I have a dentist/insurance question.

[Jalapeñomel]

So I just went to the endodontist who said that my root canal is going to cost ~$400.  I called the insurance company, who said my co-pay is $180.

I phone the endo for clarification, and they said that they don't know exactly how much the insurance will pay so they require this amount as a "deposit" in case the insurance doesn't pay the total amount requested, but I should get the $300 back, but they cannot guarantee it.  

Is this normal nowadays?  Has anyone experienced this?  Or is it shady as fuck?

[Deleted]

I have never had this happen to me. Not sure if practices are moving to this though.

[sequins]

This happens but only for maybe a price difference of $50 not $300.

[zoomzoom]

I wouldn't be surprised if more dentists didn't start doing this with all the changes in insurance. You would have a receipt of deposit, yes?

[Jalapeñomel]

Dec 18, 2014 16:20:50 GMT -5 zoomzoom said:

I wouldn't be surprised if more dentists didn't start doing this with all the changes in insurance. You would have a receipt of deposit, yes?

Yes, I would.  But how would I know how much they are supposed to get paid or how much they received from the insurance?

[Jalapeñomel]

Dec 18, 2014 16:19:36 GMT -5 jodippls said:

My H had a root canal a few months ago and something similar happened. They overcharged what they expected him to pay after insurance. He had to actually request a refund from the dentist for the difference once it was all done. It was shady as fuck.

I phoned the insurance company, and they said my co-payment is $180.  To me, that is how much I am expected to pay, regardless of the charge.  Is that incorrect?

[Jalapeñomel]

Dec 18, 2014 16:23:43 GMT -5 teeah22 said:

That seems a little weird, but I wouldn't jump to shady. Did they give you an estimate with codes? I'm wondering what all they were coding out for. A root canal should only be one code, but sometimes if they have to do it in two appointments then they will bill out an additional code. That's something they won't really know until they get in there.

No, they didn't get me any sort of written estimate.  They gave me a total amount that the root canal would cost and then my amount. 

[zoomzoom]

Dec 18, 2014 16:23:06 GMT -5 Jalapeñomel said:

Dec 18, 2014 16:20:50 GMT -5 zoomzoom said:

I wouldn't be surprised if more dentists didn't start doing this with all the changes in insurance. You would have a receipt of deposit, yes?

Yes, I would.  But how would I know how much they are supposed to get paid or how much they received from the insurance?

Doesn't your insurance company send you a statement once they've received the claim which shows what the doctor charged, what your deductible is, and the amount they've paid?

[Jalapeñomel]

Dec 18, 2014 16:25:12 GMT -5 zoomzoom said:

Dec 18, 2014 16:23:06 GMT -5 Jalapeñomel said:

Yes, I would.  But how would I know how much they are supposed to get paid or how much they received from the insurance?

Doesn't your insurance company send you a statement once they've received the claim which shows what the doctor charged, what your deductible is, and the amount they've paid?

I would assume so, but I have yet to receive an EOB from the dentist from the original appointment so who knows? 

[zoomzoom]

Huh. Maybe your insurance company is just slow? That's odd.

[stephm0188]

That's odd. My dentist's office gets a pre-approval from my insurance company and tells me how much I'll owe beforehand.

[Jalapeñomel]

Dec 18, 2014 16:26:36 GMT -5 teeah22 said:

Dec 18, 2014 16:25:07 GMT -5 Jalapeñomel said:

No, they didn't get me any sort of written estimate.  They gave me a total amount that the root canal would cost and then my amount. 

They just verbally told you?

Well actually they really wanted me to pay before I left, before having the procedure done.  They wrote my deposit on an appointment card when I refused to pay right then. 

[zoomzoom]

Dec 18, 2014 16:29:37 GMT -5 Jalapeñomel said:

Dec 18, 2014 16:26:36 GMT -5 teeah22 said:

They just verbally told you?

Well actually they really wanted me to pay before I left, before having the procedure done.  They wrote my deposit on an appointment card when I refused to pay right then. 

Ok, now THAT'S weird.  I don't think payment day of procedure is weird but I've never pre-paid for a dentist of doctor's visit.

[Jalapeñomel]

Dec 18, 2014 16:28:47 GMT -5 stephm0188 said:

That's odd. My dentist's office gets a pre-approval from my insurance company and tells me how much I'll owe beforehand.

I just phoned the insurance company again, and they assured me that the total amount that I will owe for a root canal is $180, nothing more regardless of what they bill them, and this must just be a policy of this particular dentist (but he's never heard of such a thing before). 

[berbles]

Dec 18, 2014 16:29:37 GMT -5 Jalapeñomel said:

Dec 18, 2014 16:26:36 GMT -5 teeah22 said:

They just verbally told you?

Well actually they really wanted me to pay before I left, before having the procedure done.  They wrote my deposit on an appointment card when I refused to pay right then. 

Now THIS seems shady to me.

I am in the process of getting a crown (without RC).  I have a temp on right now.  My permanent came in last week, but when the dentist tried to put it on, it wasn't fitting correctly.  So he re-did the mold and sent it out to be remade.

I still haven't paid for anything.  They won't charge me until the permanent crown is in my mouth.

Can you get a 2nd opinion?

[Jalapeñomel]

Dec 18, 2014 16:33:25 GMT -5 berbles said:

Dec 18, 2014 16:29:37 GMT -5 Jalapeñomel said:

Well actually they really wanted me to pay before I left, before having the procedure done.  They wrote my deposit on an appointment card when I refused to pay right then. 

Now THIS seems shady to me.

I am in the process of getting a crown (without RC).  I have a temp on right now.  My permanent came in last week, but when the dentist tried to put it on, it wasn't fitting correctly.  So he re-did the mold and sent it out to be remade.

I still haven't paid for anything.  They won't charge me until the permanent crown is in my mouth.

Can you get a 2nd opinion?

I think it may be worth it, although the fucker hurts, and I really want it taken care of (and this is the third consult for this same damn tooth). 

[polarbearfans]

can you see another dentist for your root canal? unless your current dentist is super amazing, i would start checking reviews and getting referrals. I do not prepay for anything, especially when told a refund would be difficult

[agnes]

Seems odd to me. When I had my wisdom teeth they gave us an itemized cost of my copay (X for tooth extraction, Y for xray, etc) the balance for what insurance didn't cover (like IV sedation) AFTER the procedure was done. But then again, I could be wrong because H handled it while I was out of it.

[zoomzoom]

Dec 18, 2014 16:32:46 GMT -5 Lucy Honeychurch said:

Dec 18, 2014 16:31:11 GMT -5 zoomzoom said:

Ok, now THAT'S weird.  I don't think payment day of procedure is weird but I've never pre-paid for a dentist of doctor's visit.

I can honestly understand it, given how often people default on medical bills.  And dental insurance is always notoriously skimpy, so we're talking larger amounts than for a normal doctor's visit copay.

I can understand if, on the day of treatment, they'd ask for payment up front.  But pre-paying before the actual appointment?  No.  What if she were to decide to seek treatment elsewhere? 

[Jalapeñomel]

Dec 18, 2014 16:38:24 GMT -5 zoomzoom said:

Dec 18, 2014 16:32:46 GMT -5 Lucy Honeychurch said:

I can honestly understand it, given how often people default on medical bills.  And dental insurance is always notoriously skimpy, so we're talking larger amounts than for a normal doctor's visit copay.

I can understand if, on the day of treatment, they'd ask for payment up front.  But pre-paying before the actual appointment?  No.  What if she were to decide to seek treatment elsewhere? 

I'm fairly certain this is why they wanted me to pay right away. And the woman was a bitch about it when I said that I am not ready to make a deposit today (And, admittedly,  could be clouding my judgement). 

[zoomzoom]

I don't think your judgement is cloudy. Unfortunately, I'd probably seek help elsewhere. Do you have a general dentist?

[Jalapeñomel]

Oh, this is a yelp! review:

"It's very unfortunate that the staff at this facility ruins what could be a wonderful experience. They are very unknowledgeable, and not very friendly. Everyone at this place looks miserable. When you walk into the "nice looking" office you get the feel that it's inviting.. however the moment you meet the faces of the staff.. it doesn't look too nice and inviting after all. From the assistant who took my xrays who was not very friendly, very rough and just looked extremely miserable. To the staff that handles the patient billing, who tried to overcharge me by almost $400 because she did not understand the insurance coverage. What a waste of my time! Hopefully the Dr's at this facility will reconsider their employees and maybe they would not lose patients. I wonder if the Dr's even know how their office is run. It's not like patients go there for fun.... we go there for pain relief and some help! Not to be mistreated especially when in pain"

[berbles]

Dec 18, 2014 16:31:51 GMT -5 Lucy Honeychurch said:

This makes sense to me. Your co-pay for a root canal might be $180, but they may not be able to tell yet if they have to do a core build-up or etc, or whether they might require more anesthetic than normal, or nitrous, or if it's extraordinarily difficult and they just can't tell yet.

Which is exactly why you don't pre-pay for dental visits.


The only time I've had to pay upfront, based on an estimate, was at the e-vet.  And even then, I argued them down because it was a Friday and they estimated my cat's stay for the whole weekend.  They wanted 2/3rds of THAT, which was like $700.  I had just paid $2500 for my cat to have surgery and she had a reaction when she was coming off the ketamine; I knew she would be fine in a few hours and I would be there at 7am to pick her up.  I made them re-do the estimate for ONE night and paid the 2/3rds of that.  They still owed me money back when I picked her up.  /tangent

[katb]

When I had a crown/bridge, I had to prepay a certain amount. I think my total responsibility was @$700 - root canal, crown one one tooth, pseudo bridge on another side. I had to have at least 50% paid, and this is a dentist I have used for the last 10 years - I trust him. I just had one wisdom tooth pulled but I didn't have to prepay for that.
He is really good though, about estimating the insurance. I never prepaid for anything except the crown. My husband has had peri scraping down, my DD1 has had fillings, etc. That was the only time.

[holly22]

I had one done earlier. When I made the appt they told md they'd find out what my portion would be and they'd collect at my ally. They called back and provided the amount I'd owe before my appt

[sent]

My dad had a root canal done recently. I sent him to an endodontic specialty office. They charged him $400 after the procedure and said they would file with the insurance company, and if the insurance company doesn't pay what is expected they will then charge the rest. If they pay more, they send a refund.

Few other things - price can vary based on which tooth it is. Root canals on back teeth sometimes cost more than ones on the front. Maybe this is where the discrepancy is?  Also the office might be billing for a consultation which may not be covered by your insurance based on the limitations of your insurance.  Like they only cover 2 exams or consults per year and you have already used them all up.  

ETA - some offices ask for deposits for longer procedures like root canals.  

Or it could just be a shady office.

[eav2c]

I've been to a few dentists in the last year and the last two dentists I've gone to did this. Once I was an established patient, they haven't had me pay for procedures up front. FWIW, I had to pay upfront in full to even schedule a root canal a year ago and I was pissed at the time but once it was done, I was so relieved.

[adhdfashion]

I have never paid upfront for any dental work. That's weird.

[iamgrace]

Kinda weird, but all offices are different. I've always had pre-determinations on paper when ever I've needed dental stuff done, with or without insurance.

[jenna]

I just had a crown done, and the admin at the office went over the financial numbers with me before the dentist started the procedure. She had the costs printed out on paper, and had me sign at the bottom of the page.  I paid after the dentist did the majority of the work.

My OB did have me prepay for E's birthing costs and costs of visits. Pretty sure the estimate was about $800, so I made payments in installments during regular visits. Glad I didn't have a big OB bill on top of the Hospital bill. I ended up overpaying (since my insurance paid out more - and the overpayment on my part was not the OB's fault) but the OB issued me a refund right away - once all the paperwork cleared after E's birth.

TL;DR - I vote it's odd you got a verbal estimate with a request for prepayment before the procedure.