Are dentists ripping us off?

When I go to the hospital or doctor and have work done, insurance knocks down the submitted charges to their price allowed in the health insurance plan.

Then the insurance pays the percentage of that amount allowed & the provider sends us the bill for the remaining amount, not paid by insurance.

When I go to the dentist. They submit the charges to insurance, insurance knocks it down to the plan price allowed, the allowed amount/ percentage is paid by insurance…….THEN I get get a bill for the reminder PLUS the difference from the summitted charge & the allowed plan price!

So this seems like a ripoff to me. I pay for health insurance to benefit from discounted plan prices allowed. I don’t get billed for the amounts above the amount allowed. Why should dental insurance be any different.

Example…. I have a $1000 bill for a consult with a surgeon. Health insurance allows $564 for this coded charge. Covered at 80% let’s say, so I get a bill for the 20% of the allowed amount of $564. My bill would be $112.80

My dentist submits charges of $1000 for a procedure. Dental insurance allows $564 for the coded charge. Covered at 80% and I get a bill for the 20% of the allowed amount $112.80 + an additional $436 for the difference from submitted charge to the allowed charge. So my total bill is $448.80 because I did t get the benefit of the plan pricing discount as I do with my health insurance!

Yes they rip us off. Every person I’ve talked to that works/worked for a dentist has plenty of stories… I’d trust a used car salesman well before a dentist.

Not to mention they are the WROST clients to guide. They repeatedly cancel trips last minute, they are arrogant and they treat you like they are doing you a favor by hiring you. I’m ready to put up a no dentists clause on my website. Ok that’s the end of my dentist rant

Not all dentists are like this… This does come down to the practice also. I have heard the ins and outs of this as my wife is a Dentist.

Ralph Wiggum wrote:

That’s the first thing that came to my mind too!!!!

Dental insurance is not at all like medical insurance. It basically only covers routine visits. Dentists are smart. Once you accept insurance as a medical provider your profits dive.

How can profits dive by accepting insurance? You’re now getting steady run of clients with insurance.

I’m talking about good insurance, over $2,000 billed for an afternoon appointment.

The problem I’ve come to understand after talking with my dental insurance provider is this…..
– submitted charges are reduced to plan allowed amounts, for covered procedures. This discount is generally 35% less than the submitted charge. Dentists now this joining the plan and write off the difference.
-amalgam fillings are covered at 80%
-white fillings on posterior (back) teeth are only covered at 80% of the amalgam plan amount. He lies the problem…..because these are “alternately covered” procedures , the dentist can choose to write off the difference or not to. If they do, that’s great. Mine does not ….and therefore expects 100% of the submitted charge and isn’t apparently decent enough to knock down the amount, to the otherwise expected plan discount of 35% off all other submitted, covered procedure charges. So, full charge for the procedure. That’s not gonna work.

Just this loophole in the insurance that allows 100% of submitted charges on white, back fillings, increases my bill about $450, in addition to my existing portion and on top of what the insurance is paying too. It’s a $450 kick in the teeth!!

I don’t think it’s dentists ripping you off, but you’re just seeing the limits of what your insurance covers. You could get more coverage but as always that would come with a substantially higher premium.

Here’s a thought, though. Every dentist can provide a cost breakdown before you have any procedure. My dentist does this on everything that isn’t 100% covered and they show me this before having the work done or even making an appointment to have it done.

Also, are you contributing to a healthcare savings account? Also, you can price shop your procedure. Armed with what your insurance will pay, call around.

You can also–no kidding–consider a trip to Mexico. No, really. My parents have all their work done down there while they are in Arizona for the winter. Most procedures are half the USA price. The dentists they use are from California, they set up shop in Mexico because insurance is vastly cheaper and I also suspect there’s a tax dodge involved.

Grouse

My mom and step dad go to Costa Rica for major dental work. They save A LOT of money and use reputable dentists. Gotta do your homework on it, as I’m not sure of specifics.

Well I contacted our dentist, talked with the billing person and explained my displeasure with the practice of throwing the difference of these “alternate procedures” onto our bill. I also explained that our dentist previous to this one, in another state, did not pass this cost onto the patient. I was told that this was their policy and was non negotiable.

So I asked for all dental records for our family to be made available for me to pick them up today and cancelled all remaining appointments for the three of us.

Easy enough. Nothing p’s me off more than a greedy sumbiatch!!

If any of you can tell me of a dentist that does not bill the patient for the difference of the posterior composites …..pm me with a name please.

Chris Messerschmidt wrote:

Not all dentists are like this…

I’m sure that is 100% true but how do you find one you can trust? I had a friend who was recommended to get 22 fillings… he checked with another dentist who said he could only find 4 that even resembled needing attention.

I recently was told by my dentist who I “trusted” that I needed a crown. I checked with another dentist and he laughed and said there’s nothing to fix. So now I have no idea how to pick a good dentist… we need an IDO recommended list of dentists

I go to the UM dental school. They do great work and very inexpensive.

OK – here is my take on dentist and insurance. I choose to NOT pay for dental insurance through my work. For me to pay the insurance it is like $50 per month and then the insurance only covers regular visits and a percentage of major work. For my annual check up and cleaning I pay $120 with xrays etc. So for my wife and I to go each year we are up to $240 so just paying on my own is saving me $360 per year which I can put some of that away for any major work.

Now I admit I have been blessed with great teeth(only one cavity in my 61 years)but the wife has gone through everything there is. With the way we do this, we seem to pay less than those with insurance, we get no hassles from the dentist as we pay up front and we are still saving some money.

PS- when I had two kids that needed braces, I did buy the insurance for those years, but still wonder about that as insurance still only paid for a percentage.

What area are you in? I recently switched dentists, and would highly recommend Merry Dental in Eden Prairie if you are in the cities. I understand your rightfully upset in your scenario, but overall I’ll take the relatively straight forward billing of a dentist over regular medical any day of the week and twice on Sundays. With Dental at least you can pay out of pocket a reasonable price for routine work, which is almost unheard of in the medical industry (and a major reason for the inflated prices imo).

Thomas, if you have the option to, look into an a supplemental dental coverage on your health insurance. I have blue cross blue shield and I have added their supplemental dental plan to my coverage for about $12/month. I go to the dentist more often than most as preventative care and this supplement pays virtually everything that my health insurance won’t.

What you are describing does not seem typical… Once you have confirmed that a specific dentist is “in network” for your insurance then they should have accepted the write-downs associated being involved with that insurance provider. Can you confirm if this dentist was part of your insurance provider’s network?

This is not specifically the scenario described here; however, the entire health/dental care insurance industry has been changing significantly in the past few years as costs are being passed down to the consumer, specifically the healthier consumers who are now carrying additional burden of increased government oversight as well as mandates for who qualifies for specific plans. As an example 10 years ago I was able to schedule an appointment for virtually any Dr. within my network costing me only a $10 co-pay, now those same appointments could cost hundreds of $$.

I fired my first dentist when I was 15. The guy made me wait over an hour past my appointment time and then gave me the five minute once over. Then he said “stop on the way out and set up your next appointment”. I told him no way, after making me sit around for that long he’s fired. That got his back up, he said “You can’t fire ME!” I pointed out that I was paying him to do a job. That makes him the employee. And he’s a lousy employee because he overbooks and makes people sit in his waiting room all afternoon. Then I walked out.

FWIW, I haven’t ever had a job where they offered dental insurance. One of these days they’re all gonna fall right out of my head.

S.R.

Rick Janssen wrote:

OK – here is my take on dentist and insurance. I choose to NOT pay for dental insurance through my work. For me to pay the insurance it is like $50 per month and then the insurance only covers regular visits and a percentage of major work. For my annual check up and cleaning I pay $120 with xrays etc. So for my wife and I to go each year we are up to $240 so just paying on my own is saving me $360 per year which I can put some of that away for any major work.

Now I admit I have been blessed with great teeth(only one cavity in my 61 years)but the wife has gone through everything there is. With the way we do this, we seem to pay less than those with insurance, we get no hassles from the dentist as we pay up front and we are still saving some money.

PS- when I had two kids that needed braces, I did buy the insurance for those years, but still wonder about that as insurance still only paid for a percentage.

Well, there’s that. Insurance costs more than cleanings and x-rays. Our company quit offering dental coverage for this very reason.

Most of all, you really need to add up your premiums and see how much they cost compared to what you’d pay annually on cleaning and x-rays.

If you’re having dental work done regularly, you really need to question if it is really necessary. I had some of the worst teeth as far as dental work growing up. Mainly because I never brushed my teeth. Now, I go twice a year for x-rays and cleanings and haven’t had any work done in about 4 years. I still only brush my teeth once a day. So either I’m really good at it once a day or my dentist isn’t recommending unnecessary work. Although, this lastvtimebin shecwarned me that the tooth next to my crown will need a crown as well pretty soon. I asked how soon and she said maybe in the next 6-12 months.

Also, it seems most dentists are now offering “memberships” that are essentially like insurance. You pay a one time annual fee and you get all cleanings included and discounts on all other dental work. The amount comes to a little less than the amount you’d pay annually on cleanings so it’s worth it altogether.

Another comment about the unnecessary dental work, there have been a few local dentists in the news lately for doing significant amounts of unnecessary dental work. If I remember correctly, at least one of these guys might be going to jail.

It’s definitely a thing, so watch out.

A guy on the lake owns his own business ( resort) he goes down to Mexico to get his dental work done. I’m sure he writes it off. Hes always happy with the work provided and it’s very cheap.

Thanks again guys.

I won’t be back in Mexico anytime soon but sounds like a great option if I was.

I like the idea of the dental school students drilling into my toofers at a discounted rate. Seriously, no different than having procedures done by resident doctors and such at Mayo.

FWIW, my (now former) dentist was “in network”.

…. yup, he’s fired as of today. I got my records today. My family and our insurance will go elsewhere.

As luck would have it, I was able to call today and get in much sooner than I expected, to the UMN Dental School. So that’s the plan. Special thanks to Pauleye!

Deleted wrote:

FWIW, my (now former) dentist was “in network”.

If they were in network and they passed the costs of the insurance “write-down” back to you I would have be looking for a new dentist as well.

Will

Healthcare is not service work any longer. Medicare reform, reimbursement, and Provider greed have changed it. Its all about $$$$.

I’ve also heard stories to be very wary of “a nation-wide chain” that advertises that your first visit is “free.” It sounds like their average patient is told they have 14 cavities………..

Joe Scegura wrote:

<div class=”d4p-bbt-quote-title”>Chris Messerschmidt wrote:</div>
Not all dentists are like this…

I’m sure that is 100% true but how do you find one you can trust? I had a friend who was recommended to get 22 fillings… he checked with another dentist who said he could only find 4 that even resembled needing attention.

I recently was told by my dentist who I “trusted” that I needed a crown. I checked with another dentist and he laughed and said there’s nothing to fix. So now I have no idea how to pick a good dentist… we need an IDO recommended list of dentists

As a teenager I had 3 fillings done. Went back a few months later and the dentist said there were 5 more that needed to be done. I was still on my Dad’s insurance at this time so he asked me to get a 2nd opinion. 2nd dentist looked at my scans and checked my teeth. Said he would classify 1 area as an area to watch and even questioned the legitimacy of the prior work and also the quality of the work.

The dental field is just a get rich scheme IMO. A necessary evil.

X2 on the UM dental school that’s the only place i go .just wish I would’ve known about the place sooner

My good friend of over 25 years is a dentist, he doesn’t do unnecessary work and does a great job.

He talks about the fact that 1/3 of his clients are on state assistance and he loses money each time they come in. The equipment, rent, dental hygenists, office staff are all very expensive. Other customer’s bills are twice as much to make up the difference.

Don’t get me wrong, he isn’t broke and is successful, but he also went through 8 years of school, worked hard, saved up and bought his own practice, so I think he earned a good salary.

Dentists also have the highest rating of suicide for any profession

DaveB wrote:

My good friend of over 25 years is a dentist, he doesn’t do unnecessary work and does a great job.

He talks about the fact that 1/3 of his clients are on state assistance and he loses money each time they come in. The equipment, rent, dental hygenists, office staff are all very expensive. Other customer’s bills are twice as much to make up the difference.

Don’t get me wrong, he isn’t broke and is successful, but he also went through 8 years of school, worked hard, saved up and bought his own practice, so I think he earned a good salary.

Dentists also have the highest rating of suicide for any profession

I’m not on any sort of welfare & never have been.

My problem with this dentist is ~ billing me the difference from the submitted charge, to the allowed amount under the plan, for the posterior composite fillings. That’s shameful! I now consider him a crook. Then I called a handful of other dentists once I talked with my insurance, confirmed & understood what was actually going on to cause me more than a 20% share of the bill. The other dentist I called were crooks too! I’m seeing a pattern.

The difference with medical vs dental that I see, is when charges are submitted by my doctor, whatever plan amount is covered ~ is all I pay my percentage of. The difference between submitted to allowed by the plan, is written off. Should be the same with dentists. It was written off with my previous dentist in another state. He lived quite well too.

I’m a conservative so I believe in folks making a profit but I despise thieves.

Dentist rate #2 for suicide.

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OK, I just checked with my wife, who is our CFO regarding medical-related billing issues. The problem is not the Dentist, the problem is the Insurance companies, who can dictate what they want to contribute, and stick the patient with the balance.

Find (and pay for) a Dental insurance policy that will pay EVERYTHING over the 20% you want to be responsible for, and your problem goes away. If you were a roofer, and the insurance company was only willing to pay $300 out of a $1000 bill, would you eat the difference?

HRG