Do you pay at dr/dentist before you leave?

[DisneyTarheel]

Some dentists have found it is much more cost effective to require patients to file their own insurance. They can keep a leaner staff if they don't have to deal with the insurance.

 

[rainy~daze]

when i go to an innetwork dr or dentist, i only pay a copay if it applies, and have them submit to insurance then bill me....if out of network I pay in full then submit for my own reimbursement. If the dr is participating in your plan, they are not supposed to bill you upfront because they don't know the exact amount the insurance will pay, or write off as discount, or if you have a deductible they might not be the dr entitled to that money-i.e. if other claims get processed before their claim, and that money goes to the deductible, so you really only owe them $50 instead of $250, and then it is a pain to get your money back! Unfortunately, the insurance company can not force the dr to do that, it is part of their contract, but the insurance still will tell you they should submit to us first and then bill you(the patient), but each drs office has their own billing requirements, so can charge you. Sometimes the insurance will call the dr on your behalf and explain to them that they are under contract and should be billing the insurance first and not making you pay out of pocket in advance(except for copays, they have to be pd at time of visit) and the drs office will accept that. I think it is something the insurance company should be enforcing, considering we do pay enough to have the coverage. We shouldn't have to let someone else be earning interest on our dollars until either the insurance or dr reimburses us.

 

[gottaluvdis]

No. I never pay anything at the time of service. Dentist and pediatric dentist both submit for me. I pay co-pays or deductibles later, after I get the statement from our insurance company and the dentist sends a bill. Our dentists routinely charge over what the insurance company will allow, but we are not responsible for the difference. I would have no way of knowing this if we had to pay at the time of service. I would switch dentists if either of them had us pay during the visit.

 

[bags6490]

I'm a dental hygienist who has delt with quite a few oral surg. offices in my time. It seems that there are as many different payment policies out there as there are oral surgs. The ones that require upfront payment in full have always told us that they don't have a history with most patients who are coming for 3rd molar removals. They see them for that procedure and don't ever see them again. They don't know if the person is a prompt payer or if they are going to have troubles with that persons insurance. Most people have a long term relationship with their general dentist (going every 6 months or more), so the general dentist knows they aren't going to get burned by a certain patient, in most cases. Not saying I agree with the reasoning, but if an oral surg. has the pay in full policy upfront, he or she has probably gotten burned in the past. In the future, if you have to be referred to a specialist, ask your dentist or his/her staff what that specialists payment policy is (they will probably know or can find out for you). If it doesn't work for your budget, ask if they can recommend someone else who has an office policy that will work with you and your insurance company a little better. HTH!

 

[LuluLovesDisney]

I'm a dental hygienist who has delt with quite a few oral surg. offices in my time. It seems that there are as many different payment policies out there as there are oral surgs. The ones that require upfront payment in full have always told us that they don't have a history with most patients who are coming for 3rd molar removals. They see them for that procedure and don't ever see them again. They don't know if the person is a prompt payer or if they are going to have troubles with that persons insurance. Most people have a long term relationship with their general dentist (going every 6 months or more), so the general dentist knows they aren't going to get burned by a certain patient, in most cases. Not saying I agree with the reasoning, but if an oral surg. has the pay in full policy upfront, he or she has probably gotten burned in the past. In the future, if you have to be referred to a specialist, ask your dentist or his/her staff what that specialists payment policy is (they will probably know or can find out for you). If it doesn't work for your budget, ask if they can recommend someone else who has an office policy that will work with you and your insurance company a little better. HTH!

Thanks for your help. It's a little different in my case -

My tooth was pulled by my regular dentist who has seen me since I was two years old. It's weird because I've never needed to pay in full before and I always pay as soon as insurance goes through. I didn't understand why I had to pay 250 up front if insurance was going to pay for some of that. I guess they're probably sick of dealing with insurance and would rather me fight for my money instead of them.

 

[lbgraves]

We use to pay only the part that the insurance wouldn't cover at the dentist's office. Now BCBS has stopped doing this. They send the check to the patient so now we need to pay the full amount to the dentist.

 

[MickeyMonstersMom]

I had two wisdom teeth out a few years ago (and will probably get the other two out this year). I paid 40% the day of extraction and paid the balance off with monthly payments. My insurance paid $35 per tooth.

 

[patsal]

Around here you don't even get in until the bill is paid! I pay Dr. prior to the visit at the reception area. My DD's braces have to be paid for 50% before they will even make an appointment to begin the treatment. If I am lucky I will be reimbursed 50% of the total cost for her entire treatment. Eye Dr. gets paid befire I can leave and before any items are ordered. The only place that does not require a payment upfront is the regular dentist when a cleaning is the only procedure involved--they know the insurance covers that in full.

 

[ceecee]

I work in a dental office, we ask that the patient pay their part at the time of treatment. If they pay when they schedule we give a discount. It is too expensive to bill patients for a co-pay that we know in advance.
It is not unusual that a specialist will have you pay up front. Many of the ones around here require payment at the time of service and the insurance can reimburse the patient.
We pay our $10 co-pay at the doctor's office at the time of service and eye dr as well. Glasses or contacts we have a co pay of $25.00 and they collect before they order.

 

[LisaNJ25]

If it is something that will not be covered 100% I will have it pre-authorized first (I think that is the word). The only time I ran into this was DH's wisdom teeth, bridge and ds's braces. That way the dentist knows what my part will be and I only pay that.

Thankfully I have no co-pay for drs appts, dentist, or specialist.

Even with the eye dr they submit it.

Only co-pay I have is $25 for the ER.

 

[mamalle]

I hear ya- if they are willingly participating in the contracted network- they should not be making you pay upfront prior to them billing the insurance. my dentist's office mgr will pull up the costs that the insurance will pay- say for a crown and what my cost will be.

the only time I had a problem is our medical insurance at the pediatrician's office. they always ask for the copay upfront. well I took dd in since she had a ear infection- vomiting, fever, etc. they told me I had a balance- which I knew darn well I didnt. there had been some error in the coding from a past visit that was obviously not fixed. she was a quite snippy little thing and basically told me that dd couldnt been seen until I paid it- I was pissed. I told her you are delaying her care when it is a billing error? I demanded she call the billing dept and low and behold the girl was very nice and stated that I was right and by the way you are going to have a credit since the took a co pay for your son's well child visit a few months ago and there isnt one. I said Im handing back the phone to this girl and you need to tell her this. I wish I had told the doctor when I went back but dd was hurting so bad.. unfreaking believable.. I work in a busy er and that would never happen. delay of care is a no no due to non payment- for anything! from a sore throat to a massive heart attack. Not supposed to happen.. Unfortuntely dentist arent under the same laws..

 

[Merriwind]

If it is an in-network provider, no, I don't pay anything. No one can "make" you pay. You can always forget your checkbook. Drs charge an outrageous amount, which is always knocked way down by BS/BC. If I paid 20% of the outrageous amount, I'd be chasing around a lot of doctors for refunds. (I made that mistake once. The doctor that wanted payment at the time of service took 2 months to refund me a $40 overcharge.)

If they are out-of-network, I would say you pretty much have to pay. We have a very nice out-of-network dentist who files and gets payment from BC/BS, but that is out of the ordinary. They don't agree to any discounted fee, but our plan is very good, so we have made out well there. (Thank goodness, DH cracked a tooth below the gum last year--what a procedure!)

Good luck!

 

[hentob]

Never. I have never even paid our dentist. Our insurance covers everything.

I MY DENTIST!

 

[rhiansmom]

I had all four wisdom teeth pulled in January. It was around $1000 to be paid in full up front BEFORE they would even touch me. It's very typical around here for dentists to be paid before they do the service as most dental insurance plans cover very little after cleaning and routine exams.

 

[sara74]

Thought I would weigh in here since I am a dentist after all...and DH is too. I am employed by my practice part time and as such have no say in billing policies but what we do is give the patient an estimate of their copay at the time they schedule their visit. They are expected to bring that copay with them to their next visit. For example - Joe has a cleaning and needs a filling. At the end of his cleaning visit, when he schedules his filling our receptionist gives him a written estimate of his next visit. This shows the fee, the expected insurance and the calculated copay. That copay is his responsibilty to bring to the next visit. It is relatively easy for us to know what remaining benefits someone has as we are their regular dental care providers. We have good luck with collections that way and have a great front desk staff that knows our patients insurance plans very well. It is expensive for an office to bill a patient after the fact for a balance when it is pretty easy to determine closely what the copay would be when the patient is right there in the office.

DH is a specialist (periodontist) and things are a little different for them. For one, since he sees patients referred by another office and the patient may have had services at that other office, then he has no way of truly knowing what benefits the patient has remaining. Many plans have annual maximums and if a patient has a crown at their general dentist and then comes to see him, whatever he does may exceed that maximum and then he would be stuck trying to collect the difference from the patient several months after the fact. It's hard to get many people to pay their balance when the treatment is months in the past! Also, some procedures, such as wisdom tooth extractions, may get coverage under medical insurance. However, the medical insurance company often will not pay directly to a dentist, even when they will cover a procedure performed by a dentist. In this case it is necessary for the patient to pay the dentist and cash the check from the insurance company themselves. Maybe you can imagine that it can be a nightmare for an office if a patient pays nothing to them at the time of the procedure, then receives and cashes a check from the insurance and then is billed by the dentist who provided the care. Sometimes it is very hard to collect that money.

Then there is the fact that insurance benfits take weeks, and sometimes months, to get to the provider from the insurance company. Our costs are incurred the day the service is provided. Our water bills, staff salaries, electric bills and supplies are all there that day, but the insurance reimbursement might not arrive for 2-3 months. Even though my office does not require payment of the fee up front I do understand why some offices do. I don't want to demean dentistry but dental offices have bills too. Does anyone go to the mechanic and then leave without paying, telling them to bill you? Do any of us go to the grocery store and then leave without paying? I know it is not quite the same, but can you see where I am coming from? Billing processes take lots of staff, time and postage for relatively small balances. Insurance money takes several weeks to come in and sometimes longer, and all the while there are still bills to pay for the office. So while we don't do it at our office, asking for payment at the time of service is perfectly reasonable in my eyes.

Hope this helps, and doesn't raise too many eyebrows!

 

[famofsix]

My peds office doesn't have a list of service prices which drives me nuts. So what I do is I call the insurance company and get the exact amount they will pay and then when I pay my bill after the appointment I subtract the amount the insurance will pay and pay the amount. The office seems alright with this. One time they insisited that my insurance would cover a procedure and my insurance denied it. So the dental office did not charge me so that was good. My insurance is pretty crappy and I think we could go somewhere else cheaper but this dentist is good to my kids and they do all the cleanings at once in the same huge room so appointments for cleanings don't take long.
My insurance pays the dentist directly.

 

[LuluLovesDisney]

Thought I would weigh in here since I am a dentist after all...and DH is too. I am employed by my practice part time and as such have no say in billing policies but what we do is give the patient an estimate of their copay at the time they schedule their visit. They are expected to bring that copay with them to their next visit. For example - Joe has a cleaning and needs a filling. At the end of his cleaning visit, when he schedules his filling our receptionist gives him a written estimate of his next visit. This shows the fee, the expected insurance and the calculated copay. That copay is his responsibilty to bring to the next visit. It is relatively easy for us to know what remaining benefits someone has as we are their regular dental care providers. We have good luck with collections that way and have a great front desk staff that knows our patients insurance plans very well. It is expensive for an office to bill a patient after the fact for a balance when it is pretty easy to determine closely what the copay would be when the patient is right there in the office.

DH is a specialist (periodontist) and things are a little different for them. For one, since he sees patients referred by another office and the patient may have had services at that other office, then he has no way of truly knowing what benefits the patient has remaining. Many plans have annual maximums and if a patient has a crown at their general dentist and then comes to see him, whatever he does may exceed that maximum and then he would be stuck trying to collect the difference from the patient several months after the fact. It's hard to get many people to pay their balance when the treatment is months in the past! Also, some procedures, such as wisdom tooth extractions, may get coverage under medical insurance. However, the medical insurance company often will not pay directly to a dentist, even when they will cover a procedure performed by a dentist. In this case it is necessary for the patient to pay the dentist and cash the check from the insurance company themselves. Maybe you can imagine that it can be a nightmare for an office if a patient pays nothing to them at the time of the procedure, then receives and cashes a check from the insurance and then is billed by the dentist who provided the care. Sometimes it is very hard to collect that money.

Then there is the fact that insurance benfits take weeks, and sometimes months, to get to the provider from the insurance company. Our costs are incurred the day the service is provided. Our water bills, staff salaries, electric bills and supplies are all there that day, but the insurance reimbursement might not arrive for 2-3 months. Even though my office does not require payment of the fee up front I do understand why some offices do. I don't want to demean dentistry but dental offices have bills too. Does anyone go to the mechanic and then leave without paying, telling them to bill you? Do any of us go to the grocery store and then leave without paying? I know it is not quite the same, but can you see where I am coming from? Billing processes take lots of staff, time and postage for relatively small balances. Insurance money takes several weeks to come in and sometimes longer, and all the while there are still bills to pay for the office. So while we don't do it at our office, asking for payment at the time of service is perfectly reasonable in my eyes.

Hope this helps, and doesn't raise too many eyebrows!

Thanks for the info! It's all good to know, although it does make me wonder why they didn't tell me what my portion would have been there and have me pay that. Payment in full still seems odd. In addition, unlike groceries, dental work can cost thousands - not everyone has that kind of money sitting around at their time of need. Why not at least see what insurance will pay first?

Your POV as a dentist is very interesting and I do understand how difficult it can be to make ends meet. I could understand if the office was new and did not have many patients, but this just caught me by surprise -esp. since I'd been here before many times.

It's good of your practice to inform patients beforehand. I'm sure it eliminates a lot of confusion.