I wouldn’t mind having my PCP do more things in the office IF they could tell me what it would cost. I have such a high deductible I might as well not have insurance and trying to get a cash price is impossible.
@mountainmomof3 I feel for you- that is exactly what happened with my mouth. The distrust runs deeper than the fear, which I also experience.
@threebeans. This is taking all practices by surprise. My office finally has cash pricing but it’s kinda impossible to have it on everything we do. We have a list for all the basic things we do but we can’t predict what a new patient will need since everyone’s issues are different. It’s a challenge for both sides of this issue.
Some office will just discount a certain amount but typically you create a cash price on what Medicare /bluecross will pay. There are again regulations on how to do this this. The doctors just can’t make up an amount to try to help the patient out.
Dentists are small fish in terms of “scamming” patients, orthopedic doctors are the big bad sharks.
@Knowsstuff Thanks for the reply. I would LOVE to sit down and talk to someone with your inside knowledge of the heath care system! It fascinates and frustrates me equally.
Medicine is an odd situation in that neither the provider nor the consumer typically knows the price of what is being provided. What other good/service is like that?
@threebeans. It’s frustrating on our end also. Insurance companies pay by region. They won’t ever tell us what they will pay for “x”. You can request up to 10 codes at a time but there are thousands of procedure codes. Then another insurance company might pay more so you don’t want to bill to low. It’s stupid and crazy. For new docs not part of a large group or hospital it’s basically a guessing game. More and more young doctors are just becoming employees of the hospital. Watch out though. If you don’t meet your hourly quota or dollar quota then you can be let go. Yes, this really happens and why I am so grateful after 30 years in practice I don’t “need” to sell my practice like so many others that have done recently. My patients actually love the idea that I spend time with them. Crazy idea huh?
I am incredibly fortunate to have been going to the same dental practice for more than 35 years, and I can’t say enough good things about it. The original dentist was fantastic, and the doctor who bought his practice when he retired is also amazing. She refers to a top-notch endodontist when that sort of work is needed (she got me an appointment with him the same day when I had issues last fall), and she refers to a great oral surgeon for that sort of thing (extractions …), which I also needed last fall. She has a couple hygienists, but I always go to the same one - she has been there more than 30 years. She tells me this dentist is one of the best. I have given stellar reviews on social media for the practice.
As far as health insurance goes … ugh. My son had a scratch on his eye & went to urgent care one evening. The bill was ridiculous - when I called to find out why they charged for a procedure they didn’t do, I was told not to worry about it … my insurance covered it. What?! When I explained that my insurance is high-deductible, they told me the insurance company allows them to “bundle” the procedure that was done with another, more expensive procedure. I informed them that I wanted to only pay for the procedure my son had. They were huffy - said it wouldn’t count toward my deductible, because it wouldn’t go through insurance - but cut the cost WAY down. So ridiculous.
And don’t get me started on the supposed “cost finder” our insurance has. The cost has never been what they said it would be.
My father was a dentist for almost 50 years. He said that being a dentist was like working on a watch with someone spitting on your fingers.
Never go to urgicare. Their prices are so much higher in the long run. If they billed for something you didn’t get then that is fraud or your not understanding what they are telling you. Most hospitals have an outpatient clinic in the hospital. Many urgicare docs or nurses just refer out anyway. I know since I get a lot of these referrals. Many times I have to repeat something like an x-ray since they took the wrong views or not enough views to make a diagnosis like on a fracture. So it’s now more expensive for the patient… Basic cold /cough then urgicare. Just about anything else go to your own doctor.
We finally have an excellent dentist who never suggests unnecessary work. He even talked me out of getting a bridge (from him) and sent me to a periodontist for an implant after I was told by an oral surgeon that an implant wouldn’t be possible. The best part is he is young, so hopefully won’t retire soon like our other good dentists.
My only big disappointment is the routine use of x-rays annually even when no problem is reported. Even the American Dental Association does not endorse routine x-rays anymore. Digital equipment means the x-rays are virtually free to perform so the insurance reimbursement is pure profit, minus the hygienist labor and equipment maintenance. Rather than express my reservations to the dentist I just delay my cleaning appointment when the x-rays are scheduled. I’ve heard the argument that I get more radiation from a few minutes in the sun but it’s still bothersome to be unnecessarily exposed to radiation.
@momsquad when we began shouldering more of our health care expense I began questioning things like the x rays being taken (respectfully though since they ARE the professionals!) I just explained that since I have to pay for it I would prefer to do it less often OR after the exam if there is a reason. She agreed since I have not have a cavity in over 10 years. Another time my DD had a toenail issue and I had to take her to a Dr. to get it fixed. They wanted to X ray. I asked how it would change the treatment of the toe, since as a layman I had assumed there is no way to fix it if it were broken (and it didn’t hurt, swell or discolor so I did not think it was broken). She admitted that it would not change the treatment at all but she would have to note that I refused X rays. So they were trying to cover their end at my expense .
Speaking of insurance companies’ “cost finders”, I’m going for a DEXA scan this week and I decided to check Aetna’s cost finder to see what it would cost. I have Medicare as my primary insurance and a FEHB Aetna plan as secondary to pick up what Medicare doesn’t cover.
There was a list of all the places in my area where I could have it done, along with the amount billed, the amount reimbursed and the amount I would have to pay out of pocket. The cheapest one was around $161 and Aetna would pay $34 (the contracted amount) and I would owe nothing. The most expensive was at the local hospital which bills $1860 and is reimbursed around $1350 by Aetna. Again, I would owe nothing. There were several others that fell between those two extremes. I couldn’t believe the hospital charged over 10 times more than the local privately owned radiology place! No wonder health care is such a mess.
“Dentists are small fish in terms of “scamming” patients, orthopedic doctors are the big bad sharks.”
I believe it. My husband had a diagnostic MRI for his knee. He asked ahead of time what the cost multiple times and finally got a quote. They had our insurance info. Since we hadn’t met our deductible yet, the practice REQUIRED full payment before doing the procedure. Many weeks later, we get the insurance companies claim form. The cost for the procedure was $1500 less than what they made him pay. We figured they would proactively send us a check. He got busy so it was a good month before husband addressed it. They never sent him a refund for the overbilling. He called them a few times before being able to talk to the right billing person. Her response was you need to call us for a refund. They don’t automatically send it out. My guess is they wind up keeping some people’s money.
On top of that, the orthopedic surgeon who is supposedly the best in the area admitted the MRI was inconclusive but he had a hunch there was a problem he could fix once he got in there. Husband passed on the surgery.
I know we have at least one dentist on here but maybe she is scared to comment 
I wonder if some dentists are not truly upsetting solely to make money but because there is a benefit to the patient (just not urgent). Like the filling may fail soon, so why not fix it now? kinda thing.
I can’t believe so many dentists would actually be deceiving and scamming people. It’s analogous to when I take my car to get the oil changed and they try to get me to change the air filter and transmission fluid etc. It certainly isn’t going to hurt and one could argue it will help the car, but I don’t think the cost/benefit works in my favor.
OMG. I posted a few weeks ago that I felt I was entering the maze of dental work. For at least a year, my front teeth get chipped. The dentist said he wouldn’t put on veneers as my lower teeth were shifting and I’d break the veneers. So I went to the young orthopedist he recommended. He won’t order the Invisalign braces until a tooth is inspected as may need a root canal. So back to dentist and full set of X-rays. Dentist doesn’t feel necessary at the moment, but can’t be sure. Tomorrow to The Endodontist. My dentist says this Endodontist won’t operate if not necessary. My response, “ ya, show me an Endodontist who won’t find a reason.”
My dad was a dentist. When we chose an orthodontist for my son, we interviewed 5 people. The WE actually means my dad. He said most pediatric dentists like to pull baby teeth, but the X-rays show the adult teeth are pushing up normally. Extractions just frighten a child. My dad had me take my son to a dentist since he was 2, sit on my lap, and have the dentist shoot water in his mouth.
Anyway, I’m the biggest skeptic ever. I just don’t have the knowledge to dispute the recommendations. Braces for a year? A root canal when I have no symptoms?
Aren’t failing fillings detectable by probing (finding gap between the filling and tooth) or X-ray (decay around the filling)?
But also, it may be that the increased popularity of less durable white fillings may result in greater actual need to replace failing fillings – and since each replacement involves drilling out more of the actual tooth, higher frequency of replacement increases the likelihood of eventually needing a crown.
Perhaps pages like this may help:
https://www.animated-teeth.com/root_canal/t3_root_canal_reasons.htm
https://www.animated-teeth.com/
My response, “ ya, show me an Endodontist who won’t find a reason.”
@bookworm , if you live in MI, I can show you one! The endo I went to when I was having issues explained my pain, prescribed steroids to reduce the swelling within my tooth, and told me no root canal was needed. H and S both had necessary root canals done by this guy, and we hope he never retires.
For those who question the need for dental work, find a dentist who will show you your xrays on the computer monitor. It’s really easy to see what they see, and the dentist can show you the reason.