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06/24/2008 08:08:02 PM · #1 |
Sorry for the venting but it really chaps my hide.
I try to be a good mom...I really do. I make my kids go to school when they don't want to go, I teach them the values that I find important, I make them live by the "golden rule," and I drag them kicking and screaming into the dentist's office every six months for a checkup and cleaning (and whatever else might be needed). When I was a kid, a dentist's visit was considered a luxury unless there was something catastrophically wrong...it was just never in the budget. So I pay nearly $100 a month for mediocre dental insurance that covers us at 80% for most normal things, up to $1000 a year maximum per person and a $50 per person deductible.
Anywho...we go for their six month checkup today. I'm on my kids constantly about brushing and flossing, sometimes having to battle the little one at great lengths. It paid off, because today, two of the three had ZERO cavities, and the middle son had one. One cavity between them all. They all got new xrays, cleanings, flouride treatments, and sealants, and the one cavity (of course) needed a stainless steel crown.
For this little visit with one cavity, the bill was $1847.40. I nearly fainted. My insurance paid their part, except of course the little fees here and there (sterilization fee? OSHA fee?), and my part was $225. I know it could be worse...believe me...and I'm thankful for the mediocre insurance I DO have because I would hate to pay it all myself. But I ask you...is it just me or does dentistry seem to be so pricey that it really is a luxury for most people?
One other thing...my middle son had a spacer put in about four years ago when he had to have a baby molar pulled. The new tooth is finally growing in now, so the dentist today wanted to remove the spacer (which incidentally, comes out on its own regularly and we have to push it back in place ourselves). The charge for his gloved fingers to take it out? $299!! I told him no thanks, we'd take it out ourselves. They said OK, and my son took it out on his own in the office. They didn't bill me for it, but it's on the receipt and treatment plan and I bet dollars to donuts they bill my insurance for it... which will mean there will be $299 less to go towards our yearly maximum for him.
Grrr!
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06/24/2008 08:28:44 PM · #2 |
Try paying the medical bills for someone that has epilepsy and no medical insurance. Neurologists and hospitals are not cheap. While you're at it, pay her mortgage payment, utilities, and other bills too because she lost her job because she can't drive. Oh, and don't forget the dentist bills.
Trust me, I would much rather pay your $225.00, or even the $1847.40. :)
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06/24/2008 09:12:21 PM · #3 |
I agree completely that it is a luxury, the prices for even the smallest operation are mind blowing. Personally I have two abscessed teeth that thankfully only give me problems once in a while, I went to get them pulled and was told my root was too healthy and I would need a specialist, the specialist is not covered under my insurance and he wants $12000 to pull both (without any of the many complications that have been explained to me), or I can opt for dual root canals at only $2250 a piece.
I'm sure someone will call BS on this, but doesn't it seem the things which are the most required are the most expensive? Tooth aches are something that can drive a person to pulling their own teeth out with a rusty pliers and the dentists, insurances companies, and suppliers know it and use our desperation to their advantage.
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06/24/2008 09:24:40 PM · #4 |
| Completely agree... dental insurance is mostly a joke. I had to have a root canal in May... $1500, and I didn't have insurance. |
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06/24/2008 09:28:42 PM · #5 |
It's the little stuff that seems ridiculous.
My son had surgery, for reasons not relevant to this thread, and one of the items we were charged for was the marker used to mark the incision. I'm sure theres some cutting edge marker technology buried deep inside that thing, but when I watched them use it in the prep room, I couldn't see anything special about it. The only thing special was the price: $40. for a marker. |
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06/24/2008 09:32:29 PM · #6 |
Originally posted by Spazmo99:
It's the little stuff that seems ridiculous.
My son had surgery, for reasons not relevant to this thread, and one of the items we were charged for was the marker used to mark the incision. I'm sure theres some cutting edge marker technology buried deep inside that thing, but when I watched them use it in the prep room, I couldn't see anything special about it. The only thing special was the price: $40. for a marker. |
That $40 includes the 5 seconds of time usage to actually draw the incision line. 50 cents for the marker, 39.50 for the time and effort. |
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06/24/2008 09:35:57 PM · #7 |
Originally posted by Spazmo99:
It's the little stuff that seems ridiculous.
My son had surgery, for reasons not relevant to this thread, and one of the items we were charged for was the marker used to mark the incision. I'm sure theres some cutting edge marker technology buried deep inside that thing, but when I watched them use it in the prep room, I couldn't see anything special about it. The only thing special was the price: $40. for a marker. |
I know it is silly. I actually asked a doctor about this. He told me the increased cost is to declare it and make it sterile and thereby suitable for medical use. Which isn't unlike the excuse I've heard about government screw-drivers, that the extra $190 is to ensure they will not interfere with radio, be toxic, break, etc. *rolls eyes*
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06/24/2008 10:36:05 PM · #8 |
Originally posted by cpanaioti:
Originally posted by Spazmo99:
It's the little stuff that seems ridiculous.
My son had surgery, for reasons not relevant to this thread, and one of the items we were charged for was the marker used to mark the incision. I'm sure theres some cutting edge marker technology buried deep inside that thing, but when I watched them use it in the prep room, I couldn't see anything special about it. The only thing special was the price: $40. for a marker. |
That $40 includes the 5 seconds of time usage to actually draw the incision line. 50 cents for the marker, 39.50 for the time and effort. |
No, the surgeon used the marker, but the hospital billed for it. The surgeon's bill was a separate thing. |
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06/25/2008 09:20:05 AM · #9 |
I can certainly relate to your story and I too have a full appreciation of the costs involved with dentistry.
Not so long ago, my dentist suggested we remove some lead fillings I had since my teens because... well they were lead.
The job was done and I sent my bill to my insurance and had to pay my 20% share.
Lo and behold, less than a year later, the filling gave way and I managed to break the top off of a molar and it seems I now need a crown ... to the tune of $1600.00, less than half of which is covered by insurance.
Funny thing that... we replaced a 40+ year old lead filling with a brand fangled new one that lasted less than a year. Can you spell conspiracy... I earnestly believe that going to a dentist is a "SELF FULFILLING PROPHECY" in that sure as you are sitting there with your mouth open... they will find something new to have you open your wallet.
There... all vented ... and I feel much better :O)
Ray |
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06/25/2008 09:32:56 AM · #10 |
| I can top your dentist bill. My daughter's recent bad tooth caused an almost $30,000 bill with no insurance. Because she's over 18 I can't cover her. She ended up in the hospital for 5 days for an absess that got the strep infection in it. The side of her face swelled, swelling her neck and causing her air flow to be severly restricted. She needed 5 days of IV antibotics! After she got out it was another visit to the dentist to have the offending tooth pulled. |
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06/25/2008 09:40:28 AM · #11 |
Be thankful.....we picked up the balance (Approx. $5K) that was NOT covered by our group insurance for my daughter's orthodontic work.
Yes, it *IS* a luxury, but I can think of very few things I would rather spend money on than my daughter's health and sense of self.
I have crooked teeth and I have always been self-conscious about it......she has a BEAUTIFUL smile now!
[thumb]639475[/thumb]
Be glad that you're able to afford to be able to take care of the kids!
You're a good mom!......8>)
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06/25/2008 10:44:49 AM · #12 |
I have no dental insurance or package. I hate insurance, so I just pay the dentist as appointments come. Our dentist and dental hygenists are always trying to upsell us too. If they had their way I'd get X-rays every day until I glowed.
P.S.
I worked as IT Manager for an insurance company for the worst year of my life, when I had to sit in on twice-weekly antimotivational management meetings and listen to the CEO scream about being in the business of "MAKING MONEY, NOT GIVING IT AWAY!"
Message edited by author 2008-06-25 10:47:53.
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06/25/2008 11:02:57 AM · #13 |
Yeah, I feel you! With 5 kids, I pay out the wazoo for dentistry :-/
This smile:
Cost me $2500 because we hadn't had our dental insurance for a year yet and they made me pay full cost (he was 8 at the time). Now, they have to put his braces BACK on because his teeth are crowded as they are coming in (he is now 13) and it's gonna be $3500. Thankfully, our insurance has kicked in now and it should cost us $1200 for him. My 10 year old needs braces and so will my 8 year old (ICK!). I count myself lucky that my 12 year old has beautiful straight teeth and hoping the baby will too :)
At least there IS insurance though... could you imagine if you didn't have it?? :) |
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06/25/2008 02:17:09 PM · #14 |
Originally posted by RayEthier:
I can certainly relate to your story and I too have a full appreciation of the costs involved with dentistry.
Not so long ago, my dentist suggested we remove some lead fillings I had since my teens because... well they were lead.
(edit for brevity)
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When i started going to my current dentist, i had not been to a dentist in 5 years. This guy mentioned that my fillings were mercury, old, and should be replaced because they would probably start falling out "soon". But my insurance won't pay to replace them until they are actually loose. So i declined. Hmmm... 3.5 years later, they are all still fine, no hint of falling out.
I'm sure it's because i go to see him like clockwork, every 6 months... |
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06/28/2008 09:12:59 PM · #15 |
| How do you become a dentist??? Can I get an online degree or something??? |
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06/28/2008 09:50:43 PM · #16 |
Originally posted by TCGuru:
Yeah, I feel you! With 5 kids, I pay out the wazoo for dentistry :-/
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I never saw any of that cash! :-P |
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07/02/2008 06:57:37 PM · #17 |
Originally posted by L1:
They didn't bill me for it, but it's on the receipt and treatment plan and I bet dollars to donuts they bill my insurance for it... which will mean there will be $299 less to go towards our yearly maximum for him.
Grrr! |
I would hope not as that would constitute insurance fraud. If you see that, you need to talk to your insurance company.
Also, if it makes you feel a tiny bit better, in the bizarro world of medical billing just because your insurance company was billed $1847 doesn't mean the dentist received anywhere close to that amount.
Message edited by author 2008-07-02 18:58:37.
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07/02/2008 08:42:17 PM · #18 |
A lot depends on the doctor - my dentist is a gem. We've got a copay of $20 and he never collects it. Awesome. I found him before I dental insurance and needed a lot of work.
What burns me is you never know what the bill will be. Yeah, the copay is $20 or whatever. Visit the ER? $50. And then there is always a bill for something else - bloodwork for $47. Why? "We sublet the lab work" they say so it's not covered by the copay.
I had an MRI done and got a bill for $550. On top of the 2 bills from seeing the regular doctor (get a shot..get a bill). Had I known I'd be billed for over $600 I might have thought twice or at least tried shopping around for a better deal.
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07/02/2008 08:50:52 PM · #19 |
Originally posted by Prof_Fate:
A lot depends on the doctor - my dentist is a gem. We've got a copay of $20 and he never collects it. Awesome. I found him before I dental insurance and needed a lot of work.
What burns me is you never know what the bill will be. Yeah, the copay is $20 or whatever. Visit the ER? $50. And then there is always a bill for something else - bloodwork for $47. Why? "We sublet the lab work" they say so it's not covered by the copay.
I had an MRI done and got a bill for $550. On top of the 2 bills from seeing the regular doctor (get a shot..get a bill). Had I known I'd be billed for over $600 I might have thought twice or at least tried shopping around for a better deal. |
Your doctor does not control copays at all. That is dictated by your insurance. Your dentist(?) not collecting your copay is against his contract with the insurance company and he could get in trouble with them for not doing it (so don't blab it). You would not believe the constraints placed on a doctor in an insurance contract and we have little bargaining power because we cannot often collectively bargain.
Other laws also come into play. You cannot necessarily have your own lab as it may go against what are known as "Stark III" laws which were meant to prevent kickbacks and such but also put such things like a doc's office also running a blood lab into a real gray zone.
Finally, if that weren't enough there are little games the insurance companies play which may get you extra copays when maybe the doc wishes he/she didn't have to do it that way. Bill a doctor visit and a blood draw on the same day without charging two copays? the insurance company may simply say, "hey, we're gonna just combine that all together and pay you for the visit only, the blood work is free."
Message edited by author 2008-07-02 20:54:16.
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07/02/2008 09:09:54 PM · #20 |
| Doc, I have to say, hearing your perspective is very interesting to me. I know my perspective as a "patient," but we rarely get to hear the doctor's end of it, and I often wonder if they don't take the fall for a lot of stuff that insurance companies dictate. |
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07/03/2008 08:29:02 AM · #21 |
My dentist will tell me what I will be billed by the insurance company.
My pharmacist will too - and they don't all charg the same. One outfit here always charged me teh max, $20, on every prescription. I changed pharmacies when another charged me $7.42 for THE SAME STUFF (my daughter is on a prophalactic antibiotic).
My eye doctor will also tell me what I'll be paying above and beyond the copay.
The doctor's office -ANY doctors office- can't, so they tell me. They can certainly send me a bill dated the very next day though.
I have 3 choices of labs to go to - the hospital and 2 independents. And I would bet my left nut they all charge different amounts.
My GP gives me a shot and I don't get an itemized bill from the insurance company for the visit, needle, shot service and medicine - the orthopedic visit where they gave me a cortisone shot I was billed for all three items.
It's all in how it's coded on the form and some doctors work the system. I've seen it, been told about it, and sometimes benefited from it.
It all needs to be simplified and strightened out. If you have insurance it's one price, if you don't it's another. Insurance often pays around 50% of what's billed so why not bill a proper amount and get paid for all of it? There must be some reason, be it for taxes or lobbying purposes or being able to say 'having a baby costs $5100' even though the insurance only pays $2600 and the doctor accepts that. (teh OB fee for my daughter back in 2004). Only 1 copay for many many many visits too, including some to the ER - so it IS up to the doctor whether they collect that copay fee or not.
I had insurance and got an ambulance ride after a car accident and the insurance was billed $750 - I paid some $250 plus the $50 ER bit.
My buddy had no insurance of any kind (not even car insurance...yeah, he got in lots of trouble for that) and got an ambulance ride and paid the same $250. His total hospital bill was $850 - I saw mine and it was twice that.
It's nice they don't charge those without insurance as much, but if the medical service providers will accept less from one patient then they need to accept less from everyone, insured or not. The costs don't change, the service provided is the same, so it looks to me like the insurance companies are being soaked for every dime.
yeah, doctors complain about the costs, the malpractice, but all the ones I know still drive luxury cars and live in big ass houses so I don't have a whole lot of sympathy for their economic plight.
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07/03/2008 08:54:52 AM · #22 |
The pharmacy I use actually has (or had, I haven't had a script in a long time) that told the customer to be aware that some medicines were cheaper than the co-pay and to ask about it. Apparently, if you go in and get one filled, and don't, the system automatically charges the co-pay, even if the cost is cheaper.
They never made me tell them though, they usually checked it for themselves and let me know. :) |
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07/03/2008 09:32:59 AM · #23 |
| Last year my wife had both feet rebuilt (toes realigned, ACL extended) in two separate operations. My middle son had to have braces, and the other 2 had a total of 9 cavities. Insurance paid some, but.. I owe- I owe, so off to work I go.. |
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07/03/2008 09:53:35 AM · #24 |
Originally posted by alans_world:
Last year my wife had both feet rebuilt (toes realigned, ACL extended) in two separate operations. My middle son had to have braces, and the other 2 had a total of 9 cavities. Insurance paid some, but.. I owe- I owe, so off to work I go.. |
My husband had open heart surgery. We know that song as well. :) |
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07/03/2008 12:14:23 PM · #25 |
Originally posted by Prof_Fate:
I had insurance and got an ambulance ride after a car accident and the insurance was billed $750 - I paid some $250 plus the $50 ER bit.
My buddy had no insurance of any kind (not even car insurance...yeah, he got in lots of trouble for that) and got an ambulance ride and paid the same $250. His total hospital bill was $850 - I saw mine and it was twice that.
It's nice they don't charge those without insurance as much, but if the medical service providers will accept less from one patient then they need to accept less from everyone, insured or not. The costs don't change, the service provided is the same, so it looks to me like the insurance companies are being soaked for every dime.
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There is a reason for this kind of billing and again the insurance companies are to blame.
When a doctor signs a contract to be a provider with an insurance company he/she agrees to be paid at their rate for different services (each service has a code). What is rarely given is the actual table of what codes get paid what. Getting one is made purposely difficult (Blue Cross lost a class action lawsuit last year to the tune of $139 million and one of the supposed requirement was making it easier to get this table). Even if you could get the table, it can change at any moment. The average doctor deals with probably 20-30 different insurance companies (although the majority of their patients may be on, say, a half dozen).
If you bill an insurance company less than their reimbursement rate, they will naturally pay you the lower amount and not say anything about them being willing to pay you more. Because of this, and because different insurance companies pay at different rates, the easiest thing is to overbill insurances so as to make sure to recoup 100% of what they are willing to pay you (while just writing off the difference). At the very least you must bill at the highest rate one of the insurance companies pays because you are also required by you contracts to bill all patients equally. (You can't bill a Blue Cross patient more or less than another.) This sucks for the out-of-pocket patient because the doc is charging inflated prices to recoup 100% from the insurance company but is also required to charge the non-insurance patient the same rate. Now, honest or compassionate docs know of ways to get around this. We offer a 20% discount for out-of-pocket patients and declare it to be a refund because there is less paperwork and office work involved. Still, many offices either don't care or don't have time to explain they may be willing to lower your bill if you are out-of-pocket. Docs who feel bad for out-of-pocket patients can also try to undercode their patients (which is against their contracts once again). There are 5 levels of office visit from simple to complex. Instead of a level III they might bill a level II at full price to the non-insurance patient saving them some money.
If I could go back to a fee-for-service life where I have a big McDonalds style billboard in the front office saying "Office visits are $175, skin testing is $7/test, shots are $15" I'd do it in a second. A few docs have done it, but it is a very risky proposition because they then go off all insurance provider lists and will probably lose referrals etc.
Message edited by author 2008-07-03 12:16:13. |
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