Twenty or thirty minutes per child. The dental diary still books a quarter-hour
From 1 September 2026 a child’s NFZ hygiene package has a minimum time of 20 or 30 minutes. In 2025 the Fund spent more than PLN 500 million on this item. A two-chair practice loses the slot when the diary still writes a quarter-hour.
1 September 2026 Prawo.pl described the new valuation rules for dental hygiene billed to Poland’s National Health Fund (NFZ). The Fund says inspections found clinics billing an NFZ hygiene package at more than the comparable private-market price.
Tartar removal, a hygiene instruction, an examination and fluoride varnish together could cost the Fund more than PLN 600 for a single visit. In 2025 the NFZ spent more than PLN 500 million on this item.
The Agency for Health Technology Assessment and Tariff System set a minimum time: 30 minutes per patient for the package with hygiene instruction, and 20 minutes without. The new tariffs replace a bonus that raised the valuation of children’s services by 50 per cent.
For a practice with an NFZ contract the argument about points is secondary. The dental practice diary now has to show a slot that will stand up to an audit and to the next patient waiting for the chair. A quarter of an hour in a notebook and half an hour in the tariff are two different working days.
What the Fund changed from 1 September
The NFZ said clinics had been reporting tartar removal in children as well as adults. Hard tartar is uncommon in small children, especially early on. The charge is that some practices billed for a service that, in some children, was not physically there.
A new professional hygiene package for children was created. It covers removal of soft deposits — food debris or plaque — together with oral-hygiene instruction and optional fluoride varnish. Professor Dorota Olczak-Kowalczyk, the national consultant in paediatric dentistry, took part in the work.
The health ministry asked the Agency for a new valuation after the Fund requested clearer rules for prevention in children’s dentistry. The new AOTMiT tariffs take the place of the 50 per cent bonus. The Agency also says it will review valuations in conservative dentistry, including fillings. That is a plan, not a change to the filling price list already in force.
The background is older than September. 13 April 2026 the NFZ central office wrote that packages ST30, ST30A, ST30B and ST30C cover hard deposits only. Removal of soft deposits is not a separate guaranteed service. The valuation of those packages also includes fluoride varnish.
The Fund said varnish and deposit removal should not be billed together on the same visit for the same patient, because the scopes overlap. Cleaning the tooth before varnish, it said, is due care, not a separate line on the invoice.
infoDENT24 quoted NFZ analysis: product ST30 — removal of deposits from half an arch — was the most expensive billed item in dental care in 2025. The value exceeded PLN 478 million. Spring was an argument about what may be stacked on one visit. September adds a minimum time and a new package for children.
Reception does not read ordinances line by line. It sees the effect in the diary: a child who came in “quickly” occupies a chair that cannot be sold to anyone else, and the settlement still has to match what the dentist writes in the record.
Example. Two chairs, NFZ in the morning
Imagine a practice with two chairs. In the morning it sees children on an NFZ contract; in the afternoon, adults privately. A hygienist works at one chair, a dentist at the other. For years reception booked a child’s hygiene visit into a quarter of an hour. The argument was simple: a preschooler rarely has tartar, “it is only plaque and a chat with the parent”.
In September families return from holidays and school starts. Parents want a check-up before the infection season. The diary fills with names from the primary school. From 1 September the package with instruction needs a minimum of 30 minutes. A quarter-hour in the notebook stops being a harmless shortcut. It becomes a visit that cannot be billed as it was written down.
The child does not come. The parent cancels by text after the slot, or not at all. The chair stands empty. Behind the door a private patient is waiting for a scale and polish; reception said “this afternoon, once the NFZ queue has gone”. The queue did not go, because an empty 30 minutes cannot be sold after the fact.
In this story one thing helps, not a catalogue of features. A shared diary in which a child’s NFZ hygiene visit has its own appointment type and a blocked 30 minutes, and a cancellation before the time frees the slot at once. Reception sees the gap. It can call someone on the waiting list instead of waiting for the chair to go cold.
A slot that will stand up
AOTMiT did not invent the minutes for decoration. The minimum time is meant to guarantee that instruction and cleaning actually happen, not “in passing” between two fillings. A practice that still books a child for 15 minutes has two choices: shorten the service or lengthen the day. The first collides with the tariff. The second eats the private chair.
In a notebook and in Excel the visit type is often one word: “hygiene”. Software that has a separate type for the package with instruction and a separate type without sets 30 or 20 minutes itself and will not stack another child on the same chair. Reception does not count in its head. The diary does not lie to the dentist who is about to place a composite.
A ready-made dental practice programme already does this in many practices: chair, clinician, time, record. The problem starts when the NFZ contract and the private price list live in two diaries, and the hygienist has a separate notebook. September then shows which notebook is “true”.
Not every practice needs a new application. With one chair and fixed hours a sheet at reception is enough to keep two children out of the same half-hour. With two chairs, a hygienist’s shift and a mix of NFZ and private work, the sheet loses track of who is free at 11 a.m.
September. The children return; the chair does not
September in a children’s dental practice is not an ordinary Monday after holiday. Parents put the check-up off until “after the summer”. School starts, and with it requests for certificates, braces and “is that decay or a blueberry stain”. The same staff who had quieter afternoons in July suddenly have a full morning and a full evening.
The NFZ contract does not grow with the queue. The monthly point limit stays. A practice that in September puts every caller into a chair spends October explaining that “there are no NFZ places left”. The parent hears a refusal. Reception hears a diary that ate October in September.
A waiting list in a notebook works for as long as someone remembers who was promised “when a slot frees”. A shared list with a service type — child hygiene, check-up, conservative treatment — lets the gap after a no-show take someone who is actually waiting for that package, not the first person in the doorway. The chair does not stand idle. The limit does not leak into an empty slot.
Some practices keep the morning for NFZ only and after 3 p.m. for private work only. That is order, not luxury. It works when the diary does not mix those blocks “just this once, because mum can only come at 4 p.m.”. One child shifted to the afternoon pushes a private scale and polish and breaks a promise to an adult paying out of pocket.
An empty half-hour
A quarter-hour without a patient hurts. Half an hour hurts twice as much, because the second chair cannot take the child who was due for instruction, and the hygienist cannot “make up” the time with a composite. No-shows in children’s dentistry have one more trait: it is the parent who cancels, often in a rush, often after the moment when someone else could have been slotted in.
A reminder the day before and a request to confirm are not a gadget. They are the only moment left in which reception can still give the slot away. A text with the time, the chair and the line “cancel by noon if you cannot come” takes off some empty visits. Not all of them. As many as can be sold to someone on the list before the hygienist has time to make coffee.
On the private price list a practice may put a fee for an uncancelled visit in its terms, provided the patient is told before booking. On NFZ that lever disappears. What remains is the diary, the waiting list and the discipline of confirmations. An appointment system in a GP practice solves the same jam in a different unit of time. In dentistry the unit is the chair, not a “fifteen-minute room”.
A patient portal in which the parent moves the appointment with 24 hours’ notice takes some of September’s noise off reception’s phone. It does not replace a conversation about a child’s fear. It replaces the third “will you definitely be here tomorrow”.
Hygienist, dentist and the second chair
The new children’s package is work that in many practices the hygienist does, not the dentist. A diary that knows only the dentist’s name does not know whether at 10 a.m. the chair by the window is free, or only the surgical chair that already has an extraction. Two chairs without a person attached are, in practice, one chair and one queue in reception’s head.
In September the hygienist has a full morning of instruction. The dentist has fillings and pain cases. If reception puts a child “with the doctor, because the hygienist is full”, a 30-minute package walks into a composite slot. Or the other way round: the dentist waits, and the hygienist has a gap nobody sees, because the diary is one handwritten book by the till.
A shared rota with a resource — chair plus person — shows who is actually free. The hygienist’s leave in the third week of September should not surface with the morning coffee. A shift, illness, a course: the same 30 minutes, only with a different hole.
Excel with two sheets (dentist / hygienist) is enough when nobody falls ill and nobody swaps Thursday. With three people and two chairs the sheet comes apart on Friday afternoon, when someone adds a name in pencil. A panel that blocks a double booking of the same chair does not treat teeth. It saves the afternoon.
NFZ in the morning, a price list in the afternoon
Most practices with a contract are not “NFZ only”. In the morning children and pensioners on the Fund; in the afternoon adults on the price list; sometimes the same chair, sometimes the same dentist. Settlement runs on two tracks. The clinical record has to be one.
From September the NFZ track requires visit time and package content to be reconcilable. A practice that has “Anna, hygiene” in the diary and a package with instruction in the report to the Fund must have in the record what AOTMiT described: cleaning, instruction, varnish if used. Otherwise an inspection reads a different story from reception.
Practice software will not replace the NFZ settlement template or gabinet.gov. Those systems stay. It helps when the appointment type in the diary carries a label — NFZ child, NFZ adult, private — and will not stack on one visit items the Fund does not want to see together. Reception does not become the translator between the notebook and the bookkeeper.
A private scale and polish after 4 p.m. has a different price and a different duration. If the diary does not distinguish them, the day report shows “how many people”, not “how much chair was sold at the private rate, and how much the contract ate”. The owner learns that from the materials invoice, not from the diary.
The same split between public payer and private price list shows up in practice software for reimbursed prescriptions: a different field, the same jam. What goes to the public payer has to be what someone entered at the chair, not what someone added from memory in the evening.
A treatment plan that does not vanish between visits
A child’s hygiene visit is rarely the last appointment in September. The dentist sees a cavity, books treatment, the parent nods and leaves with a slip saying “in two weeks”. The slip vanishes. The September phone does not catch the parent. October opens with surprise that the child was due a composite, and the diary is empty.
A plan with the next slots — hygiene, then a filling, then a review — holds to the chair, not the drawer. Reception sees that after the NFZ package private or reimbursed treatment remains. The parent gets a reminder of the second visit before they forget why they are coming back.
With a child there is also parental consent and fear. An acclimatisation visit that will not fit inside 20 minutes of hygiene should have its own type, not be “tacked on” to the package. A diary that knows the difference does not ask the hygienist to do acclimatisation in time AOTMiT counted for instruction and plaque.
Photograph, record, note of the instruction: if they live in three places, an inspector and the next dentist read three versions. One record at the visit, showing whether varnish was applied, closes the argument before anyone opens the April email about ST30.
Excel, a subscription, or a panel of your own
With one chair, fixed hours and a dozen children a week, Excel with a “time” column and an “NFZ / private” column can be enough. The owner sits at reception anyway. They see who did not come.
A ready-made practice programme is sensible when the work fits its diary: one address, standard visit types, ready-made SMS reminders, a patient record. Most practices already stand on that, and there is no reason to burn it.
An integration is enough when the diary works and only a connector hurts: SMS, a waiting list, an export of hours to the bookkeeper, a bridge to the programme the practice already uses to settle the contract. One does not then build a second practice in the browser. One adds the missing piece.
A panel of your own makes sense when the process does not fit the subscription. Two addresses, a hygienist’s chair with a different price list, an NFZ block until 2 p.m. that must not be moved “just this once”, a list of schools the practice books by class, or a parent portal the off-the-shelf product will not join to the local no-show rules. Then it is cheaper to fit the software to the diary than the diary to the licence.
A broader comparison of subscription and a commissioned build is in the piece on when SaaS stops adding up. In dentistry the test is simple: does reception know at 9 a.m. how many minutes of chair remain today for the package with instruction, and how many for private work.
What can be joined before another September eats October
GESOFT builds panels and applications around a firm’s process, not around a generic practice from a leaflet. In the two-chair story that means joining what already travels: a visit type with 20 or 30 minutes, a chair-plus-person resource, a waiting list, a reminder with confirmation, an NFZ or price-list label, a plan of later visits. Without pretending this replaces settlement with the Fund.
If the diary, the record and the SMS can be joined in what the practice already uses, an integration remains. If the hygienist’s notebook, the dentist’s spreadsheet and reception’s book tell three Septembers, it is worth writing down the data flow and only then deciding whether a panel of your own is needed.
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