Get taken by a Dentist?

[IndianaOD]

Just venting a little bit.

I have dental insurance and recently had an appt. The insurance covered everything and I had a zero balance. I had a small cavity or something and the insurance covered all but $30. That was all fine and well.

My wife went to a different dentist and we were sent a bill for $96. Same insurance, and they are a participating provider. Two uncovered services were performed. A fluoride rinse for $33 and an oral cancer screening for $60+. She had a couple of precavities filled the next week for $600 after insurance!! Something about the fillings they used weren't covered. So basically she was not informed that any of this was taking place and was never infomed of the cost.

To me this is very unethical to charge for unneccessary procedures. That $96 of nearly worthless procedures costs more than most eye exams! Needless to say we won't be going back and he may be getting a letter.

---

Members don't see this ad.

 

[armorshell]

That sucks. Remember, just because this jerk was a dentist doesn't mean this had anything to do with dentistry in general.

 

[IndianaOD]

That sucks. Remember, just because this jerk was a dentist doesn't mean this had anything to do with dentistry in general.

I completely agree. I had a very good experience with a different DDS. I guess its the good doctors that never get rich!

 

[shabu2]

In large practices, most dentists don't even discuss the fees because the office personnel usually do. I am sure if you asked the dentist, s/he would explain or figure out the charges. Most office staff just robotically charge whatever is on the doctor's notes. Shouldn't jump down the throat just yet.

 

[Ebull]

If you are at all concerned about paying for treatment out of pocket you should tell the doctor before he does anything. Most doctors provide treatment that they feel is necessary and don't want to be governed by insurance programs. It is not the doctor who is responsible for your coverage. That doctor would have probably done the same thing for all his patients regardless if they had coverage or not.

 

[OceanDMD]

I love how so many patients let their Insurance company dictate what procedures should be done. What if that cancer screening found a spot that was malignant? Sometimes they are very hard to find, oral cancer if caught early is usually very treatable. Does you wife smoke or drink? There are plenty of dentists out there that are looking for that extra buck, but don't let your insurance company plan your treatment. I treatment planned a 4 surface Onlay on a patient just the other day (trying to preserve an intact ML/MB cusp on max molar), the insurance company would not pay for it. They decided it would have to be a crown or a giant pin retained amalgam (which I will never do). Doing the crown is more destructive of tooth structure, and increases the chance fro pulpal problems. I hate insurance companies!!!!

 

[IndianaOD]

I love how so many patients let their Insurance company dictate what procedures should be done. What if that cancer screening found a spot that was malignant? Sometimes they are very hard to find, oral cancer if caught early is usually very treatable. Does you wife smoke or drink? There are plenty of dentists out there that are looking for that extra buck, but don't let your insurance company plan your treatment. I treatment planned a 4 surface Onlay on a patient just the other day (trying to preserve an intact ML/MB cusp on max molar), the insurance company would not pay for it. They decided it would have to be a crown or a giant pin retained amalgam (which I will never do). Doing the crown is more destructive of tooth structure, and increases the chance fro pulpal problems. I hate insurance companies!!!!

I don't mind paying for useful or beneficial procedures. If it was me and not my wife I would not have accepted the charges. If I am not mistaken the fluoride rinse is basically useless. Believe me, I know how much insurance sucks. Just be glad you don't deal with two different types (vision and medical). My wife has no risk factors for oral cancer and is young and healthy. I'm assuming if he was doing his job correctly he would have seen any major problems without the test.

I would love to charge $60 for a retinal photo on everyone who walked in the door, but I don't. Its actually a very useful procedure but not neccessary. I think the guy was just building a retirement fund at my expense.

 

[ItsGavinC]

If I am not mistaken the fluoride rinse is basically useless.

Yep, flouride is no good. Completely useless. I'm sure you can read the dripping sarcasm here. OF COURSE it has a benefit!

My wife has no risk factors for oral cancer and is young and healthy. I'm assuming if he was doing his job correctly he would have seen any major problems without the test.

I'm glad she's young and healthy. That's all the more reason for an oral cancer screening to be completed. It's fairly routinue for that to be completed on all new patients. Some states mandate that we perform the exam.

I won't belabor the point, but I'm sure you understand what risk factors are. They aren't conclusive causation factors. Oral cancer screenings, mamograms, pap smears, prostate exams, etc. are all done for the same reason. They are done even if you appear to be healthy and don't have risk factors.

Having said all of that, I'll make it clear that I'm not approving or disapproving of the guy's fees. My point is that you are making claims of unecessary prodecures when those procedures are standard preventative dental procedures.

 

[ItsGavinC]

To me this is very unethical to charge for unneccessary procedures.

One final thing I wanted to mention about this line. It goes above and beyond the charging--it's unethical to perform unnecessary procedures, regardless of the fee associated.

 

[gryffindor]

I would love to charge $60 for a retinal photo on everyone who walked in the door, but I don't. Its actually a very useful procedure but not neccessary. I think the guy was just building a retirement fund at my expense.

Why not? If you can justify why the photo is necessary and helps you treatment plan and diagnose, why would you feel guilty about doing it and charging the patient? I don't know what a retinal photo is or what it shows. But if my OD took one and explained to me why it was beneficial despite the insurance company not covering it, I would feel like I was getting a thorough exam and pay the $60 to know that the eye doctor has lots of data to back up that my eyes are OK.

 

[toofache32]

Dentists make recommendations on what you NEED, regardless of insurance coverage for those procedures. Many people confuse "lack of coverage" for "unnecessary."

 

[toofache32]

I don't mind paying for useful or beneficial procedures. If it was me and not my wife I would not have accepted the charges. If I am not mistaken the fluoride rinse is basically useless. Believe me, I know how much insurance sucks. Just be glad you don't deal with two different types (vision and medical). My wife has no risk factors for oral cancer and is young and healthy. I'm assuming if he was doing his job correctly he would have seen any major problems without the test.

I would love to charge $60 for a retinal photo on everyone who walked in the door, but I don't. Its actually a very useful procedure but not neccessary. I think the guy was just building a retirement fund at my expense.

I wear my 1-week disposable contacts for about 3 months straight before changing them. And I can still see just fine, so what's the big deal?

 

[DDSwithAplan]

Dentists make recommendations on what you NEED, regardless of insurance coverage for those procedures. Many people confuse "lack of coverage" for "unnecessary."

An oral cancer exam is not an acceptable insurance charge, it is part of a normal exam, it is unethical, it is like buying a shirt and having them charge extra for the buttons, but it is an important part of an oral examination

 

[johntara04]

I love how so many patients let their Insurance company dictate what procedures should be done. What if that cancer screening found a spot that was malignant? Sometimes they are very hard to find, oral cancer if caught early is usually very treatable. Does you wife smoke or drink? There are plenty of dentists out there that are looking for that extra buck, but don't let your insurance company plan your treatment. I treatment planned a 4 surface Onlay on a patient just the other day (trying to preserve an intact ML/MB cusp on max molar), the insurance company would not pay for it. They decided it would have to be a crown or a giant pin retained amalgam (which I will never do). Doing the crown is more destructive of tooth structure, and increases the chance fro pulpal problems. I hate insurance companies!!!!

Wow, I agree. 😱😉

I think patients need to remember that their insurance companies are businesses out to make money. That is their number 1 goal. They are going to do everything they can to keep you from using their product that you are paying a lot of money for every month, even if it means the customer receives sub-standard care.

Everyone repeat with me three times:

Insurance companies want to make money, not keep me healthy...Insurance companies want to make money, not keep me healthy...Insurance companies.....

 

[docj1]

An oral cancer exam is not an acceptable insurance charge, it is part of a normal exam, it is unethical, it is like buying a shirt and having them charge extra for the buttons, but it is an important part of an oral examination

If a dentist is using something like vizilite than it is not part of a normal exam. I perform clinical oral cancer screenings at no charge every time I perform an exam, but if I were to use visilite I would have to charge for the procedure. The material for those tests are not cheap so if that is what's being done than it's not unethical. I do, however, believe that the patient should be well informed of the difference between a clinical screening and a procedure which will cost them. If the dentist is charging for an oral cancer screening based on a visual clinical exam than you may have a point.

 

[mg777]

Just venting a little bit.

I have dental insurance and recently had an appt. The insurance covered everything and I had a zero balance. I had a small cavity or something and the insurance covered all but $30. That was all fine and well.

My wife went to a different dentist and we were sent a bill for $96. Same insurance, and they are a participating provider. Two uncovered services were performed. A fluoride rinse for $33 and an oral cancer screening for $60+. She had a couple of precavities filled the next week for $600 after insurance!! Something about the fillings they used weren't covered. So basically she was not informed that any of this was taking place and was never infomed of the cost.

To me this is very unethical to charge for unneccessary procedures. That $96 of nearly worthless procedures costs more than most eye exams! Needless to say we won't be going back and he may be getting a letter.

Cancer screening is worthless procedure? Dont equate dentl medical exams you dont understand to useless, ask the dentist whats going. The dentist isnt required to explain fee scheduling as part of the treatment plan to the patient. The dentist should have gave her all treatment options she could do that day from less expensive amalgams to composite, or no treatment at all. The latter would have been less than eye exam and hopefully fit your budget.

 

[Robert Paulsen]

I lived in Tokyo for a few years and experienced the effect of "socialized" healthcare first-hand.

In Japan, people go to the dentist when they are in pain. They do not go for preventive care. I was not aware of this and went to see a dentist for a routine cleaning/exam. After taking panoramic x-rays he looked in my mouth and said everything was very good. He then reached for the drill and went to town on one of my teeth. In Japan they drill off the top of the tooth, leaving a thin margin around the edges. Then they take an impression, order a filling, and schedule you to come in in two or three days after the casting arrives so they can install it.

I went back for the filling install, but before he put it in, he grabbed the drill again and proceeded to mutilate another tooth.

After talking to some of my coworkers, I learned how the system works. The government and large corporations insure everyone for health/dental care.
Dentists in Japan (at least at that time, in the late 80s) will drill and fill every tooth in your head as long as you keep going back to them, because they can bill the government for services. Needless to say, I stopped going to the dentist in Japan as soon as I got that second filling installed.

RP

 

[Temest]

My wife has no risk factors for oral cancer and is young and healthy. I'm assuming if he was doing his job correctly he would have seen any major problems without the test.

Your wife is not immune from becoming a statistic. Over 25% of oral cancer victims have no risk factors. Ask your wife if the dentist had her rinse with anything or used a light other than the patient light for the oral cancer screening. If so, then checkout out D0431 in the CDT. It's a billable procedure.
I'm guessing 1) that you think that if every procedure was free, or your insurance covered 100%, then the procedudre is legitimate and 2) you would be the first to sue if your wife developed oral cancer. You should thank your dentist for providing PREVENTIVE services.

 

[Sweeti8286]

She had a couple of precavities filled the next week for $600 after insurance!


I'm not familiar with the charges in private practice...what kind of precavities would cost $600? How many teeth are you talking about??

I think there are indeed dentists out there who try to get as much as they can from insurance companies- because 1) it won't be the consumer paying, it's the insurance and 2) if you do end up being billed after the insurance, it'd seem like you got off "cheap". So, I can see it's a win-win situation for both parties, but unethetical and illegal. I've recently had this happen to my brother and sister-in-law where they both went in to the same dentist for about an hour tops for a routine exam, x rays, and prophy. I saw their pre-insurance statement and questioned them. According to their description, my brother had a cleaning that lasted about 15 minutes, no probing or anesthetics was used. My sister-in-law went in for about 45 minutes (she was pregnant, so she didn't go during the 9 months and I'd imagine had more to scale) She reported no probing (or a bunch of numbers being read) and no anesthetics. Well, my brother received a pre-statement of 2 quad scaling and root planing billed to the insurance while my sis-in-law got 4 quad scale and root planing, that is in addition to the x ray and exam charge. A month later, the 2 quad of S/RP on my brother's statement was changed to regular adult prophy. Then another month later in May- it got changed back to 2 quad S/RP. There's definately something shady going on here. (btw, the dentist charges $99 for prophy versus $256 PER QUAD for S/RP) So that's a HUGE difference! I'm still trying to see where I can find the law that states the maximum charge the dentist can bill them if we were to reproduce their records or just the x rays. Because things just don't make sense....this is a general practicioner who can S/RP all 4 quadrants w/o probing to create a perio record and no anesthetics on a healthy 29 year old in under an hour. So, we're talking about $700 for 15 minutes for prophy (or 2 quad "S/RP")/exam/x rays and over $1200 for a 45 minute session of prophy ("4 quad S/RP)/exam/xrays.

Anyway- when I go to the dentist (and I don't have dental insurance)- I also was charged for the oral cancer screening- I think that's part of the "periodic oral exam" rather than seperate charge. I don't quite remember, but I do distinctly see those words on my bill for something like $35.

If anyone has thoughts on what I had wrote about my bro/sis-in-law or what I can do about it, I'd appreciate your comments. Feel free to PM me. Sorry to divert the attention from original post. 😉

 

[gryffindor]

"Filling precavities" sounds like it could be a sealant or PRR on an adult, which is also almost never a covered procedure beyond age 18. But it can be a good procedure for many adults for many reasons.

Sweeti8286, I'm not going to comment on whether your brother's dentist was right or wrong in the billing and treatment your relatives received because I wasn't there. But for your own info, not all probing depths have to be read aloud for the patient to know it is being done. I used to do a lot of hygiene as GP, and I would check probing depths on everyone. Most of the patients were 3 or less. However, I would bust out my pen with the disposable pen cover and start recording unusual ones if I came across any. I didn't work with an assistant (oh the luxury!) and did the probing and any recording myself, so my patients wouldn't have heard numbers. I usually explained what I was doing before I did anything during the cleaning/exam, however, this is just how I practiced.

 

[johntara04]

I'm still trying to see where I can find the law that states the maximum charge the dentist can bill them if we were to reproduce their records or just the x rays. Because things just don't make sense....this is a general practicioner who can S/RP all 4 quadrants w/o probing to create a perio record and no anesthetics on a healthy 29 year old in under an hour. So, we're talking about $700 for 15 minutes for prophy (or 2 quad "S/SP")/exam/x rays and over $1200 for a 45 minute session of prophy ("4 quad S/SP)/exam/xrays.

The dentist can charge whatever he can get people to pay. $250 per quad for S/RP is about average in my area. $99 for a prophy is cheap.

 

[NileBDS]

... So basically she was not informed that any of this was taking place and was never infomed of the cost.

To me this is very unethical to charge for unneccessary procedures. That $96 of nearly worthless procedures costs more than most eye exams! Needless to say we won't be going back and he may be getting a letter.

I don't know about you guys, but I would be infuriated over receiving a $600 bill for something that I was never told was performed, and not even explained why it was done in the first place.
Whatever procedures you recommend are only that, recommendations, until the patient agrees/consents to them, and only then do they become treatment.

Typically before ANY procedure is done, other than the initial exam and/or x-rays, there should be an agreed upon treatment plan signed by both the patient and attending dentist. Of course this is a legal document more than anything, but also an informed consent from the patient to "go ahead" with that specific treatment and that you have done your RBA's already.

I find it unacceptable for a patient to not know what is going on with their treatment, and to add insult to injury, receive a bill for it too.
What happened to patient autonomy ?

At least this is how things should be done. Now whether or not that specific provider decides to do things his own way, he at least should be accountable for his decisions.

As far as the procedures themselves being necessary or not (which I think the fluoride was not, considering her age), should again be referred to the patient. Once the patient understands what treatment is being proposed and how (and to what extent) they would benefit from it, leaves them to decide what is best for them and what is "unnecessary".

That's just me.

 

[Temest]

Typically before ANY procedure is done, other than the initial exam and/or x-rays, there should be an agreed upon treatment plan signed by both the patient and attending dentist. Of course this is a legal document more than anything, but also an informed consent from the patient to "go ahead" with that specific treatment and that you have done your RBA's already.

Angry patients (and spouses) too often suffer from amnesia when things are not as they want them to be. Esp. when it come to a bill. Legal document?? I once had a patient with #7 blown out with a post sticking out of it and 7mm pocket lingually. She want a crown. I refused and referred her back to her periodontist. She refused the referral. Being a nice guy (or was I $$ hungry?) I explained vocally AND in writing that I would place a core and put on a temp ONLY. I made her sign the chart with her refusals. Well....after 2 months she wanted a permenant. I refused. She sued and I got screwed for the barristers fees + any money she spent.
Get real. The wife and spouse are pissed.

 

[Sweeti8286]

I used to do a lot of hygiene as GP, and I would check probing depths on everyone. Most of the patients were 3 or less. However, I would bust out my pen with the disposable pen cover and start recording unusual ones if I came across any. I didn't work with an assistant (oh the luxury!) and did the probing and any recording myself, so my patients wouldn't have heard numbers. I usually explained what I was doing before I did anything during the cleaning/exam, however, this is just how I practiced.

I understand that you have to work alone sometimes, even when it comes to charting. But with the time period that was described, can you chart AND do a prophy in 15-20 minutes? (I'm not even counting the x rays and exam time) Even if you can, I highly doubt it'd be quality. I have explained and showed what a probe is to them, and they both don't recall being "poked" all around. I've asked one of my professors that most insurance require a perio record to pay for a S/RP procedure and they don't typically pay more than 2 quads of S/RP in a single appointment. I'm just doing what I can to find out what went on based on the answers and what I can do to protect my relatives from possible insurance fraud and perhaps the dentist as well.

On top of that, they were only expecting a regular prophy.....not $1500 worth of "cleaning" in about an hour. They weren't informed of the S/RP procedures. I mean, what would happen if they didn't have insurance and the dentist still performed these procedures?? I would be beyond pissed if I got stuck with that bill.

Typically before ANY procedure is done, other than the initial exam and/or x-rays, there should be an agreed upon treatment plan signed by both the patient and attending dentist. Of course this is a legal document more than anything, but also an informed consent from the patient to "go ahead" with that specific treatment and that you have done your RBA's already.

Is there such a law that states that there has be a document signed by both parties agreeing upon the treatment plan proposed? Or can it be like a verbal agreement? For example, "you need a filling here, schedule an appointment to come back for it"?

I explained vocally AND in writing that I would place a core and put on a temp ONLY. I made her sign the chart with her refusals. Well....after 2 months she wanted a permenant. I refused. She sued and I got screwed for the barristers fees + any money she spent. Get real. The wife and spouse are pissed.

Why did you get screwed if you have the ducumentation that she signed stating you would only do the core and temp only and refused to see a specialist? I can see that considering it's a temp, it would imply there's a final restoration on its way- in this case, did it count as "abandonment" because you refused to do the final restoration?

The dentist can charge whatever he can get people to pay. $250 per quad for S/RP is about average in my area. $99 for a prophy is cheap.

Sorry- I meant the maximum allowable amount the dentist can charge to reproduce the record or x rays, not the amount they charge for their services.

 

[lnn2]

Just venting a little bit.

I have dental insurance and recently had an appt. The insurance covered everything and I had a zero balance. I had a small cavity or something and the insurance covered all but $30. That was all fine and well.

My wife went to a different dentist and we were sent a bill for $96. Same insurance, and they are a participating provider. Two uncovered services were performed. A fluoride rinse for $33 and an oral cancer screening for $60+. She had a couple of precavities filled the next week for $600 after insurance!! Something about the fillings they used weren't covered. So basically she was not informed that any of this was taking place and was never infomed of the cost.

To me this is very unethical to charge for unneccessary procedures. That $96 of nearly worthless procedures costs more than most eye exams! Needless to say we won't be going back and he may be getting a letter.

That unneccessary $60 unneccessary procedure might save your wife's life!

The oral cancer screening is usually a part (included) of the dental exam. It's rarely a separate charge. But then again if your wife's dentist had a specialty training or he just simply wanted to charge it as a separate fee then you're stuck with it.

We don't provide fl rinse for adults, just toothbrush and floss. If they don't use them then we'll do fillings the next time we see them!

Dental fees are varied, dictated by dentists in private practices.

 

[dee783]

I've been going to my current dentist for the last 3 or so years, and i just realized that he doesn't do any probing or even take any x rays when i go in for my cleanings. (but he does polish my teeth nicely) The only time I remember him take x rays or probe was the first time I went there. He charges 150 for the cleaning for "diagnostic and preventive" services. Have I been taken?? Dentists that i have shadowed have the hygienist do the patient's cleaning, including the probing and charting and then the dentist will do an overall check of the cleaning, including examination of the head, neck and throat, and cancer screens for smokers.

 

[toofache32]

I've been going to my current dentist for the last 3 or so years, and i just realized that he doesn't do any probing or even take any x rays when i go in for my cleanings. (but he does polish my teeth nicely) The only time I remember him take x rays or probe was the first time I went there. He charges 150 for the cleaning for "diagnostic and preventive" services. Have I been taken?? Dentists that i have shadowed have the hygienist do the patient's cleaning, including the probing and charting and then the dentist will do an overall check of the cleaning, including examination of the head, neck and throat, and cancer screens for smokers.

If the dentist himself does the cleaning and charting, I would guess he isn't very busy.

 

[Sprgrover]

...
Is there such a law that states that there has be a document signed by both parties agreeing upon the treatment plan proposed? Or can it be like a verbal agreement? For example, "you need a filling here, schedule an appointment to come back for it"?...

This falls under the jurisdiction of the civil court system, in which there doesn't have to be a specific law, and often there isn't, for a judge or a jury to make a ruling (unlike criminal law). A verbal agreement between two consenting parties that are able to enter into a contract (e.g. the patient can't be sedated, a dependant minor, and so on) would count as a contract, however, it's best to document such things in writing with signatures of both parties, considering the burden of proof would more than likely be placed on the dentist. And beyond this, you have to also worry if yours is a plantiff state, which Temest's sounds like it is.

 

[QCkid]

As far as the procedures themselves being necessary or not (which I think the fluoride was not, considering her age), should again be referred to the patient. Once the patient understands what treatment is being proposed and how (and to what extent) they would benefit from it, leaves them to decide what is best for them and what is "unnecessary".

That's just me.

Flouride could be indicated. You can't say that it was unnecessary. Patient might be prone to caries, have a lot of decalcified enamel, lack normal saliva flow, or have erosions do to some chemical process (drinks a lot of soda).

 

[NileBDS]

Angry patients (and spouses) too often suffer from amnesia when things are not as they want them to be. Esp. when it come to a bill. Legal document?? I once had a patient with #7 blown out with a post sticking out of it and 7mm pocket lingually. She want a crown. I refused and referred her back to her periodontist. She refused the referral. Being a nice guy (or was I $$ hungry?) I explained vocally AND in writing that I would place a core and put on a temp ONLY. I made her sign the chart with her refusals. Well....after 2 months she wanted a permenant. I refused. She sued and I got screwed for the barristers fees + any money she spent.
Get real. The wife and spouse are pissed.

Can you please elaborate a little bit more about your case ? It sounds interesting (and quite shocking) !

What state do you practice in ? Was she a patient of record at you office ? What did she sue you for ? How/why did they dismiss your chart documentation ?

 

[NileBDS]

Is there such a law that states that there has be a document signed by both parties agreeing upon the treatment plan proposed? Or can it be like a verbal agreement? For example, "you need a filling here, schedule an appointment to come back for it"?

I wish I had an answer for that, but I do not.
From the standpoint of the few malpractice lawyers I have spoken to or heard lecture, a written signed document is your best bet. It is a legal document.
Unless there was a credible 3rd party present for the length of your discussion, I am sure an oral agreement will turn into an ugly he said she said.

Document, document, document.

 

[NileBDS]

Flouride could be indicated. You can't say that it was unnecessary. Patient might be prone to caries, have a lot of decalcified enamel, lack normal saliva flow, or have erosions do to some chemical process (drinks a lot of soda).

Right. But in that case I still would not recommend a one shot "in-office" fluoride treatment like you would a pedo pt.
I personally would Rx that patient some adjunct home care products such as a fluoride mouthwash and/or high fluoride toothpaste and/or saliva substitute and/or neutralizing mouthwash to deal with their condition long term.
Only in a limited number of cases, where the patient has pretty good OH and no active lesions going on would I maybe recommend a fluoride varnish (along with all the home care products).
And like I said before, that's just me. Each one of us will probably look at different cases from different perspectives.

 

[DrJeff]

My wife has no risk factors for oral cancer and is young and healthy.
.

I'm sure then she would forgoe her yearly pap smears and breat cancer exams too based on the young and healthy reasoning.

Look, chances of her having oral CA yes, are low, but NOT 0%. Chances of nay younf healthy person having any type of CA are low, but it does happen, and early diagnosis is paramount to getting the best possible outcome.

Don't blame the dentist for performing the proceedure, blame the insurance company(or the employer) for not covering it

 

[IndianaOD]

I'm sure then she would forgoe her yearly pap smears and breat cancer exams too based on the young and healthy reasoning.

Look, chances of her having oral CA yes, are low, but NOT 0%. Chances of nay younf healthy person having any type of CA are low, but it does happen, and early diagnosis is paramount to getting the best possible outcome.

Don't blame the dentist for performing the proceedure, blame the insurance company(or the employer) for not covering it

What I can't understand is why my dentist didn't perform all these tests and this other one did. If we would have been infomed of the costs and options before hand I would have been fine with it. She never had a cavity in her life. Why did my dentist use a covered type of filling while hers didn't? I'm just telling you the guy will loose patients if he doesn't educate them. The tests may or may not have been beneficial, but my wife came away feeling like she got taken and living on the sallary of a post-doc position isn't easy with $700 of unexpected costs.

After my current job I'm droping dental coverage anyways. I'll just pay for the visits.

You could screen for eveything in the world, heck get an MRI for fun. Doesn't mean it makes sense because it catches 1 patient in a million in that age braket.

 

[Daurang]

Do you have PPO or DMO? If you have DMO then i can't really sympathize with you because they pay like crap and you deserved it and the dentist deserved it for taking it. But if you have PPO then I'd agree with you and the dentist should have included it with the comp exam. I'd walk out and refuse to pay if I get the same bullcrap because there are plenty of offices that give complimentary oral cancer exam.

 

[north2southOMFS]

You could screen for eveything in the world, heck get an MRI for fun. Doesn't mean it makes sense because it catches 1 patient in a million in that age braket.

My guess is that if your wife showed up tomorrow with some form of oral cancer you'd be the first in line at Dewey, Cheatem, and Howe ready to sue the dentist who failed to perform an oral cancer screening on your wife.....

My other guess is that your wife has a self breast exam card hanging in your shower. If you could do a self oral exam, knock yourself out....

We don't do resource exhaustive or financially taxing screening exams in this country. I hardly think 35 dollars for a cancer screening is either of those. Plus, the coding is for malignancy screening, when in reality we are screening for many (mostly) benign lesions which can be easily removed when they are small, but if left untreated too long will require a more disfiguring resection.

 

[DrJeff]

What I can't understand is why my dentist didn't perform all these tests and this other one did. If we would have been infomed of the costs and options before hand I would have been fine with it. She never had a cavity in her life. Why did my dentist use a covered type of filling while hers didn't? I'm just telling you the guy will loose patients if he doesn't educate them. The tests may or may not have been beneficial, but my wife came away feeling like she got taken and living on the sallary of a post-doc position isn't easy with $700 of unexpected costs.

After my current job I'm droping dental coverage anyways. I'll just pay for the visits.

You could screen for eveything in the world, heck get an MRI for fun. Doesn't mean it makes sense because it catches 1 patient in a million in that age braket.

The big factor may be how and what each of your dentists use for screening for oral CA and the type of fillings that were placed.

Your dentist may have very well done the visual exam for oral CA without any added "light assisted" devices and/or small scrapings of the gum tissue taken for screening purposes, and your wife's may have used some of them. Many dentists implementing the light assisted screening technology will charge seperately for it.

If your fillings were covered by insurance and her's weren't, the 2 most likely causes would be that yours were either the silver kind in your back teeth or tooth colored in your front teeth (both of which are "insurance friendly") and your wife had tooth colored fillings in her back teeth(some dentists DON'T/won't place anything but tooth colored fillings so the less expensive silver colored fillings may not have even been an option for her at that office).

Most of this again is an insurance company issue with why they choose not to cover procedures and the fact that dental insurance in many cases isn't like medical insurance where dental insurance typically just covers a percentage of a procedure with the balance being your responsibility whereas medical insurance tends to cover the entire procedure after a smallish, standard copay. Trying to compare medical and dental insurance is like trying to compare apples and oranges, their both fruits, but that's where the similarites end.

 

[OceanDMD]

If the dentist himself does the cleaning and charting, I would guess he isn't very busy.

I have a busy practice. We do over 2 million a year in production. EVERY NEW PATIENT is seen first by the dentist for a comprehensive exam (before a cleaning) which includes charting, probing, and a cancer screaning. We take a Pan on every new patient. In my opinion, it is inappropriate to schedule a new patient with hygiene for a prophy. If this patient has subgingival calculus, >5 mm pockets, how does an adult prophy benefit this person? If I cant get my new patient in with hygiene within 2 months I will clean them. It has nothing to do with being busy.

On a side note, there is no additional fee for the cancer screening. However, there are new products out that include chemicals and light which cost a practice money. These cancer screening are more thorough, and I certainly agree with posting a fee for them. You as a patient have a right to deny this screening just as the dentist has the right to dismiss you as a patient. Nothing pisses me off more than a patient that refuses bite wings, pans, or other diagnostic procedures. Ive picked up carotid blockages on a pan before with a 50 year old. If you dont like what your dentist recommends, its easy to find one that doesnt check for these things,has never had a patient with perio, and still restores anterior teeth with amalgam or glass ionomer.

 

[IndianaOD]

My guess is that if your wife showed up tomorrow with some form of oral cancer you'd be the first in line at Dewey, Cheatem, and Howe ready to sue the dentist who failed to perform an oral cancer screening on your wife.....

My other guess is that your wife has a self breast exam card hanging in your shower. If you could do a self oral exam, knock yourself out....

We don't do resource exhaustive or financially taxing screening exams in this country. I hardly think 35 dollars for a cancer screening is either of those. Plus, the coding is for malignancy screening, when in reality we are screening for many (mostly) benign lesions which can be easily removed when they are small, but if left untreated too long will require a more disfiguring resection.

It was $66 thanks. I have Cigna dental PPO for another poster. For all our dentists on here who gripe about insuances (who wouldn't) how many provide their employees with cut rate vision insurance? For example, Spectera, Davis and others. Even most of the "good" insurances pay me no more than $66 if I'm lucky. So basically my entire comprehensive exam with 15-20 min of doctor time is worth the same or less than a questionable cancer screening carried out by the hygenist? That's what I spent 9 years of post high school education for? There's a reason I tell people to go into dentistry! Same schooling, big time payoff!

 

[gryffindor]

It was $66 thanks. I have Cigna dental PPO for another poster. For all our dentists on here who gripe about insuances (who wouldn't) how many provide their employees with cut rate vision insurance? For example, Spectera, Davis and others. Even most of the "good" insurances pay me no more than $66 if I'm lucky. So basically my entire comprehensive exam with 15-20 min of doctor time is worth the same or less than a questionable cancer screening carried out by the hygenist? That's what I spent 9 years of post high school education for? There's a reason I tell people to go into dentistry! Same schooling, big time payoff!

I wouldn't offer my employees cut rate vision insurance, or any vision insurance for that matter. Not worth the paperwork involved to get $20 off a pair of eyeglasses every other year or whatever it is those plans offer, "good" or cut-rate. Seems like you have discovered that you will be dropping your dental coverage and just paying your dentist without the insurance middleman. I think the same applies to your profession as well and I don't hesitate to tell anyone that dental and vision insurances are IMO worthless. It's the trip to your local ER without medical insurance that scares me as to how many digits the bill they will mail you many weeks later will have - 4? 5? 6+ if it was actually a serious injury involving being admitted?

 

[Daurang]

I agree with you IndianaOD. I don't think your dentist should have billed you separately for the oral cancer screening.

I have a question for you... why do glasses cost $600 when your cost is only $1 for frames and 50 cents per lense? Even my best friend of 25 years charged me $300 which I think is a ripoff. I finally had it with such ripoff prices and order online through zennioptical for $20 bucks and they come with antiglare, antiscratch.

 

[gryffindor]

I have a question for you... why do glasses cost $600 when your cost is only $1 for frames and 50 cents per lense? Even my best friend of 25 years charged me $300 which I think is a ripoff. I finally had it with such ripoff prices and order online through zennioptical for $20 bucks and they come with antiglare, antiscratch.

Ummm, because the optometrist wants to make a decent living? What kind of question is this? There are plenty of procedures and things in dentistry that are low cost/high profit. Why shouldn't it be the same for other professions?

 

[johntara04]

Ummm, because the optometrist wants to make a decent living? What kind of question is this? There are plenty of procedures and things in dentistry that are low cost/high profit. Why shouldn't it be the same for other professions?

I think he is telling the OD not to rip on a cancer screening charge when the OD does the same thing.

 

[IndianaOD]

I agree with you IndianaOD. I don't think your dentist should have billed you separately for the oral cancer screening.

I have a question for you... why do glasses cost $600 when your cost is only $1 for frames and 50 cents per lense? Even my best friend of 25 years charged me $300 which I think is a ripoff. I finally had it with such ripoff prices and order online through zennioptical for $20 bucks and they come with antiglare, antiscratch.

Quality frames and lenses cost far more than that =). Why does a dental exam run 200-300 when the same doctor time with an OD is much less? $1200 for a couple of cavities? Its because optometry has done a horrible job undervaluing services and overvaluing products.

For another poster, would you like your patients to get their fillings, crowns etc online? You should think of how you would want to be treated before going off and supporting crooked internet companies and taking your OD to the cleaners. ODs couldn't survive without the spectacle profits. With the same difficulty and time of education, ODs already make quite a bit less than dentists even with spectacle sales. You get what you pay for. Cheap walmart glasses are crap. This is something which allows you to see your world every day. People will spend $100 on a pair of shoes they wear 5x a year yet won't pay $70 for anitreflective that lets them see better every day for 2+ years.

I agree, optometrists should charge 2-3x their exam fees and cut the spec costs by 1/4. Though if you really look into it, most private OD offices mark up their products much less than most other "retailers." A lot of frames at walmart cost them $3-4. Most decent frames cost ODs $60-90 at least.

 

[DrJeff]

Quality frames and lenses cost far more than that =). Why does a dental exam run 200-300 when the same doctor time with an OD is much less? $1200 for a couple of cavities? Its because optometry has done a horrible job undervaluing services and overvaluing products.

For another poster, would you like your patients to get their fillings, crowns etc online? You should think of how you would want to be treated before going off and supporting crooked internet companies and taking your OD to the cleaners. ODs couldn't survive without the spectacle profits. With the same difficulty and time of education, ODs already make quite a bit less than dentists even with spectacle sales. You get what you pay for. Cheap walmart glasses are crap. This is something which allows you to see your world every day. People will spend $100 on a pair of shoes they wear 5x a year yet won't pay $70 for anitreflective that lets them see better every day for 2+ years.

I agree, optometrists should charge 2-3x their exam fees and cut the spec costs by 1/4. Though if you really look into it, most private OD offices mark up their products much less than most other "retailers." A lot of frames at walmart cost them $3-4. Most decent frames cost ODs $60-90 at least.

On a side note, you'll regularly find us dentists walking aroud the office with $1000+ pieces of eye wear in the form of loupes hanging around our necks.

Seperate side note/question for Indiana OD, what would be the "average" percent overhead for you guys?? Typically a dental office will be a few percent either side of 60%. Some such as daurang who posted in this thread will if memory serves me correct get the overhead down around 30%, others will have overheads approaching 80%😱 Just curious

 

[IndianaOD]

On a side note, you'll regularly find us dentists walking aroud the office with $1000+ pieces of eye wear in the form of loupes hanging around our necks.

Seperate side note/question for Indiana OD, what would be the "average" percent overhead for you guys?? Typically a dental office will be a few percent either side of 60%. Some such as daurang who posted in this thread will if memory serves me correct get the overhead down around 30%, others will have overheads approaching 80%😱 Just curious

Are you talking about practice overhead? An OD is very lucky to break 30% of gross. Most make around 28% of gross.

The equipment is very expensive as I'm sure is the same on your side. We have two types of insurance to deal with (vision and medical) which is a full time job. A binocular indirect (thing that looks like a spelunking light) with the condensing lens is over $2000 so take that! =)

 

[IndianaOD]

On a side note, you'll regularly find us dentists walking aroud the office with $1000+ pieces of eye wear in the form of loupes hanging around our necks.

Why spend $1000 when you are using $50 spectacles?😱

 

[johntara04]

Why spend $1000 when you are using $50 spectacles?😱

Because that is what orascoptic tells us is a smoking deal. 😀🙄😱

 

[DrJeff]

Are you talking about practice overhead? An OD is very lucky to break 30% of gross. Most make around 28% of gross.

So our overheads generally speaking aren't that different

The equipment is very expensive as I'm sure is the same on your side. We have two types of insurance to deal with (vision and medical) which is a full time job.

Ditto, Dental Chairs, $5,000-$15,000, Drills $400 - $2000,
Lasers/Computer aided restoration fabrication machines - $50,000 - $100,000, etc, etc, etc.

Insurance claims processing, major, major time expenditure since no matter what type of insurance it it, insurance companies are/can be a pain in the a$$😡

A binocular indirect (thing that looks like a spelunking light) with the condensing lens is over $2000 so take that! =)

Got you beat(almost), I'm STRONGLY considering purchasing a surgical microscope at around $10,000😱😉😀

Bottom line, we're in the healthcare BUSINESS, and unless you're turning a profit, those folks at places like the electric company, the lending institutions that floated you the cash for school + business equipment, etc., and you're employees won't be happy😉