My dentist recommended an oral surgeon for Wisdom Tooth extraction. When I went, and after I talked to the doctor, I found out that there was a $100 consultation fee that is not reimbursed by insurance. I have several problems with this.
I think I should have been told of the consultation fee before seeing the surgeon.
If I went to an orthopedic surgeon for a consultation re: knee replacement I would not be charged for the office visit if I had the surgery done by him/her as the global surgical fee included pre-operative planning. Otherwise it would be double billing.
If insurance will not pay for this then I think that it must not be usual or customary.
You would if you went to the one my wife did. She injured her knee while we were in Spain and when we got home she was refereed to an orthopedic surgeon by her regular doctor. The Surgeon charged $60 consultation before even talking to my wife. This really stunned both of us as we’d never heard of it before.
But what stunned us even more is that my otherwise insanely good government employee insurance wouldn’t pay a cent of it. $60 isn’t no big deal as I have almost no deductibles. It’s just the insistence that we pay it before she was even allowed to go into the office was a shocker. “No we won’t bill you. Your insurance won’t pay this so you have to pay it now! Right now!”
I’m wondering if this is related to no more free estimates on car repairs. Paying a grease monkey $25 so he will tell me how much he’s going to charge when he actually fixes my car really sticks in my craw!:mad:
I guess, like with the auto repair estimate, I could understand the fee if you consulted and then didn’t use the service. Regardless of what they do for a living peoples working time has value. But you’d think there would be some leeway for when you consult and then actually use the service.
Oh, sorry, that’s nothing. I was charged $400 by an ENT doctor for a 5 minute new patient meet and greet after being referred over by a nonprofit-clinic doctor. The ENT did stick something in my ear for several seconds and give me an estimate for a surgical procedure, a removal of a skin tag near my throat, so I’m sure it was justified. :dubious: I had to complete the clinic’s “compassionate care program” paperwork to eventually get the fee waived. The actual procedure would have cost about $800, but I didn’t have the money after being charged $400 for the first meeting, so I still have the skin tag though it went in remission. Another time I was charged over $100 by that same clinic along with $450 lab fee for a vitamin B blood test. I have vowed never to step foot in that clinic again so I won’t have to declare bankruptcy due to medical fees.
Me neither, and I’ve had all four wisdom teeth pulled at various times.
OP, can your regular DDS not do the job? The only thing that raises a red flag here is that your dentist (presumably a DDS) is referring you to an oral surgeon. Not knowing your particulars, and I will admit that I am not a dentist; I can’t say if that’s a questionable thing or not; but I can say that all four of my wisdom teeth were removed by an ordinary DDS, in his office chair, who charged me ordinary DDS rates for extractions. I did not need to see an oral surgeon.
I would suggest that you do a little research and find out exactly why an oral surgeon was referred. There may be a very good reason based on your needs and physiology, but (sadly) there also may be nothing more than, “I want to give a colleague some business.” Especially if you’re paying the tab yourself (as I did in all cases; I have no dental insurance), you owe it to yourself to find out what’s going on.
Any professional is entitled to charge you for a consultation. You may consult, and then have the recommended work done by someone else, and then he is not paid for his time. It is convenient if the consultation fee is wrapped up in the work performed, but for doctors of all varieties in the modern world billing is a complicated process and it is much simpler to charge the consultaton seperately.
If this is the US my question is why he would be charging a “consultation fee” instead of a standard office visit code that could be billed to insurance. So yeah, that seems unreasonable. I think dentists are moving away doing things other than filling cavities- my dentist always refers patients on for extractions and root canals.
My regular dentist has explained that while he is trained to pull teeth if necessary, that the oral surgeon that he sent me to pulls teeth all day long, whereas he (the regular dentist) only pulls teeth very rarely.
Last week I paid a $175 consultation fee to an oral surgeon. I’m trying to get implants in my upper jaw, so I can bite again. Apparently, some people just don’t take too well to dentures, and I’m one of them. And I’m going to see another oral surgeon, for another estimate, because this procedure is rather pricy.
I don’t know about the OP , but none of the dental insurance policies I’ve had even had a code for “standard office vist”. There were codes for “oral examination” (limited to once or twice a year, so not quite like an standard office visit to an MD), for Xrays, for procedures (cleaning,extraction etc) ,for prosthetics ( dentures,bridges). orthondontia and "emergency visits for relief of pain " (also limited to one or two a year). If I had a consultation separate from my regular exam about something like replacing a bridge with a denture and then decided not to do it, there is no way that my insurance would reimburse me any part of the consultation fee. If I did have the work done , then I get reimbursed whatever the policy pays for that procedure.
Mine were also pulled by a regular dentist. In my case they weren’t impacted so maybe that has something to do with it. I have one that’s kinda growing sideways, under the gum and the dentist said if it ever started bothering me, I needed to see an oral surgeon. But other than that…isn’t pulling teeth kinda part of being a dentist? If I was seeing a dentist who didn’t feel comfortable pulling teeth…I’d be looking for another dentist.
You should certainly be told if the practice is charging for things that will not be covered by an insurance policy the practice otherwise accepts. I’m not entirely convinced the fee itself is unreasonable, but it should be clearly disclosed upfront.