Dental Appointment?

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wiredspider

Diamond Member
Jun 3, 2001
5,239
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I have dental insurance, so I decided to finally get my wisdom teeth looked at. When I didn?t have insurance it was going to cost somewhere in the range of $300-$400 per tooth in New York.

So now in Delaware with dental insurance, contacted an oral surgeon for a consult. The receptionist lady told me they want me to pay for the visit first ($75 for office visit and $105 for X-Rays) then they would file a claim with my insurance company. Is that normal? $180 for a fairly simple visit, my X-rays in New York were around $5-$10 each and they want $105 for them here?

My main concern is that they want me to pay upfront. Seems odd that they would want me to pay then file a claim ? I mean I?m only gonna go there if it?s covered, what have been other people?s experiences with this?
 
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MageXX9

Senior member
Jan 25, 2005
442
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I think that happens some times. Doctor's offices will do that so they are sure they don't get shafted. Your insurance would probably cut you a check after the claim has been filed.

Don't take my word though, I'm just guessing.
 
SpiderWiz

SpiderWiz

Senior member
Nov 24, 2004
897
3
81
It really depends on your insurance. Some policies prevent the DDS from billing you up front. While other policies allow this practice. Check with you insurance provider.
 
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QED

Diamond Member
Dec 16, 2005
3,428
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You probably will have to pay even if you do have dental insurance as a lot of dental plans have a decent annual deductible.

My first visits to the dentists have typically been unreimbursed because of my deductive ($75 per person per year).
 
kranky

kranky

Elite Member
Oct 9, 1999
21,019
156
106
I had to pay up front when going to an oral surgeon even though I had good insurance. It was their policy.
 
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wiredspider

Diamond Member
Jun 3, 2001
5,239
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ended up paying a $20 co-pay because they are impacted so they are going after my health insurance for the claim instead of dental (except for the x-rays). now to schedule a week off for the surgery : /.
 
D

Dunbar

Platinum Member
Feb 19, 2001
2,041
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My advice, get a list of the procedures and type of anesthetic being used along with pricing. Contact your insurance company directly and ask them what is covered. I trusted what the receptionist at the oral surgreon told me and it cost me twice as much ($500) out-of-pocket.

Make sure you get the strong pain killers!
 
T

toolfan

Senior member
Oct 11, 1999
285
0
76
Originally posted by: Dunbar
Make sure you get the strong pain killers!
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Make sure they put you under. When I had two of my wisdom teeth out years ago, I only got a couple shots of novacaine. That numbed me up enough, but it was the grinding, sawing, snapping noises that were the worst part. That's the last time I get oral care out of the back of a van... :Q

 
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Turnpike

Senior member
Oct 30, 2003
222
0
0
It is very common practice for payment upfront, any medical practice is looney if they don't require payment in full day of the scheduled procedure. Insurance companies/plans can be very complicated and takes time for approvals and such, that's probably why they want it up front.

If you're getting 3 or 4 wisdom teeth out and some or all are impacted, and you are over 24 yo I highly recommend some sedation for your comfort. It's not necessary, but it's a nice convience.
 
kranky

kranky

Elite Member
Oct 9, 1999
21,019
156
106
Looks like we've lost the distinction between an oral surgeon (as the OP said) and a dentist.

An oral surgeon probably requires payment up front because the average patient is only going to be there once. It would be too easy for people to get the work done and just blow off paying for it because they won't need to go back.

Not too long ago places like that would work with you - if you were a local, referred by a dentist you've been going to for a long time, etc., they would let you pay later. But now with discrimination lawsuits, it's easier for them to just make a blanket policy to pay first.
 
G

Garet Jax

Diamond Member
Feb 21, 2000
6,369
0
71
Originally posted by: wiredspider

I have dental insurance, so I decided to finally get my wisdom teeth looked at. When I didn?t have insurance it was going to cost somewhere in the range of $300-$400 per tooth in New York.

So now in Delaware with dental insurance, contacted an oral surgeon for a consult. The receptionist lady told me they want me to pay for the visit first ($75 for office visit and $105 for X-Rays) then they would file a claim with my insurance company. Is that normal? $180 for a fairly simple visit, my X-rays in New York were around $5-$10 each and they want $105 for them here?

My main concern is that they want me to pay upfront. Seems odd that they would want me to pay then file a claim ? I mean I?m only gonna go there if it?s covered, what have been other people?s experiences with this?
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Call your insurance to make sure the initial consult and X-Rays will be covered. In addition, find out the negotiated rate (between insurance and dentist) for the two indicated procedures. Make sure not to pay more than that because that is what is going to be re-imbursed.

To keep costs down, insurance companies negotiate a lump sum monthly payment for common procedures (typically only with large providers). If this is one of those sceanrios, then your insurance company will not cover any out of pocket expense you incur.

I have never seen or heard of this being done - although I understand the reasoning. You may want to try and find another dentist since most of the work is being pushed to you.
 
E

Eddieo

Senior member
Nov 17, 2004
329
0
0
Originally posted by: SpiderWiz
It really depends on your insurance. Some policies prevent the DDS from billing you up front. While other policies allow this practice. Check with you insurance provider.
Click to expand...

I would do the above.
 
moshquerade

moshquerade

No Lifer
Nov 1, 2001
61,504
12
56
Originally posted by: j00fek
Originally posted by: Citrix
no its not normal. find a new dentist.
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yeh you shouldnt have to pay out of pocket if you have dental ins

:thumbsup:
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read: all oral surgeons may ask for some payment up front. they are specialists. he can't just go "find a new dentist".
 
K

krunchykrome

Lifer
Dec 28, 2003
13,413
1
0
Originally posted by: wiredspider

I have dental insurance, so I decided to finally get my wisdom teeth looked at. When I didn?t have insurance it was going to cost somewhere in the range of $300-$400 per tooth in New York.

So now in Delaware with dental insurance, contacted an oral surgeon for a consult. The receptionist lady told me they want me to pay for the visit first ($75 for office visit and $105 for X-Rays) then they would file a claim with my insurance company. Is that normal? $180 for a fairly simple visit, my X-rays in New York were around $5-$10 each and they want $105 for them here?

My main concern is that they want me to pay upfront. Seems odd that they would want me to pay then file a claim ? I mean I?m only gonna go there if it?s covered, what have been other people?s experiences with this?
Click to expand...

Damn, how bad are your teeth?
 
M

MrBond

Diamond Member
Feb 5, 2000
9,911
0
76
Originally posted by: wiredspider
ended up paying a $20 co-pay because they are impacted so they are going after my health insurance for the claim instead of dental (except for the x-rays). now to schedule a week off for the surgery : /.
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You shouldn't need a week off for recovery. A lot of it depends on your job and what you do, but 1-2 days MAX after the surgery should be fine. I had two (impacted) out and the next day I was eating normally and out and about.

 
J

JS80

Lifer
Oct 24, 2005
26,271
7
81
Originally posted by: wiredspider
ended up paying a $20 co-pay because they are impacted so they are going after my health insurance for the claim instead of dental (except for the x-rays). now to schedule a week off for the surgery : /.
Click to expand...

Dude you don't need a week for wisdom teeth removal.
 
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