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

[Pea-n-Me]

I think we touched on this yesterday, i.e. why does this whole "behavior management" thing even exist in pediatric dentistry?

These articles might help explain it. (And don't shoot me, I'm just the messenger! )

1. Challenges of Managing Child Behavior in the 21st Century Dental Setting

Todays parents reflect the changes in society. The traditional parent role included setting limits and saying no. In an attempt to be a friend to their child, many parents have abrogated their responsibility to establish boundaries, maintain discipline, teach self-control, and instill respect for others. In a recent survey, pediatric dentists reported that changes in parenting styles have adversely influenced child behavior in the dental office. Some behavior management methods, traditionally a part of the armamentarium of pediatric dentists, are now perceived negatively by parents.

http://www.smiles4kids.com/articles/Managing Behavior of Children in the 21st Century.pdf

2. Pediatric Management: How To Become The Person in Charge!

With todays permissiveness, its more critical than ever for dental professionals to become experts in child management. A 2004 article in Pediatric Dentistry addresses the impact of societal changes on pediatric behavior in dental offices. Children have fewer boundaries, the article states, and less discipline and self-control. Both parents and contemporary culture expect less from children in terms of behavior than we used to expect.

More and more frequently, we see children who have turned the tables on authority. They control their parents to an astonishing degree, and expect to do the same with us. If we want to provide them with quality dentistry, we cant let that happen. So what techniques can we use to become The Person in Charge?

http://www.rdhmag.com/articles/prin...ement-how-to-become-the-person-in-charge.html

 

[Pea-n-Me]

I think I'll post this separately so it doesn't get lost in the info above.

Interesting definition here from the Washington State Legislature:

"Behavior management" means using the assistance of one additional dental professional staff to manage the behavior of a client to facilitate the delivery of dental treatment.

 

[rosemerry]

it is really unethical. If i am a dentist, i would never charge such petty cash. Doctor is a holy profession.

 

[Donnask8pro]

Where in Jersey are you? I am in South Jersey and have the BEST ped dentist ever! I switched from another maniac to this practice and will never leave.. (until they throw me out) lol

 

[goofyintoronto]

Write up your own invoice for 50 dollars for "Parental Restraint Fee" and then add on a 20 dollar processing fee. Send it to your dentist with a specified due date....and then send a "late notice".

I love this!

 

[Shelleybeans]

I'm also going to add a fee for 'extended waiting room time'.

So glad you still have your sense of humor!

 

[Robbi]

The worst dentist we ever saw was a pediatric dentist. He was a jerk. Gave him 2 chances and then I started bringing my kids to the regualr dentist who was more patient.

 

[luvmy3]

Screaming the entire time. That's the key, and the reason for the extra charge.

Oops, I totally overlooked that in the OP

I still think the OP has grounds to fight the charge though since according to her the assistant only sshhhed her baby, they didn't hold or restrain her herself.


Pea, I won't shoot you. I actually agree with that article.
We see the effect of certain parenting styles everywhere, look at all the threads here complaining about them Its no surprise that people like dentists would have to deal with it, and charge accordingly for it.
Sometimes I wish I could bill a parent for the effect their parenting style has on me
(I am not at all saying this was the case for the OP)

 

[mom2my3kids]

The insurance may or may not pay it, I got charged for both kids for floride because my insurance only covers it once a year and my dentist office for some reason applies it twice a year..

 

[Pea-n-Me]

I believe I saw somewhere that Behavior Management charges are not covered by insurance due to the high number of fraudulent claims they've had historically. (Note this is not to say that all such charges are fraudulent.)

 

[Pea-n-Me]

Oops, I totally overlooked that in the OP

I still think the OP has grounds to fight the charge though since according to her the assistant only sshhhed her baby, they didn't hold or restrain her herself.

I believe that the sssh and the mom being there and holding were the culmination of the treatment decision, not the entire thing. What they did allowed the treatment to happen successfully.

Pea, I won't shoot you. I actually agree with that article.
We see the effect of certain parenting styles everywhere, look at all the threads here complaining about them Its no surprise that people like dentists would have to deal with it, and charge accordingly for it.
Sometimes I wish I could bill a parent for the effect their parenting style has on me
(I am not at all saying this was the case for the OP)

I was actually a little surprised to come across such literature. It probably helps explain why I left two pediatric dental practices myself.

 

[Shelleybeans]

I believe I saw somewhere that Behavior Management charges are not covered by insurance due to the high number of fraudulent claims they've had historically. (Note this is not to say that all such charges are fraudulent.)

So PC, informative, and intelligent!

 

[MomToOne]

Just because a kid screams is not in my book grounds for an extra charge. Sorry, that's just part of the business. It requires no extra time or significant effort on their part to just let the kid scream away, so an extra charge is not valid if that's all they did on their part. Are there articles about how to handle this? Sure, and I hope a dentist reads them or is otherwise trained in how to handle it. But if there is no extra labor or time taken, it does not deserve an extra charge.

BUT if the dentist did in fact spend extra time, either working with the patient or explaining things to the mother in more detail than usual, or used an extra assistant, then I would consider the charge valid.

Only the dentist will be able to explain and justify this one. The fact that the dentist "often adds it" isn't an explaination I would find acceptable. Wanting a specific explanation for why it was added in this case is a reasonable request.

 

[Pea-n-Me]

So PC, informative, and intelligent!

Say what? Please explain what you mean.

 

[IndianaPrincess]

The insurance may or may not pay it, I got charged for both kids for floride because my insurance only covers it once a year and my dentist office for some reason applies it twice a year..

This happened to us. When I called and asked about why it was on our bill, the office apologized and removed the charge. Part of accepting insurance is accepting what insurance pays and not passing the extra to the patient. If it is outside of what your insurance covers, then you have to agree to it beforehand or they are out of luck and have to write it off.

OP - I hope you press this!

 

[tvguy]

I believe I saw somewhere that Behavior Management charges are not covered by insurance due to the high number of fraudulent claims they've had historically. (Note this is not to say that all such charges are fraudulent.)

If you Google it, I think you will it hard to find an insurance company that does not cover Behavior Management fees. Federal insurance programs, which tend to exclude a lot of services, cover it.

 

[kellylfitz]

This happened to us. When I called and asked about why it was on our bill, the office apologized and removed the charge. Part of accepting insurance is accepting what insurance pays and not passing the extra to the patient. If it is outside of what your insurance covers, then you have to agree to it beforehand or they are out of luck and have to write it off.

OP - I hope you press this!

I said I wouldn't post again, but I feel the need to correct this because it is patently false. If something is not covered by insurance, then it is the patient's responsibility. If a patient wants veneers to make their teeth look better, no insurance company in the world will cover it, but you bet that the patient will be paying for it. If the insurance company decides that the patient could have had a filling instead of a crown (regardless of the fact that the patient really needed a crown), then the patient will be paying for it. An insurance company trying to dictate what a dentist can and cannot do outside the scope of the policy has been found illegal in multiple states.

Insurance companies are in it for their own profit and the patients ideal care is not their number one priority. The only thing the insurance company does is force the dentist to set his rates according to their fee schedule. A dentist can't charge the patient more than the insurance company's set fee and then collect the remainder from the patient.

 

[Gina-Gina-Bo-Bina]

The only thing the insurance company does is force the dentist to set his rates according to their fee schedule. A dentist can't charge the patient more than the insurance company's set fee and then collect the remainder from the patient.

They can here in Canada.

Our dentist routinely rounds up on all procedures. If the Dental Fee Guide says it can be billed up to $97.25 for that particular procedure, his charge will be $100. And we are out of pocket for the difference, as our insurance coverage will not pay beyond what is set out in the fee guide.

 

[kellylfitz]

They can here in Canada.

Our dentist routinely rounds up on all procedures. If the Dental Fee Guide says it can be billed up to $97.25 for that particular procedure, his charge will be $100. And we are out of pocket for the difference, as our insurance coverage will not pay beyond what is set out in the fee guide.

I cannot speak for Canada as I have not practiced there, but it is very illegal in the United States and any dentist doing it can be criminally prosecuted for insurance fraud. That is not to say that some dentists don't do it.

 

[kirstenb1]

kellylfitz, I think upthread you said you were a dentist. My children and I go to my dentist (and they always have). She is wonderful!! And it sounds like you're very conscientious, and a great dentist.

Our last appt was last month. Our younger dd who is 8 and has autism had 2 cavities. I had one under an existing cavity. Our dentist was able to fill hers in 15 minutes, max. No lidocaine shots, thank goodness. The only reason I mention dd has autism is that this dentist has spent 7 yrs building a relationship with dd. I think that is so crucial, because you see the payoff when treatment is needed, like then. No tears, no drama.

On the other hand, my cavity, which was my first in 30 yrs, took an hour from lidocaine shots, to finishing drying of the filling. It was a yucky process, drilling through the old filling, and making sure she drilled out all the new cavity. This is where I have to really express my thanks to you guys. I got billed $135 for an hour's worth of work. I can't imagine a medical doctor spending an hour with me, and only billing $135. I trust her implicitly, because she always puts our health first, and $$ second. Never tries to sell me on the whitening procedures LOL, thank goodness!!

You sound like my kind of dentist!!