I'm so angry - dentist charged for "behavior management"!

[Shelleybeans]

Reading between the lines: dentists don't want to deal with patients like this, either.

Wow, that wasn't kind at all! Whether you were referring to the OP or her child. Is your intent to judge or help here?

 

[ceecee]

I would not pay for it! If it is a clamp and it is a disposable one, no way the Dentist paid 35.00 dollars for it.

No, there is an actual code for "behavioral management" billed in 15 min increments. I checked our ADA code book. I've never heard of a disposible clamp (it's a small device so the child can't bite down and cause major problems) you just autoclave them like the other instruments, no big deal. Our office isn't a pedo office but we get some pretty uptight adults! Valium works well on them. I know a lot of pedo offices sedate (the one we refer to calls it "foofoo juice") patients we refer there do really well with it. If the dentist was able to do a composite filling in 5 minutes with behavioral issues, he did well.

 

[Pea-n-Me]

Wow, that wasn't kind at all! Whether you were referring to the OP or her child. Is your intent to judge or help here?

Do you really think that this type of behavior is going to endear this PARENT to the dental staff?

No way i would pay the $35 behaviour management fee! Are they joking? She's 15 months old! i'd march over to that office on monday, pay the fee (MINUS THE BEHAVIOUR MANAGEMENT FEE) and simply explain how ridiculous they are being. You helped hold her, what exactly did they do different to calm your 15 month old? seriously!

The dentist above said it would be better to find a new dentist since the relationship is probably irrepairable, and I agree. It goes both ways.

99% of the time, it's the parent that is hard to deal with.

 

[3boymthr]

OP- Just a quick question. Would you be so upset if they said the fee was for an extended appointment? That's probably what they are charging you for.

 

[Pea-n-Me]

No, there is an actual code for "behavioral management" billed in 15 min increments. I checked our ADA code book. I've never heard of a disposible clamp (it's a small device so the child can't bite down and cause major problems) you just autoclave them like the other instruments, no big deal. Our office isn't a pedo office but we get some pretty uptight adults! Valium works well on them. I know a lot of pedo offices sedate (the one we refer to calls it "foofoo juice") patients we refer there do really well with it. If the dentist was able to do a composite filling in 5 minutes with behavioral issues, he did well.

Thank you for posting this. I would imagine the OP must have gotten her answer by now, too.

 

[eyor44]

Our Ped Dentist doesn't charge for this. When you fill out the paper work for any dental work there are explanations of what they might have to do, gas and a papoose board, but no extra charge.

 

[crisi]

No, there is an actual code for "behavioral management" billed in 15 min increments. I checked our ADA code book. I've never heard of a disposible clamp (it's a small device so the child can't bite down and cause major problems) you just autoclave them like the other instruments, no big deal. Our office isn't a pedo office but we get some pretty uptight adults! Valium works well on them. I know a lot of pedo offices sedate (the one we refer to calls it "foofoo juice") patients we refer there do really well with it. If the dentist was able to do a composite filling in 5 minutes with behavioral issues, he did well.

My dentist has used a disposable clamp like thing (to keep my mouth open) with me. I suppose that's the opposite of a clamp - basically, its a little wedge.

 

[ThisIsTheYear]

UPDATE: The billing person in the office said that it's not an automatic charge. The dentist noted it, to be billed. When I asked why it was billed, she said that she would have to ask the dentist when he comes in on Monday. She mentioned that they sometimes add the code because a child is crying or they need to add more time. I will find out what the dentist has to say on Monday before I type out anymore of my emotions. Thank you for the support!

 

[Pea-n-Me]

UPDATE: The billing person in the office said that it's not an automatic charge. The dentist noted it, to be billed. When I asked why it was billed, she said that she would have to ask the dentist when he comes in on Monday. She mentioned that they sometimes add the code because a child is crying or they need to add more time. I will find out what the dentist has to say on Monday before I type out anymore of my emotions. Thank you for the support!

It sounds like you have your answer.

 

[ThisIsTheYear]

OP- Just a quick question. Would you be so upset if they said the fee was for an extended appointment? That's probably what they are charging you for.

Nope! But I would still try to fight it because the entire appointment took no more than 10 minutes. If it was disclosed to me before the appointment that I would need to pay $35 for extended time (even if it was 10 minutes), then I would have no problem paying it.

 

[Pea-n-Me]

Nope! But I would still try to fight it because the entire appointment took no more than 10 minutes. If it was disclosed to me before the appointment that I would need to pay $35 for extended time (even if it was 10 minutes), then I would have no problem paying it.

I think you will probably win the battle, but lose the war, if you get what I mean. Just saying.

Look, if you want to go in and have a discussion with the dentist, by all means, you should. It's important for both of you (dentist and parent) to be on the same page. However, you, at this point, have so much anger, as well as the expectation of a "fight" going in, that things likely aren't going to go well for you at this office. (Even after having a better understanding of the charges than you did before you started this thread, I'd think.)

I'm betting the dentist will drop the charges given your extreme reaction to them. All I'm saying is that, perhaps you should go in there without the guns blazing, and maybe things will work out for you there better than they would if you go in like this

Good luck with whatever you decide, and however you handle it.

 

[luvmy3]

UPDATE: The billing person in the office said that it's not an automatic charge. The dentist noted it, to be billed. When I asked why it was billed, she said that she would have to ask the dentist when he comes in on Monday. She mentioned that they sometimes add the code because a child is crying or they need to add more time. I will find out what the dentist has to say on Monday before I type out anymore of my emotions. Thank you for the support!

Thanks for updating OP. I am really surprised, I would have bet money that is was because they had to use the clamp on such a young patient.
From your OP it doesn't sound like there was extra time involved or excessive crying above a normal reaction to the dentist. I could see that charge for a child that screams, flails arms and writhes around but it doesn't sound like that was the case for you.
I would probably make am issue about the charge and hope they decide to waive it.

 

[bjgonzo]

My 4 kids see a pediatric dentist and I love him! I've been very lucky and have found 3 great ones so far. My 4 year old had a couple of cavities that had to be filled, the first dentist in the practice wanted to use a general and do it in an OR. Thankfully we saw a different doc who does it in the office. He used what they call a "pillow" that they place between her teeth to keep her from biting. She cried the whole time, but did not have to be held down by anyone. It did take him extra time since he was trying to reassure her it we were not billed anything extra for this. I get his time is valuable, but I too would want to know why the charge is there.

OP our insurance company tells us the max they are allowed to bill us on our explanation of benefits, does your insurance company send you one or have one you can look at online? I would be checking with them as well to see, the practice may not be "allowed" to bill that to you.

 

[Pea-n-Me]

Thanks for updating OP. I am really surprised, I would have bet money that is was because they had to use the clamp on such a young patient.
From your OP it doesn't sound like there was extra time involved or excessive crying above a normal reaction to the dentist. I could see that charge for a child that screams, flails arms and writhes around but it doesn't sound like that was the case for you.
I would probably make am issue about the charge and hope they decide to waive it.

How to explain this.

The fact that the patient WAS crying and needed "support", i.e. behavior management, is what the charges are based on. They were able to do a quick, successful job BECAUSE OF their expertise. They are entitled to be compensated for this. To an outsider, it didn't appear anything special was done, but it was.

If you read through some of the links posted, you'll see that Mom being in the room in and of itself is an accepted behavioral management technique. I'm sure there were others, but we only have Mom's take on it. I'd bet if the dentist could respond here, we'd hear others specific to the case.

I'm not sure why this is such a hot button issue for people.

 

[kellylfitz]

I don't want to soapbox or argue so I won't post anymore after this, but there are always gross misconceptions what things cost once they become "for medical use". For example, we have a substance that we use during root canal procedures. It is called MTA and is essentially portland cement that costs pennies in the non-medical world. Somehow the medical version of it costs hundreds of dollars. Yes, hundreds of dollars for a few uses. The stuff your dentist uses is probably much more expensive than than think.

I'm kind of confused by what people mean when the are talking about clamps. There are two kinds of clamps we use in dentistry. The first is a clamp that holds the mouth open. It goes in the side of the mouth and looks kind of like a pair of scissors. Usually this is only used on kids since most adults are compliant enough to use a bite block (a little piece of rubber they bite on). The other clamp we use goes around the tooth we are working on and provides isolation from contaminants in the environment. All of these things are regularly used, not disposable, and no dentist I know charges for their use.

I never used this kind of charge, but it certainly isn't unethical to do. I just didn't think it was worth it or right to do personally. I had some patients that were an absolute breeze to work on and the procedure went much faster than I anticipated. I didn't give them a discount based on this so I didn't charge the more difficult patients more. I figured it all worked out in the end.

 

[luvmy3]

How to explain this.

The fact that the patient WAS crying and needed "support", i.e. behavior management, is what the charges are based on. They were able to do a quick, successful job BECAUSE OF their expertise. They are entitled to be compensated for this. To an outsider, it didn't appear anything special was done, but it was.

If you read through some of the links posted, you'll see that Mom being in the room in and of itself is an accepted behavioral management technique. I'm sure there were others, but we only have Mom's take on it. I'd bet if the dentist could respond here, we'd hear others specific to the case.

I'm not sure why this is such a hot button issue for people.

I was just sharing my opinion, don't really need an explanation from you, but um thanks anyway. I've already said that I am totally for this kind of fee and have no problem with a medical professional charging it when necessary.

I said "from your OP......" which means that judging from what the OP said the appointment was like it doesn't sound like there was very much "support" given from the dentist or assistant. So in that case I could see the OP making the charge an issue and having it waived because it doesn't sound as if the support was really necessary.
Now yes I get that dentist can and should charge that fee when needed, but from what the OP said it doesn't sound like they did anything other than shush the baby (in terms of what that charge is for). There was no extra time, no extra people called into the room, etc......

 

[Pea-n-Me]

I was just sharing my opinion, don't really need an explanation from you, but um thanks anyway. I've already said that I am totally for this kind of fee and have no problem with a medical professional charging it when necessary.

I said "from your OP......" which means that judging from what the OP said the appointment was like it doesn't sound like there was very much "support" given from the dentist or assistant. So in that case I could see the OP making the charge an issue and having it waived because it doesn't sound as if the support was really necessary.
Now yes I get that dentist can and should charge that fee when needed, but from what the OP said it doesn't sound like they did anything other than shusjh the baby (in terms of what that charge is for). There was no extra time, no extra people called into the room, etc......

Not sure why the snark.

You said you thought it was about the clamp. Whatever

 

[luvmy3]

Not sure why the snark.

You said you thought it was about the clamp. Whatever

Didn't mean to sound snarky, just taken back that you felt the need to "explain this" that is all. Sorry.

I thought it was about the clamp because it sure didn't sound like they did any other behavior management themselves.
And again, I get all the things they could charge for, but seeing how the only thing needed was mom in there it is definitely something she could try to have waived as there was nothing really above and beyond in terms of making the baby behave. Heck my kids dentist requires parents to be in the room. Anyway, I am in no way saying they shouldn't charge for it, just that the OP may have a good argument to try not to have to pay it.

And again sorry if I cam across snarky

 

[ThisIsTheYear]

How to explain this.

The fact that the patient WAS crying and needed "support", i.e. behavior management,

But 'I' was the one 'supporting' her. I held her tight and sang to her. 'I' got hot and sweaty from keeping her still.

They were able to do a quick, successful job BECAUSE OF their expertise. They are entitled to be compensated for this. To an outsider, it didn't appear anything special was done, but it was.

But, what could they have possibly done to manage her behavior? This is what I'm wondering.

If you read through some of the links posted, you'll see that Mom being in the room in and of itself is an accepted behavioral management technique.:

I don't think I should have to pay $35 for being in the room and constraining my daughter.

 

[Pea-n-Me]

NP I'm sorry, too.

FWIW, I didn't mean to "explain it" specifically to you, despite quoting you. It's just that throughout this thread, from many posters and most recently the OP herself, there still seems to be misunderstanding, even after an explanation from the dentist's staff.