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Patti DiGangi, RDH, BS, believes dentistry is no longer just about fixing teeth. Dentistry is oral medÂicine. Her work helps dental professionals embrace the opportunities and understand the metrics that accurate insurance coding provides. The ADA recognized her expertise by inviting her to write a chapter in its CDT 2017 Companion book and again for its CDT 2018 Companion. She is the author of the DentalCodeology series of easy-to-read, bite-size books. Her latest book, "Teledentistry: Pathway to Pathology" was co-written with Cindy Purdy, RDH, BS. She can be reached at email@example.com.
Dental hygienists are arguably an officious bunch. They love their rules; they trot them out like prize ponies, showing everyone that they know the score and were taught well. But U.S. dental hygienists have a secret. They are thugs, and they don’t even know it.
Whenever a new product advertisement comes out featuring a dental hygienist, the internet groups are all abuzz commenting on the model's hair length, mask placement, patient goggles, open or closed collar on the lab jacket, earrings, makeup, nails, infection control protocol breaks and who knows what all else! They break their arms patting themselves on the back for noticing that the faucet still has knobs in the background of the picture. Chairside, they continue to charge out the prophy code in patients who they are obviously treating for a periodontal condition. Who’s it hurting? Everyone.
Who’s committing fraud?
Look at the case of Dr. XX who was jailed for Medicaid fraud because he never noticed his office manager double-billed for procedures and pocketed the money. The dentist paid the price for that negligence.
Dental hygienists, the same people who notice an open collar on an advertisement, practice on a patient with bleeding and periodontal pockets and never recommend a salivary test for periodontal pathogens. They sweat bullets and take “after” radiographs to determine if the calculus is removed and charge out a simple preventive appointment, D1110. Is that insurance fraud? What’s the risk?
What’s the risk?
Does it matter what the risk is? Laws are intended to be followed. Laws are society’s way of agreeing on how to live. Insurance rules are in place to help keep businesses on track. When a dentist does a crown and charges a filling, what’s that called? Aside from being called crazy, it’s fraud. It's the same when a dental hygienist uses his/her skills to work in a bloody field deep below the crest of the tissue but charges for a simple procedure reserved for healthy tissues. It is also a crazy fraud. But it’s even worse because they are, in effect, committing crimes, namely:
Facebook buzz on OPA
Where do you sit? If you’re reading this, you’re probably seething because you know someone who is not the epitome of a dental hygienist; someone who has turned off their brain years ago.
Recently, the buzz on the Facebook dental hygiene groups was about a “new” type of practitioner invented by the ADA called an OPA-oral preventive assistant. In this role, someone would scale and polish teeth for next to nothing and be trained on the job. Oh, the horror! The Modern Millennial Hygienist, someone who has grown up under the team metaphor, will look at this development and wonder how it got to be that way. What motivated the ADA to make this recommendation? Money is the obvious answer, but what happened to make this such a priority? There are already too many schools, too many unemployed and too few dental school graduates, so why offer another team member?
We’re interested in hearing your take. Are you a thug, battering patients and stealing from your employer, forcing it to find alternatives to the classic dental hygienist? Voice your opinion below-only a voice can tease this problem apart.
In the future, we’ll explore the idea of the two-year degree. Did you really graduate in two years? We didn’t think so.
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