guess you could say a life of good dental hygiene starts at home. More specifically it starts with young children at home. That means parents, listen up. You have the power to provide your child with the tools and habits that can lead to a cavity free life. That’s right…no cavities. 

Kids love “cavity-free dental check ups“. It means no appointments requiring sleepy juice (freezing by injection with a needle) for a dental filling. No watching them after a dental appointment to ensure they don’t chew on their cheeks because they can’t feel it.

What?  Your kid loves to go to the dentist and doesn’t mind any of this?   That’s good because if they have a filling as a child, chances are that filling will need to be replaced more than one time in the future. When it is replaced, more natural tooth structure is lost, and every time this tooth is treated there is risk to the nerve in the tooth. What does that mean? This means the nerve could become damaged and root canal treatment required.  Then what? After a tooth has had  root canal treatment it is recommended that a crown be placed. It doesn’t end there, as a crown doesn’t last forever.  

But the good news is, you can spend a few minutes each day helping to prevent cavities. Dental hygienists  recommend toothbrushing for 2-3 minutes. Thus the timer on electric toothbrushes is 2 minutes long.  So, 3 times a day at 2 minutes = 6 minutes per child. More if they snack often. Piece of cake right?

 Now in reality, and having children of my own I know it is not 6 minutes per child. When my son was 2 -3 yrs old , it was 6 minutes of brushing and 10 minutes for my husband and I to hold him down. Thank goodness that stage didn’t last forever, as it was not something we looked forward to each day. 

This difficult stage I believed was pay back. Prior to having children I was a dental assistant and helped place fillings in children’s teeth. I once worked in a hospital setting with a dentist that placed many fillings, extracted decayed baby teeth, and placed stainless steel crowns on children’s teeth. Due to the amount of dentistry they required, and their young age, they were treated under general anesthesia in the OR. I remember thinking “why doesn’t someone just brush these kids teeth?”. Then I had children.

You can have the best intentions and limit sugary snacks, but essentially most foods can contribute to cavities. Fruit for example, contains natural sugars that supply bacteria in the mouth with fuel. The bacteria release acids, and the acids break down enamel, causing a cavity. Fermentable carbohydrates as well as sugars in children’s medicines are also fuel for bacteria. Bacteria love it, but tooth enamel doesn’t. 

Teeth need to be cleaned properly of food particles after eating to prevent or cut short this “acid attack”. One’s own saliva can neutralize the acid after approximately 20 minutes.  If a child is snacking frequently add up the minutes per day an acid attack is occurring to their teeth. In other words, for children that have a sippy cup – water is a great choice for drinking throughout the day, otherwise their teeth could be exposed to acids for a majority of the day.

 Children love to exhibit their independence at an early age, and despite their best negotiating don’t give in and let them brush their teeth “by themselves”. Don’t break down even if they use the puppy dog eyes…stand firm. If really young, they are likely only chewing the toothbrush, but that good let them have “a turn”, then its “parents turn”. Children do not have the manual dexterity to reach all the surfaces throughly. Thus, parents need to help until they are 8 or 9 years old.

Flossing is another story, they really can’t master this technique until they are 10 or 11 years old. I know I have seen some adults in the dental chair who haven’t mastered their own flossing despite their own self confessed once a week attempts for 30 years , so seriously, can your children do it?     Plastic floss handles are a great tool for both parents and children.

So if you have been at a loss because you thought that  brushing EVERY night was all that was required for your children, and yet they have had a cavity, consider how often they are snacking, and how many minutes their teeth could be under acid attack.

Remember to prevent children from getting a cavity (also called tooth decay) one must :

– brush and floss after eating   (only brushing at night  2 – 3 hours after last eating doesn’t cut it)

– adults need to help with toothbrushing until age 8 -9 yrs old

– adults need to help with flossing until 10-11 yrs old

Often children are taking medications, or using inhalers for medical conditions that can create a higher risk for cavities, if this is the case, ask for suggestions from your dental hygienist….. dental hygienists love to talk “prevention”….

It’s an enigma, wrapped in an enigma with fluoride on top…

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Why can’t you just tell me how much a dental cleaning is?

I have answered several of these inquiries, and I realize it can be very frustrating when “shopquestionping for a dental cleaning” in the attempt to get a quoted price. I hope to shed some light on this issue. I have worked in dental clinics for many years, and this issue has surfaced over and over, but still exists.

If you read an earlier blog post of mine, you will understand that “dental cleaning” is a very general term used by both patients and dental health care providers. It doesn’t identify the various procedures that can make up a dental hygiene visit.

Polishing and fluoride application are quite clear, and in Canada have a specific procedure code used with a set fee for each.  So you can phone a clinic and ask “how much is polishing, how much is fluoride?”, and you can get a stated fee.  Easy enough. This fee varies from clinic to clinic. In Alberta there is no provincial fee guide for dentists or hygienists.

Phone and ask “how much is a cleaning?”, and you will get various estimates. Why estimates and not a set fee?  The amount of scaling and rootplanning required can not be determined over the telephone. The person on the phone hasn’t seen your teeth, doesn’t know how much calculus build up there is, doesn’t know how deep the pockets are around your teeth, and doesn’t know that you may be more comfortable with freezing for your appointment.  Scaling and rootplanning are billed in units of time, so it depends on how long it takes to complete the procedures. Therefore you will get estimates only over the phone or via email.

Registered Dental Hygienists can provide many more services than I have touched upon here, and I could go into great lengths to describe all of the beneficial treatments, but I will leave that for another time.

I hate to compare it to the car mechanic, but if the analogy works… I can’t phone and tell my mechanic I hear a noise, and ask “how much to fix it?”. Well, actually I can do that, but I won’t get a set price answer. I’m told it needs to be seen, they need to “diagnosis” the problem first. They can only tell me once they determine what is required. Wow that sounds familiar…

One patient asked me “why are fees such a mystery with you dental people?”.  The best way to get a clear picture if you are looking for quotes – is ask about specific procedures.

I must say that I encourage people to ask questions, shop around if your economic situation requires it, but it is also important that you trust your health care providers, ask about their experience, services offered, and educational background. Be well-informed, and be critical of what you read on the internet. Please don’t try “professional debridement” at home, even if you find a video online that shows you how to do it.   🙂

Disclaimer: I am not using professional dental terminology because this information is not intended for other dental health care professionals. This is intended for the general public who tell me they just want to know why they find it difficult to get a “straight answer”. I am aware dental hygienists prefer terminology such as professional debridement instead of dental cleaning. I also advocate use of other remineralizing products as an option or in conjunction with fluoride, and advocate selective polishing.

Stick out your tongue…it could save your life

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When your dental hygienist asks you to stick out your tongue, it’s not rude to comply… they are screening for changes to the tongue and tissues inside the mouth that could be signs of oral cancer.  

 You know the drill, or hopefully you have had the experience of an “oral cancer screening”, they grab the end of your tongue with that gross tasting gauze..

If your hygienist or dentist doesn’t do this- ask for it. Some dental hygiene and dental clinics have cool equipment like velscope – that incorporates fluorescence visualization technology to help detect abnormal tissue , including cancer and precancer. Again more dental lingo I know- basically they shine a light inside your mouth and abnormal tissue fluoresces differently than normal tissue.

Often patients think hygienists are a bit overboard with concern, and it requires the attention of a Hollywood star being diagnosed with a “not talked about so much” disease to increase public awareness. Michael Douglas being diagnosed with oral cancer has done this. The Academy Award winner has recently been diagnosed with a tumour in his throat, and now faces an eight-week course of chemotherapy and radiotherapy

I read this morning

“Hollywood star’s diagnosis highlights high risk of mouth cancer

This high profile case has brought oral cancers into the limelight, and oral health experts are keen to make the public more aware of the key risk factors and early warning signs.

Douglas quit smoking in 2006, after a long ‘half a packet a day’ habit. Yet, the possibility of developing oral cancer remains higher for ex-smokers than non-smokers for 20 years after quitting. Tobacco is considered to be the main cause of mouth cancer, with three in four cases being linked to smoking. Drinking in excess is also a known factor, with those who both smoke and drink to excess being up 30 times more likely to be at risk.

The chief Executive of the British Dental Health Foundation, Dr Nigel Carter said: “It is crucial the public know about the risk factors and early symptoms as early detection can save lives. Survival rates can increase from just 50% to over 90% with early detection – yet over two thirds of cases are diagnosed at a late stage. “Many people have not heard of mouth cancer, and do not realise how common it is – latest figures show that over 5,300 cases are diagnosed in the UK in a year and that men over the age of 40 are twice as likely to develop the condition as women.”  ”

So stick your tongue out ….have a look…and please feel free to “stick your tongue out” at me in the dental hygiene clinic!!!

The billing of a dental hygiene appointment demystified…

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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 only have a cleaning every 9 months, because that is what my insurance covers”…well you can actually go as often as you want, insurance won’t cover every visit, BUT YOU CAN go as often as you want …if you hate flossing you could go to see the hygienist every few days …but seriously you have other places you need to be so Floss! 

Keep in mind your dental insurance coverage is NOT based on what you may require. It is coverage negotiated and provided as a benefit package – typically by an employer. Or a “package” you apply for.  

Due to the status of the health of your gum tissues and bone levels, the hygienist may recommend that 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 hygiene needs of each patient.  I would be more concerned if the dental hygienist you see doesn’t customize your hygiene frequency to your specific needs. Hygienists use 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 achieving top-notch oral health , and the benefit of keeping your teeth 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 root planing, polishing, application of desensitizing materials, diagnostic radiographs to assess bone levels, or reviewing which plaque removal aids would be best for you. The hygienist may even create teeth trays to wear at home with remineralizing materials to prevent decay. Each individual has individual needs.  That is why your invoice when you leave a dental hygiene appointment has a list of individual procedures.

And what does all of that dental lingo mean?   Scaling and rootplanning in 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, smoothes rough areas so plaque bacteria cannot attach as easily

Fluoride can be gel, foam, varnish or rinse applied topically to teeth – again this should not be an “automatic treatment”, rather the dental hygienist will determine if it or a fluoride alternative is suitable for you. There are also fluroride free – re-mineralizing agents that can be used to strengthen and prevent decay.

Insurance Plans usually have limitations such as 1 polishing procedure per 9 months…or 1  exam and x-rays per 12 months)…

Insurance coverage for scaling units may include – 16 units per calendar year,  if you have a great plan maybe coverage will state unlimited scaling units per year . You could have a plan that covers only 2 units of scaling a 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 that you may require scaling, root planning at these 3, 4 or 6 month hygiene visits, but don’t necessarily need polishing, or xrays and a check up exam every visit. So what the dental hygienist is 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 insurance find 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 hygienist 4 times a year and you are willing to pay for 2 of the visits… you get to have healthy gums, a healthy mouth, and a healthy heart which contributes to overall health.  One patient told me they spent more on their pet last year than they did on their teeth.

The other solution…follow advice from your dental hygienist in terms of what you can do at home …and then repeat this daily.

What is a Dental Hygiene Clinic, and who are dental hygienists anyway?

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I am asked some of these questions often, so if one person wants to know, many probably do..

Regulations enacted under Alberta’s Health Professions Act (effective November, 2006) allow registered dental hygienists to provide services in a variety of practice settings in addition to working in a dental office. Often called “Independent Hygienists” ….I know new lingo

Practice settings include a dental hygiene clinics, mobile services or both. Yes – thats right a mobile hygienist could come right to you…or visit nursing homes to see your loved ones. Please, someone send a dental hygienist to me if I am ever in long term care or can’t make it to a dental hygiene appointment. Hygienists on the move.

Lifetime Smiles Dental Hygiene Clinic is stationary- we can’t come to you- but please feel free to come to us- we welcome all patients. If you want to find out more about a mobile hygienist have a look at the College of Registered Dental Hygienists of Alberta(CRDHA)- they have a list of independent hygienists in Alberta. If you are in a province other than Alberta – contact the provincial association for a list.

As indicated on the CRDHA site in their practice, Registered dental hygienists in Alberta do one or more of the following:

•assess, diagnose and treat oral health conditions through the provision of therapeutic, educational and preventive dental hygiene procedures and strategies to promote wellness,
•provide the services described in this section as clinicians, educators, researchers, administrators, health promoters and consultants.

Registered dental hygienists in Alberta:
•have met the educational and other requirements criteria for registration.
•apply a dental hygiene process of care model.
•practice with a foundation of evidence-based knowledge and theory.
•practice collaboratively with clients, colleagues and other health care professionals.
•provide client-centred services to prevent and treat oral disease and promote wellness.
•are involved in a variety of key responsibility areas related to dental hygiene practice (e.g. clinical, education, health promotion, administration, research, etc.).
•are legally, ethically, and professionally accountable for their practice and recognize personal limitations.
•maintain ongoing competence (e.g. through continuing education, research, reflective practice, practice hours, etc.).
•possess additional education, competencies and/or certification when performing advanced practice procedures.

Wow…and if that is not enough hygienists can apply to be on specific rosters indicating that they have the education and competencies to:

•prescribe the limited medications used in dental hygiene practice
•administer local anaesthetic by injection    (aka. freezing)
•prescribe and administer nitrous oxide/ oxygen for conscious sedation

So to summarize, registered dental hygienists are one smart group!!      and while I know we have a reputation of being   “lecturers of flossing”…we care a great deal about teeth, oral health and overall health…

 

Want to find a dental hygiene clinic, or mobile clinic in Canada? Locate a Dental Hygienist.com allows a search by city, province or name