Another Dentist Vent

About 5 years ago I changed dental insurance. My old dentist didn’t accept my new plan. I had been with the group for ages- they were literally the only dental group I had ever gone to.

So I switched. It was a business decision of theirs to not take my coverage, so I made the business decision of going elsewhere.

I am lucky though- I had many good options nearby. This would have been harder if I had to travel far.
 
I'm guessing they are no longer accepting the insurance is because they charge too much.

No time like the present to change.
 
Insurance pays all of our dental visits. But a cleaning is only 80.00. You have an insanely $ dentist. Definitely change.
 

Insurance pays all of our dental visits. But a cleaning is only 80.00. You have an insanely $ dentist. Definitely change.
It would seem you have an insanely cheap dentist.

Just checked the most recent claim in my insurance:

ServiceAmount BilledAmount Paid
Periodic oral evaluation$58$57
Prophylaxis - adult$103$99

A total of $161 is billed and $156 is paid by insurance.

$630 for three cleanings and x-rays for one does not seem to be that much.
 
I would also look for another dentist. You are just talking copays for the cleanings now. What if they actually need some work done? That could get really expensive really quickly.
 
I don’t know if they offer sedation, my kids never needed it (or me in the room after a couple of years).

Of course, it depends on the child, their age, comfort level, type of treatment, etc. I liked having the option for both. YMMV.
 
It would seem you have an insanely cheap dentist.

Just checked the most recent claim in my insurance:

ServiceAmount BilledAmount Paid
Periodic oral evaluation$58$57
Prophylaxis - adult$103$99

A total of $161 is billed and $156 is paid by insurance.

$630 for three cleanings and x-rays for one does not seem to be that much.
What is billed to insurance is much higher than if you paid cash.
We have delta dental. Those charges are correct. But if I didn’t have insurance. The overall bill would be under 100.
Consumers have good competition concerning dentist if they don’t have insurance. Just have to shop around and find one that is a good deal. I live in Ohio. I have read where it’s one of the cheaper states for cash dentist visits. Who knows though.
Dentist is no different than a barber. If you pay cash..... some of that won’t be reported. That’s straight from one who told me.
We have always had dental insurance. So thankfully. No need to shop around. Delta dental is accepted probably by 99% of dentist.
 
I'm guessing they are no longer accepting the insurance is because they charge too much.

No time like the present to change.

I recently discovered a very strange accounting practice being done by a dentist -- well, strange to me, but I'm not an accountant.

I knew that my insurance was maxed out for the year, so I told the office I would just pay OOP. They are in-network, though, so they could not charge me more for the procedure than the insurance would have paid had I not hit my annual limit. The chatty clerk told me that, no, she did not want my payment immediately, because they first had to send a bill to the insurance company that was higher than the contracted R&C amount. When the insurance company naturally declined it, they would then take a partial tax write-off before "settling" and closing out the bill when I paid the insurance company's approved amount. They estimated that it would be 2 months before they actually billed me. Sure enough, when the bill came it was attached to an EOB & contained a line-item for a loss written off.
 
Last edited:
If you do decide you maybe want to stay with your current dentist, I would call the insurance company and ask about the reimbursement before just taking the word of the Dentist office that you will get the full amount from the insurance company.
 
Nope.

I'd cancel the appointment and get recommendations from family and friends for a new provider, then verify they accept my insurance. There are many dentists in my area and there is no way I'd jump through hoops over a decision they made to stop accepting my plan.
 
I'd find a new dentist, because if you need other work done like fillings, crowns, etc, that won't be covered either, and those bills can add up. We've had to change our dental insurance a few times, to make sure that the dentist, endodontist, etc that we want takes the insurance. Usually OOP is going to be cheaper than insurance charges though, but still. To save hassle and worry, i'd find a new dentist or new insurance.
 
We have decided to switch dentists. My SIL is a hygienist at another office in town and, obviously, all 3 kids are comfortable with her so we are going to that office. They accept our plan. I'm waiting on a call back today to see when we can get them in for cleanings. If it is within a few weeks I will go ahead and cancel the appointment with their current dentist and if it isn't for a few months we're going to go ahead and keep this appointment, get their teeth cleaned on time, then switch for the next cleaning.

My only worry is that if one of the kids needs work done they will refer us back to her but my SIL said they really only do that if they feel like the child won't cooperate as the pediatric dentist has more options that way but DD13 and SD9 are both old enough where that isn't a worry.
 
What is billed to insurance is much higher than if you paid cash.
We have delta dental. Those charges are correct. But if I didn’t have insurance. The overall bill would be under 100.
Consumers have good competition concerning dentist if they don’t have insurance. Just have to shop around and find one that is a good deal. I live in Ohio. I have read where it’s one of the cheaper states for cash dentist visits. Who knows though.
Dentist is no different than a barber. If you pay cash..... some of that won’t be reported. That’s straight from one who told me.
We have always had dental insurance. So thankfully. No need to shop around. Delta dental is accepted probably by 99% of dentist.


there is almost nothing true in this post. absolutely nothing true. you must hang around many dishonest business people.
 
Last edited:
My dentist stopped accepting my insurance quite a few years ago. We stayed with him. He's worth it.
I went to the same Dentist from about 1970 to 2007. He never was in network for any insurance, he refused to take part, but always worked with patients and often if the balance due was under $20 he just ate it. I agree, a good Dentist is worth it.

But to OP, yes, your Dentists fees seem way way way out of line.
 
I went to the same Dentist from about 1970 to 2007. He never was in network for any insurance, he refused to take part, but always worked with patients and often if the balance due was under $20 he just ate it. I agree, a good Dentist is worth it.

But to OP, yes, your Dentists fees seem way way way out of line.

question: what is the expected fee for a cleaning, xrays and exam for a pediatric dentist? keeping in mind he is a specialist? you think $210 is way way way out of line? just wondering.
 
question: what is the expected fee for a cleaning, xrays and exam for a pediatric dentist? keeping in mind he is a specialist? you think $210 is way way way out of line? just wondering.
Just doing a quick Google Search of Pediatric Dentist fees, yes, this seems like almost double of what I would expect. While I went to Pediatric Dentist, my kids just went to a regular Dentist. Not sure what if any additional expenses a Pediatric Dentist has over a regular Dentist, so the fees should be similar.
 
IME, the premium you pay for a pediatric dentist's services will be around 20-25% over a regular dentist. Typically they have staff who are more carefully trained to handle frightened kids, they have broader anesthesia options, and they have a full array of instruments specially sized for smaller mouths. (They also tend to have professionally decorated office spaces with extra waiting-room enterainment options, but that's really not why you go.)

We had to use one with my older child, who is on the spectrum; dentist visits tend to be really traumatic for autistic kids who have personal space issues. Two regular dental practices rejected us as patients with him; they were not equipped to handle the screaming and thrashing.
 
I just checked my bill, cleaning costs $178 at my regular dentist, but most services cost more here than other areas.
 
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.

Just cancel and let them know you have to cancel because they don't take your ins. They shouldn't charge you because they basicily cancelled themselves.
 


Disney Vacation Planning. Free. Done for You.
Our Authorized Disney Vacation Planners are here to provide personalized, expert advice, answer every question, and uncover the best discounts. Let Dreams Unlimited Travel take care of all the details, so you can sit back, relax, and enjoy a stress-free vacation.
Start Your Disney Vacation
Disney EarMarked Producer






DIS Facebook DIS youtube DIS Instagram DIS Pinterest DIS Tiktok DIS Twitter

Add as a preferred source on Google

Back
Top Bottom