Another Dentist Vent

[Turn the Page]

All 3 kids see a pediatric dentist in town. We have been at that practice for about 5 years now. DH has dental insurance that covers 2 cleaning a year, etc. and we have never had any issues with it.

The office just called me to let me know that they are no longer accepting our insurance and that we have 2 choices. We can either pay the entire bill upfront and be reimbursed by our insurance or we can pay the expected copay and pay the balance when we are reimbursed, usually in about 30 days but we can't make any additional appointments until the balance is paid. For the next scheduled cleaning we have to pay either the full amount of $630 or the expected copay of $180. The cleanings are covered 100% so I'm a little unclear about how they came up with the expected copay amount but whatever. What really irritates us is that their appointment for the next cleaning is on Thursday morning. Now, we have the cash sitting in the savings account so we can cover it without any issue but it still irritates me to no end that they wait until now to tell us this and then further tell me that if we need to put off the appointments they require cancellation by noon the business day before so by tomorrow at noon we have to let them know if we're keeping the appointments or not.

I am strongly considering leaving the practice over it. If the kids didn't have such severe dental issues I would in a heartbeat.

 

[Disneypro1]

Goto a dentist that accepts the insurance as primary payer. We had to change a few times. Not a big deal. I understand your issues. But I’d change for sure.

 

[NotUrsula]

I suspect your expected co-pay is for anti-cavity coating, I find that most pediatric dentists always apply it after cleanings. Most insurance companies do not include that in their straight coverage for cleanings. I know we have always had to pay for it OOP.

Beyond that, $210 is really high for a routine semi-annual cleaning, even a pediatric cleaning. If you are paying cash up front you should be able to bargain that down a bit; it's a guarantee that very few insurance companies would consider that price within reasonable and customary limits.

 

[Southernmiss]

Is there a reason they have to see a pediatric dentist?

We left our pediatric dentist and went to our regular dentist who was great with kids. His prices were cheaper, too as his office was no frills and not catering to just kids.

When they stopped honoring our insurance, we went to another non-pediatric dentist for the whole family.

 

[jrmasm]

My dentist stopped accepting my insurance quite a few years ago. We stayed with him. He's worth it.

 

[Southernmiss]

All 3 kids see a pediatric dentist in town. We have been at that practice for about 5 years now. DH has dental insurance that covers 2 cleaning a year, etc. and we have never had any issues with it.

The office just called me to let me know that they are no longer accepting our insurance and that we have 2 choices. We can either pay the entire bill upfront and be reimbursed by our insurance or we can pay the expected copay and pay the balance when we are reimbursed, usually in about 30 days but we can't make any additional appointments until the balance is paid. For the next scheduled cleaning we have to pay either the full amount of $630 or the expected copay of $180. The cleanings are covered 100% so I'm a little unclear about how they came up with the expected copay amount but whatever. What really irritates us is that their appointment for the next cleaning is on Thursday morning. Now, we have the cash sitting in the savings account so we can cover it without any issue but it still irritates me to no end that they wait until now to tell us this and then further tell me that if we need to put off the appointments they require cancellation by noon the business day before so by tomorrow at noon we have to let them know if we're keeping the appointments or not.

I am strongly considering leaving the practice over it. If the kids didn't have such severe dental issues I would in a heartbeat.

 

[mjkacmom]

This happened at our dentist, but they only bill us after they submit it to our insurance (our insurance doesn’t cover all of it but we love our dentist office of over 20 years). I know several small business owners, so many people don’t pay in a timely fashion.

 

[Searc]

All 3 kids see a pediatric dentist in town. We have been at that practice for about 5 years now. DH has dental insurance that covers 2 cleaning a year, etc. and we have never had any issues with it.

The office just called me to let me know that they are no longer accepting our insurance and that we have 2 choices. We can either pay the entire bill upfront and be reimbursed by our insurance or we can pay the expected copay and pay the balance when we are reimbursed, usually in about 30 days but we can't make any additional appointments until the balance is paid. For the next scheduled cleaning we have to pay either the full amount of $630 or the expected copay of $180. The cleanings are covered 100% so I'm a little unclear about how they came up with the expected copay amount but whatever. What really irritates us is that their appointment for the next cleaning is on Thursday morning. Now, we have the cash sitting in the savings account so we can cover it without any issue but it still irritates me to no end that they wait until now to tell us this and then further tell me that if we need to put off the appointments they require cancellation by noon the business day before so by tomorrow at noon we have to let them know if we're keeping the appointments or not.

I am strongly considering leaving the practice over it. If the kids didn't have such severe dental issues I would in a heartbeat.

They charge $630 to do nothing more than a cleaning? Tell them to kiss off and find another practice.

 

[ImDMous]

Unless you are really in love with this dentist, I would just switch to one that is in your network. It will save a lot of money.

 

[Sephrina]

All 3 kids see a pediatric dentist in town. We have been at that practice for about 5 years now. DH has dental insurance that covers 2 cleaning a year, etc. and we have never had any issues with it.

The office just called me to let me know that they are no longer accepting our insurance and that we have 2 choices. We can either pay the entire bill upfront and be reimbursed by our insurance or we can pay the expected copay and pay the balance when we are reimbursed, usually in about 30 days but we can't make any additional appointments until the balance is paid. For the next scheduled cleaning we have to pay either the full amount of $630 or the expected copay of $180. The cleanings are covered 100% so I'm a little unclear about how they came up with the expected copay amount but whatever. What really irritates us is that their appointment for the next cleaning is on Thursday morning. Now, we have the cash sitting in the savings account so we can cover it without any issue but it still irritates me to no end that they wait until now to tell us this and then further tell me that if we need to put off the appointments they require cancellation by noon the business day before so by tomorrow at noon we have to let them know if we're keeping the appointments or not.

I am strongly considering leaving the practice over it. If the kids didn't have such severe dental issues I would in a heartbeat.

If they are no longer accepting your insurance, will you be reimbursed at an out of network rate? If so, that could leave you a copay or additional amounts over what your insurance allows.

 

[Turn the Page]

They charge $630 to do nothing more than a cleaning? Tell them to kiss off and find another practice.

That is the total for cleanings for all 3 and x rays for the oldest.

 

[Searc]

That is the total for cleanings for all 3 and x rays for the oldest.

That is still crazy high.

 

[mikehn]

Its just business, dont take it personally. When the healthcare provider is outside your insurance network, they usually file the insurance on your behalf as a courtesy to you. Your insurance pays 100% of usual and customary for cleanings. Sounds like they charge more than usual and customary, thus the estimated copay. That is my guess.

 

[Turn the Page]

If they are no longer accepting your insurance, will you be reimbursed at an out of network rate? If so, that could leave you a copay or additional amounts over what your insurance allows.

Good point. Apparently they never were in network and they just accepted whatever the insurance company sent so I assumed we would be reimbursed the full amount but now I'm not sure.

 

[wgeo]

If your dentist no longer accepts your insurance that means that your cleanings will no longer be covered at 100%.

Technically yes, your insurance will pay 100% of their usual and customary amount, but because you are out of network you will be responsible for the difference. If you want to continue getting your cleanings without paying anything you will need to switch to an office that accepts your insurance.

 

[AppleDumpling]

I would go with your gut and find a new dentist who takes your insurance. Pediatric dentists usually charge more because they are considered specialists. Most kids will do fine with a family dentist (who sees patients of all ages). Find one who uses sedation (nitrous oxide) and allows parents to stay in the exam room. Ask your friends for recommendations.

 

[kdonnel]

The cleanings are covered 100% so I'm a little unclear about how they came up with the expected copay amount but whatever.

The cleanings are probably covered 100% if in network. Your dentist is out of network. As a result there is a usual and customary charge the insurance company pays and you are responsible for any amount more then that.

I went to a dentist (aka torturer) who charged much more then usual and customary. Switched to a different one who is also out of network but each cleaning ends up costing $3-$5 as that is the only amount more then the usual and customary.

 

[wvjules]

Just cancel the appointment and get a new in-network dentist.

 

[mjkacmom]

I would go with your gut and find a new dentist who takes your insurance. Pediatric dentists usually charge more because they are considered specialists. Most kids will do fine with a family dentist (who sees patients of all ages). Find one who uses sedation (nitrous oxide) and allows parents to stay in the exam room. Ask your friends for recommendations.

We just go to a family dentist, started when our oldest was 3. My kids love going, I started just dropping them off and picking them up when they were in their early teens, I don’t know if they offer sedation, my kids never needed it (or me in the room after a couple of years).

 

[RamblingMad]

Insurance sucks in the US.

And finding a good dentist is hard, especially for kids.