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Dental Appointment?

W

wiredspider

Diamond Member

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?
 
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.
 
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.
 
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).
 
I had to pay up front when going to an oral surgeon even though I had good insurance. It was their policy.
 
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 : /.
 
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!
 
Originally posted by: Dunbar
Make sure you get the strong pain killers!
Click to expand...

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

 
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.
 
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.
 
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...


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.
 
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.
 
Originally posted by: j00fek
Originally posted by: Citrix
no its not normal. find a new dentist.
Click to expand...

yeh you shouldnt have to pay out of pocket if you have dental ins

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

 
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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