Can someone in the dental field please read -solved...thnx

[delabretagne]

Thanks to all for replying... I have solved the issue now.
Cheers,

[fluffy]

Is it possible that he may have charged you the full amount for the fillings, thinking that you would claim the covered amount from your healthcare insurer yourself?

[delabretagne]

I was hoping that, but I don't think so because for my regular cleaning visit, I was not sent a bill...My coverage simply covered it all. I figure that my dentist would have sent me the full bill for that one too, and had me claim it through my insurance...


I did a bit of research online, and it seems that white fillings range between 100-300 dollars (for 2-3 surfaces) or 80-200 dollars (for 1-2 surfaces) ... plus maybe a 150 dollar fee for the visit...
So, I figured it would cost 450 at most, 80% of that being covered...

[gardengirl]

Dental plans are all different. It is your responsibility to find out what is covered.

Some plans are 80% for basic stuff, cleaning, xrays, checkups, fillings
and 50% for orthodontics and major restorative. (crowns, bridges, etc).

If you are getting white fillings in teeth which could have been done with silver fillings, your plan may not cover that. It could be that the fees laid out are based on silver fillings and there is a maximum per tooth that your plan will pay. You would be responsible for paying anything over that amount.

[WeatherWoman]

my plan doesn't cover the white and I had one done it cost me about $150. It also depends on how much stuff they had to use to fill.

[fvkasm2x]

I regularly pay 75 bucks minimum for any of the work I have done and my plan also cover 85%

Dental work is expensive.

[Lady tehMa]

Some plans require you to pay up front for some items, and then send you the cheque for what they will cover.

Call your dentist and ask them. Our dentist - when we have a plan - takes our coverage book, goes through it and lets us know up front what will and will not be covered, as well as puts notes on our file as to what we are willing to authorize. In the case of some fillings for me, they put the request in for coverage and it took a month to get approval. When we got approval is when I got the fillings. It is nice to have a dentist who will work within your budget and limitations.

[xjeepguy]

Your title should have been :

Can someone in the dental insurance field please read this

Depending on plans , basic is usually 100% and that is why you may have not received a bill in the past for cleanings and checkups etc.. Most bill the insurance and some bill you and you collect later.
With Blue Cross ( if I recall correctly ) I only paid my deductible and it was the same with CU&C dental. I've not actually spoken with anyone that had to pay up front and collect off the insurance but I know there are plans like that . You need to call your insurance company and ask or check your booklet that you would have gotten from work .

[kgcayenne]

Does your plan have an annual limit on services that can be covered?

[fvkasm2x]

Does your plan have an annual limit on services that can be covered?

Good point. Mine does...

[delabretagne]

I actually just received a phone call from my dentist... She told me that yes, that is the amount that I owe, it is not an error. She said that she should have told me in advance that the costs were going to be more than normal since I hadn't been to a dentist in a few years, and apologized that they did not tell me that.

So apparently for a cleaning, an x-ray, an exam fee, and cavity fillings it came to 1500.

Thanks for those who replied to my posting... in the future I will have to ask for costs up front, and space out any dental work.

Anyone know how to make 300 dollars... fast? lol

[xjeepguy]

Something doesn't sound right there . Have you talked to your insurance provider ? The reason " since I hadn't been to a dentist in a few years." isn't a very good reason from your dentist , IMO.

I would ask for a detailed bill separating the insured coverage AND the portion your paying out of pocket . I would want to see it all .

I actually just received a phone call from my dentist... She told me that yes, that is the amount that I owe, it is not an error. She said that she should have told me in advance that the costs were going to be more than normal since I hadn't been to a dentist in a few years, and apologized that they did not tell me that.

So apparently for a cleaning, an x-ray, an exam fee, and cavity fillings it came to 1500.

Thanks for those who replied to my posting... in the future I will have to ask for costs up front, and space out any dental work.

Anyone know how to make 300 dollars... fast? lol

[gardengirl]

I the person hadn't been to the Dentist in a few years, they probably required more treatment.

For example: It could have been like this.

New patient complete exam.
Full mouth series (xrays).
Cleaning (4 units scaling plus polishing/fluoride)
Fillings (opted for white instead of silver).

This would come to far more than a regular 6 month checkup/cleaning and a couple of fillings.

A checkup is a quick exam. The medical history and charting of existing condition is already done.
Bitewng xrays might only be required every 2 years.
Cleaning could be minimal if the patient has good dental hygiene.

This appointment could be $100-$150.

Fillings are billed out by the amount of surfaces to be repaired and the type of restoration required. The larger the restoration required, the more likely it will also need additional support such as bonding or pins (not used so much anymore) and the larger the restoration, the more likely it will have sensitivity and would require "insulation". This all adds to the cost.
White fillings are more expensive for a number of reasons. The material itself is more expensive.
The procedure is far more time consuming and technique sensitive.

[xjeepguy]

You have a point but I would certainly expect a professional dentist to tell her/him at the time of knowing what they needed to do that this and that would be NOT covered by your insurance carrier because of XXXX reasons . I think how they did that was not very professional . IMO
I would have freaked right out

I had a nasty dentist experience a few years ago and it took me 2 years to go back to see one ( ya ya I know ) . New dentist , after the initial inspection and first visit , I went to the waiting room and the very nice assistant sat down with me and showed me everything that was needed and the costs to me and what insurance covered . Very professional !

I the person hadn't been to the Dentist in a few years, they probably required more treatment.

For example: It could have been like this.

New patient complete exam.
Full mouth series (xrays).
Cleaning (4 units scaling plus polishing/fluoride)
Fillings (opted for white instead of silver).

This would come to far more than a regular 6 month checkup/cleaning and a couple of fillings.

A checkup is a quick exam. The medical history and charting of existing condition is already done.
Bitewng xrays might only be required every 2 years.
Cleaning could be minimal if the patient has good dental hygiene.

This appointment could be $100-$150.

Fillings are billed out by the amount of surfaces to be repaired and the type of restoration required. The larger the restoration required, the more likely it will also need additional support such as bonding or pins (not used so much anymore) and the larger the restoration, the more likely it will have sensitivity and would require "insulation". This all adds to the cost.
White fillings are more expensive for a number of reasons. The material itself is more expensive.
The procedure is far more time consuming and technique sensitive.

[gardengirl]

It is not the responsibility of the Dentist to tell you what your dental insurance covers.
In fact, Dentists don't know much about it at all. That is not their job.

It is also not the staff's responsibility to tell you what your dental insurance covers.
As the patient, it is up to you to find out these things before you agree to have the treatment.
If you ask for a written estimate in advance, you can call your insurance company to have them explain to you what is covered and what is not.

There are many different types of insurance and many different insurance carriers.
The staff at the dental office may be familiar with the more common ones, but they do not know all the details of every type of insurance, nor should they be expected to.

The patient is the one who purchases the insurance plan or has it as a benefit of work.
The Dentist has absolutely nothing to do with that transaction.
If you have purchased a product which is not suited to your needs, or does not provide coverage for the services you require, that is your own problem.
It is your responsibility to find out what you are getting with your plan.

A Dentist does not do treatment planning according to whatever insurance you may have.
An examination is done and recommendations are made according to what the patient requires.
It is then up to the patient to decide the course of action. If you cannot afford to have everything done at once, the Dentist may be able to amend the treatment plan and do it in stages.
However; the decision whether to have the treatment or not is entirely up to the patient.

In this case, it is highly unlikely that everything was done at one appointment.
Fillings and cleanings are rarely done on the same day.
The patient would have had an examination and probably xrays at the first visit.
The restorations and cleaning would probably have been booked for subsequent appointments.
The office most likely provided the patient with a quotation for that.
Then it was up to the patient to find out what was covered by their insurance plan.