4.17.15 Issue #684 info@mckenziemgmt.com 1-877-777-6151 Forward This Newsletter
 


Jean Gallienne RDH BS
McKenzie Management
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Treatment Plan According To Codes
By Jean Gallienne, RDH BS

In dentistry, it seems we are often afraid of getting paid for the work we do. Why is this? Could it be because many people don’t like coming to us as it is? Patients feel that dentistry and medical care are too expensive? Insurance doesn’t pay, so why should we expect the patient to pay? Is it because we don’t even value our own work?

Regardless of the reasoning that some dental professionals have, our education and quality of care are worth every penny we charge. In spite of the cost to the patient, insurance company or parent/guardian, patients have the right to know what the optimum standard of care for their mouth and needs are. They also have the right to know what their other options are, all the way down to extracting the tooth and doing nothing, or extracting the tooth and placing an implant.

It is not up to us to make the decision for patients regarding what they can or cannot afford. It certainly is not our decision to make when it comes to what level of care we offer. We should always be offering the standard of care we were educated to provide and that we would expect ourselves. Nothing would upset me more than to go to a health care professional expecting to be told what is best for me based on my individual needs, only to find out I was given advice based on what would be paid by insurance standards. I am a patient who is willing to pay out of pocket if needed to have what I am told is best for my health. After all, if I don’t have my health what do I have?

I continuously see offices under-treating periodontal disease and over-working hygienists when diagnosing and treatment planning perio disease. In addition, many offices are not being paid a fair fee for the work being done, particularly those offices taking planned insurances. Sometimes they are not even getting paid enough to cover the cost of the hygienist’s salary and the overhead required to just sit a patient in the chair – let alone actually do work on the patient.

I see many offices treatment planning two prophylaxis, a full mouth debridement and a prophylaxis, instead of treatment planning the patient for the quadrant scales that are really needed. There only needs to be one area of radiographic bone loss to use the code for 1 to 3 teeth quadrant scaling. If there is more than that, great. Treatment plan accordingly.

Treatment planning correctly gives hygienists the time needed to provide better quality of care, and it also reduces stress levels when actually performing the work needed. If the patient is numb they will be more comfortable, which again reduces not only the patient’s stress level but the hygienist’s. The patient may not have been in for a couple of years due to fear of pain. If you treatment plan this patient for a couple of prophylaxis or a full mouth debridement, they could experience that pain they were dreading and may not return for a few more years. Giving pain free injections is not out of the question, but when there is a lot of inflammation and/or calculus, the pain from the inflammation is very real.

Your practice will be getting paid for the quality of care you are providing. The patient may even end up paying less out-of-pocket over the next year because of insurance limitations on how many prophylaxis are allowed in one year. Treatment plan it in your computer with a “test” patient and see for yourself how treatment planning according to the numbers and the x-rays may indeed actually save money in the long run of a year.

Do your patients, your hygienist and your practice a favor and treatment plan according to the codes, not by what you think will cost the patient the least amount of money. Yes, maximize their insurance when possible, but let patients make decisions based on treatment planning according to the standard of care and correct coding of that care. For guidance on presenting effective treatment plans, McKenzie Management’s One-Day Treatment Acceptance Training can help.

Interested in improving your hygiene department? Email hygiene@mckenziemgmt.com and ask us about our 1-Day Hygiene Training Program or call 877-777-6151

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