How Your Hygiene Appointment is Billed
Your dental hygiene appointment is a comprehensive service tailored to your specific oral health needs. The total cost is a combination of services with set fees and services that are billed based on the time required to perform them. This ensures the fee accurately reflects the amount and complexity of the work required for your specific needs.
Set Fees for Service
Some services, like exams, x-rays, and polishing, have a standard, fixed cost because the procedure is consistent for most patients. This is different from timed services, like scaling, where the work required can vary greatly.
Hygiene Services based on Units of Time
When we bill for timed services, it's not just for the time spent actively scaling your teeth. To ensure your safety and provide the highest standard of care, the “time” also covers several other crucial clinical activities:
Preparing for the procedure: We include a review and update of your medical history, including any new medications, and discussion of any health changes that could impact your dental treatment. Your safety is our top priority.
Clinical Assessment: This can include an oral cancer screening, taking measurements and assessing your gum health, and tailoring a treatment plan and diagnosis.
Scaling and Debridement: This is the meticulous process of removing plaque and tartar (calculus) from your teeth, which may be both above and/or below the gum line.
Procedure Documentation: We perform detailed charting of your oral health status, the treatment provided; recommendations for your home care routine; and sterilization monitoring. This is a critical part of your health record.
Your hygienist includes these essential tasks into the billed units of time to accurately reflect the total professional time dedicated to your health and well-being during your visit.
Understanding Dental "Units of Time"
In Ontario, the dental profession uses a standardized system based on the Ontario Dental Association (ODA) Suggested Fee Guide. This guide breaks down time into "units."
One unit of time is equal to 15 minutes. Half units are 7 minutes or less.
Units are always rounded up to the next half unit.
So, if the comprehensive, timed portion of your appointment takes 30 minutes, you will be billed for two units of time. If it takes 31 minutes, that would be 2.5 units, 40 minutes would be 3 units, 53 minutes would be 4 units, and so on.
Why Does My Appointment Time Vary?
The number of units required for your appointment depends on several factors, including:
The amount of plaque and tartar buildup: The more buildup you have, the longer it will take to remove it thoroughly.
The presence of gum disease: If you have gingivitis or periodontitis, more extensive cleaning below the gum line is necessary.
The time since your last cleaning: If it has been a while since your last professional cleaning, there will likely be more to address. Likely more build up to remove, and will likely include additional time spent on clinical history and documentation.
Your individual oral anatomy: The alignment of your teeth and the presence of things like crowding or permanent retainers can make cleaning more intricate and time-consuming.
PLEASE BE ADVISED THAT YOU MAY NEED MORE THAN ONE INDEPENDENTLY BILLED APPOINTMENT TO ADDRESS YOUR HYGIENE STATUS.
Dental Insurance for Hygiene Appointments
We are happy to help you navigate your dental insurance benefits. Our clinic offers direct billing to your insurance company, meaning we submit the claim on your behalf.
Your Responsibility (Co-payment): You are responsible for paying the "co-payment," which is the portion of the bill that your insurance plan does not cover. This amount is due at the time of your appointment.
Every Plan is Different: It's important to remember that your insurance plan is a contract between you and your provider. Coverage can vary significantly between plans, including the number of units scaling they cover per year.
Understanding Your Plan: While we can send estimates (predeterminations) to your insurer for major treatments, it is ultimately your responsibility to know the details of your plan. We encourage you to be familiar with your coverage.
Our Commitment to You
Our goal is to provide you with the highest quality of care. Your hygienist will only use the amount of time necessary to provide you with a thorough, safe, and effective service. We will always be upfront with you about your treatment needs and the estimated time and cost of your appointment.
If you have any questions about your billing, your treatment plan, or how dental insurance works, please do not hesitate to ask our front desk staff. We are here to help you understand every aspect of your dental care.
