California dentistry and insurance companies

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oralcare123

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I moved to San Diego from Canada two weeks ago and would like to know your opinion on Deltacare USA and Liberty Dental basic and buy-up plans.Is it true that Deltacare USA pays so little, that good dentists do not accept it?
Yesterday my husband broke of his front tooth and we had to go to Smilecare dental clinic in Mission Valley.The least to say I was not impressed: they offered no treatment, no options, no temporary mesures.Too bad I can't work yet.

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I moved to San Diego from Canada two weeks ago and would like to know your opinion on Deltacare USA and Liberty Dental basic and buy-up plans.Is it true that Deltacare USA pays so little, that good dentists do not accept it?
Yesterday my husband broke of his front tooth and we had to go to Smilecare dental clinic in Mission Valley.The least to say I was not impressed: they offered no treatment, no options, no temporary mesures.Too bad I can't work yet.

Corporate dentistry at its finest. Let me guess, they had a coupon?

If you want a better experience, please go visit a traditional FFS for practice, a dentist that doesn't accept HMOs, and maybe one that you ask around "who's your dentist".

Good luck!
 
No, there were no cupon, but the list of dentists.In Canada insurance pays 80-100% of Basic services and 50-80% prosthodontics, there are no lists that is why I am so upset.I do not see a point of having insurance at all.Today we have another appointment, I will let you know what will happen when I ask for LAVA bridge
 
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Update- we found a closed door! Do not tell me California dentists do not have enough patients/work etc any more
 
1. Last I checked which was a few years ago, Deltacare pay roughly $5 for a prophy. Do you think any dentist with any competence/dignity will take it? How much do you tip your manicurist?

2. Many dentists in SoCal/Mission Valley area have multiple offices because they do not have enough patients for one location. Some also sublease the space to specialists on empty days.

3. Grab some Chinese/VNmese/Spanish newspapers. You're bound to see ads for $200 root canal and $300 crown for your husband's fractured tooth.
 
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The most unpleasant was to discover that rich company elected this kind of coverage for it's engeneers. I do not beleive I can get a quolity service for 1/10 of the price
 
The most unpleasant was to discover that rich company elected this kind of coverage for it's engeneers. I do not beleive I can get a quolity service for 1/10 of the price

Because the company wants the employees to feel good about having "dental coverage" in their benefits package.
 
I do not see a point of having insurance at all.

I do not beleive I can get a quolity service for 1/10 of the price

There is no such thing as dental "insurance." It is merely a dental plan that is the way of transferring money from employer to employee to help offset the cost of dental care. It's a shame that these companies figured out how to profiteer off your employer by giving you a service that is less than adequate while making you think you actually need "insurance" for your teeth because it's just too much to ask somebody to pay $100-300 a year to keep their mouth healthy. This is said but it is the truth right now in dentistry.

Do not tell me California dentists do not have enough patients/work etc any more

The most unpleasant was to discover that rich company elected this kind of coverage for it's engeneers

Serious man, even though you come on SDN to proclaim how annoyed you are, you will still run to the closest person who is a network provider for your "dental plan" to pay out only 20% instead of 50% and also because you think just maybe, you'll get somebody who actually is a decent dentist. Most of the time, you'll end up with somebody who probably is decent but because they are contracted to only charge $300 for a crown or free prophies (which you are paid pennies), you can quickly realize why these dentists don't want to bother with quality.

Patients sometimes get what they pay for, but sometimes they don't even get that. In dentistry, I can promise you that you will never get something that you don't pay for.
 
The most unpleasant was to discover that rich company elected this kind of coverage for it's engeneers. I do not beleive I can get a quolity service for 1/10 of the price

I doubt if your statement is completely honest nor true. Virtually all large rich companies let employees choose among different plans. Deltacare is the junk one they throw in for free if you choose not to pay the $10-$30 a month for the much better Delta Premier plan. As I've said before you get what you paid for. Now just go to your human resource and sign up for the better plan.
 
There is no such thing as dental "insurance." It is merely a dental plan that is the way of transferring money from employer to employee to help offset the cost of dental care. It's a shame that these companies figured out how to profiteer off your employer by giving you a service that is less than adequate while making you think you actually need "insurance" for your teeth because it's just too much to ask somebody to pay $100-300 a year to keep their mouth healthy. This is said but it is the truth right now in dentistry.





Serious man, even though you come on SDN to proclaim how annoyed you are, you will still run to the closest person who is a network provider for your "dental plan" to pay out only 20% instead of 50% and also because you think just maybe, you'll get somebody who actually is a decent dentist. Most of the time, you'll end up with somebody who probably is decent but because they are contracted to only charge $300 for a crown or free prophies (which you are paid pennies), you can quickly realize why these dentists don't want to bother with quality.

Patients sometimes get what they pay for, but sometimes they don't even get that. In dentistry, I can promise you that you will never get something that you don't pay for.
Amen, amen, a thousand times amen. Every time I hear a patient tell me "I used to come in every six months but then I lost my insurance." My response usually runs something like "well, I'm sorry to hear that you lost your dental benefits, but those couple checkups would only have cost you about $100 apiece. Now that tooth that hurts needs a root canal+build up+crown that's going to cost you a solid thousand bucks out of pocket even after your inaurance. Cavities and gum disease don't care whether you have insurance or not, and now you get to choose between a cheaper treatment that sacrifices the tooth, or a better one that costs you more. Happy trails."
 
Amen, amen, a thousand times amen. Every time I hear a patient tell me "I used to come in every six months but then I lost my insurance." My response usually runs something like "well, I'm sorry to hear that you lost your dental benefits, but those couple checkups would only have cost you about $100 apiece. Now that tooth that hurts needs a root canal+build up+crown that's going to cost you a solid thousand bucks out of pocket even after your inaurance. Cavities and gum disease don't care whether you have insurance or not, and now you get to choose between a cheaper treatment that sacrifices the tooth, or a better one that costs you more. Happy trails."

It's funny that so much of this is true throughout our society these days... and we have to fault both sides of the fence. Why pay for something now when you can defer the cost to later... it may cost 10x more later, but that's our kid's problems.

There are studies that do show people go to the dentist more when they have dental plans, but I'd like to see real data that people are receiving a difference in quality of care as compared to their dentist's status as a 1. cash only, 2. out-of-network provider, 3. network provider (and various levels of network status), 4. DHMO provider, and 5. medicaid provider. How about patient satisfaction x quality perceived versus quality received versus timeliness.

We can only guess why that study will never take place.:rolleyes:
 
I needed nelp in understanding how insurance/dentistry work in California.I do not need free services.,but I do not want to leave my purse and underware in the dental office eather.
Unfortunately, none of the "good" plans are available to me at the moment.Let me explain a little about canadian dental insurance: it does not pay just 20% for something, it pays 20% of the charge and the rest is patient portion,From 100$ patient pays 80$ and insurance -20$.
In my opinion,if a dentist sighned the contract, he should respect it.Otherwise what is next?
I visited another dentist, same plan.6900 for three unit LAVA bridge.My portion will be 4000$.Do you still think that I am getting anything for chip?
 
$7000 for 3 units? That's highway robbery! Take a drive to OC, there are many there that will do it for $1000 total or $2000 max. Or else go find another dentist and insist on cash discount.
 
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Take a drive to OC, there are many there that will do it for $1000 total or $2000 max.

Yeah, maybe in Irvine or inland somewhere... maybe they will speak English ... maybe have a lovely list of their services in block letters on their windows... and maybe just maybe, those dentists will be using sterile instruments. :laugh:
 
Yeah, maybe in Irvine or inland somewhere... maybe they will speak English ... maybe have a lovely list of their services in block letters on their windows... and maybe just maybe, those dentists will be using sterile instruments. :laugh:

So you sleep ok at nite charging someone $7000 for 3-unit?

Dentists in OC are just desperate because competition is so intense. I'm from SoCal myself and guess why I had to move to the Northeast. I never wanted to be here but it beats doing filling for $20 and crowns for $200 but I don't rob people $2300+ for a crown.
 
Some of you have very interesting way of thinking.Have you ever heard about responsibility to provide best services possible, work with clean instruments, DO NO HARM or it is only about money? Tell me why sign a contract if you have no intent to honor it?
 
$7000 for 3 units? That's highway robbery! Take a drive to OC, there are many there that will do it for $1000 total or $2000 max. Or else go find another dentist and insist on cash discount.

i agree that is on the high end of the price spectrum (ie, i charge $3000 for a 3 unit full porcelain). however if somebody is advertising it for $1000 i would definitely think twice; as any reputable lab would charge more than half that much in lab fees alone.
 
Some of you have very interesting way of thinking.Have you ever heard about responsibility to provide best services possible, work with clean instruments, DO NO HARM or it is only about money? Tell me why sign a contract if you have no intent to honor it?

That's why I told you not to even deal with the Deltacare or whatever crap dental hmo you got. Walk in with cash and say you want cash price not some inflated balogney skyhigh price. Your ideal price should be in the range of $300-$1400. Paying less than $300 will guarantee you basement garage quality but paying more than $1400 will guarantee you nothing.
 
So you sleep ok at nite charging someone $7000 for 3-unit?

Dentists in OC are just desperate because competition is so intense. I'm from SoCal myself and guess why I had to move to the Northeast. I never wanted to be here but it beats doing filling for $20 and crowns for $200 but I don't rob people $2300+ for a crown.

The right fee is the fee that people are willing to pay for and the service they expect as a result. Dentists can charge whatever they feel adequate for their services they feel they provide. Dental benefit plans and 3rd party payors feel they can tell you what you can charge to level the playing field... however, this is certainly not true. Not all clinical presentations/patients are the same and it maybe occurs that the patient has mitigating factors which necessitate this fee.

Do I think 7k is a significant amount of money for a 3-unit FPD, you bet. Do I think it's too high? Well, that depends. If you believe your 3-unit FPD is 7k worthy and have patients willing to pay for it, it probably is worthy of that fee. If you feel your dentistry is worth 1k for the same procedure and your patients are willing to pay that fee, then that is the fee you charge.

It's free market capitalistic thinking, not regulation by a 3rd party telling you what you can and cannot do or charge.

And yes, if I felt my treatment and services were worthy of charging 7k for a 3-unit FPD, then yes, I do sleep well at night because I know I could take the time to deliver a high quality product without cutting corners and using the best materials to deliver that result. In fact, I have been in high quality practices like this and that of PPO/network/DHMO/medicaid providers and I lost more sleep at night from the latter because the fees were so low that I could not justify doing the best dentistry possible.

Corporate dentistry highly pressures you to become a "past the lips, everything fits" dentist whether you think so or not. I never became this type of dentist and only lasted 8 months in corporate dentistry. And yes, I was a high producer, and yes, I did make a lot of money in this type of practice. I am very happy, however, that I am not in this type of practice anymore and am willing to make less money as a result. My trade off is that I do sleep better at night now than I did before. ;)
 
I became a provider for Deltacare USA for about 2 years. Then of course I resigned from their provider list after my business picked up. Best decision I ever made..Of course I can run my mouth now, since I am officially "retired" from private practice.;):)
 
So you sleep ok at nite charging someone $7000 for 3-unit?

.

wow.. I' charging close to that amount for Zirconium or Lava 3-unit and my hand-made temporary. Half that amount for PFM. It is all up to patient's choice.
 
The right fee is the fee that people are willing to pay for and the service they expect as a result. Dentists can charge whatever they feel adequate for their services they feel they provide. Dental benefit plans and 3rd party payors feel they can tell you what you can charge to level the playing field... however, this is certainly not true. Not all clinical presentations/patients are the same and it maybe occurs that the patient has mitigating factors which necessitate this fee.

Do I think 7k is a significant amount of money for a 3-unit FPD, you bet. Do I think it's too high? Well, that depends. If you believe your 3-unit FPD is 7k worthy and have patients willing to pay for it, it probably is worthy of that fee. If you feel your dentistry is worth 1k for the same procedure and your patients are willing to pay that fee, then that is the fee you charge.

It's free market capitalistic thinking, not regulation by a 3rd party telling you what you can and cannot do or charge.

And yes, if I felt my treatment and services were worthy of charging 7k for a 3-unit FPD, then yes, I do sleep well at night because I know I could take the time to deliver a high quality product without cutting corners and using the best materials to deliver that result. In fact, I have been in high quality practices like this and that of PPO/network/DHMO/medicaid providers and I lost more sleep at night from the latter because the fees were so low that I could not justify doing the best dentistry possible.

Corporate dentistry highly pressures you to become a "past the lips, everything fits" dentist whether you think so or not. I never became this type of dentist and only lasted 8 months in corporate dentistry. And yes, I was a high producer, and yes, I did make a lot of money in this type of practice. I am very happy, however, that I am not in this type of practice anymore and am willing to make less money as a result. My trade off is that I do sleep better at night now than I did before. ;)



:thumbup:
 
If none of you agreed to terms of insurance companies, situation could have been different.
Free market is when a dentist is not bound by a contract.But dental services are not T-shirts, all of us have an obligation of doing no harm.
If low pay would justify low quolity of service,imagine how you would be served in many many locations.
 
If none of you agreed to terms of insurance companies, situation could have been different.
Free market is when a dentist is not bound by a contract.But dental services are not T-shirts, all of us have an obligation of doing no harm.
If low pay would justify low quolity of service,imagine how you would be served in many many locations.

:laugh:

I don't agree to the terms of any dental plan, hence why I am not a provider for any.

Maybe Obama will fix everything for us, right!? Low pay = low quality service (generally). If you want something done right, you have to #1 take ownership, and then #2 pay for it. Get over it.

:D
 
You do not get it. I am trying to explain how wrong it is to take advantage of people. I guess you should not get upset if waiter spit's in your food, because he is not payed well.
I have enough money, but I do not want to be fooled.I also have high ethical standarts,do you?
 
insurance companies these days are all alike. i just hope Obama can fix them

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kevin biggs
Dental Insurance Quotes

Sure, just like he fixed healthcare reform and financial reform. Have you noticed that anytime he claims to 'fix' anything, it'll costs you and me much, much more money while the problem remains and we lost a bit more freedom?

Next time put your hope and change on someone with at least some experience running a hot dog stand, not a gifted speaker with no qualifications whatsoever.
 
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