They've got me by the... tooth!

I really wanted to put this in IMHO. If any doctors, assistants or folks who do medical billing want to voice about the billing practice, I’d be glad to hear it.

That said, I just need to vent–so much for IMHO.

Back at the end of the year, one of my teeth broke. My last dentist had retired, so I called my wife’s dentist. From the start, this guy and his office pretty much rocked. Without getting into details, the staff was entirely competent, really went the extra mile and objectively discussed the options without trying to sell me something I didn’t want. I decided to go ahead with a crown and paid an outstanding balance along with my deductible for this year. They ground down the tooth and fitted a temporary cap, and I walked to the front where I was informed that I would need to pay the nine hundred dollar balance for the work before receiving the permanent crown, three weeks from now. My insurance may come through before then; otherwise I need the full amount.

I can tell the difference between a doctor and a banker, and I don’t want to leave them holding the balance. Their wanting the payment before completing the work is a fair policy, but the execution leaves just a little to be desired, like maybe stating this policy before starting the work. Had they mentioned this, I could have just had them build up the tooth then saved the cash for the crown. This would have cost fifty bucks more–not much, all considered.

What really pisses me off is that billing and payments seemed to be an option until today. The balance I mentioned before was for some work that my wife had done. My wife had mentioned that they had let her make payments, and I believe that the office mentioned that they would be willing to work with me on my payments as well (unfortunately, what they said was said in passing and I can’t pin down what was said.) In any case, I found that we owed a balance and covered it with my next paycheck, and we were running a credit when I showed up for the work.

As it stands, I’ve got a filed down tooth with a chunk of Bondo tacked onto it (which hopefully won’t fall out too often in the next month or two), and there’s a part of me that wants to tell them to keep the damn crown and call it even. Realistically though, if I can’t find the money in our budget I’ll just have to postpone the visit. I’m sure that we can calmly work this out later. They’re good folks. Perhaps in some ways they’re better than me, because for now I have to say that they did a piss-poor job with the way they handled this–at the very least, their timing sucks.

IMO, this behavior sucks. If you have insurance, and IF they’ve used your insurance before, and IF they know your insurance exists and pays out, then why do they want your balance paid off? THat’s fucking ridiculous, and if you really have a problem with it, call and talk to the office manager and maybe even the doctor. If that doesn’t work, there may be one other way to exact some sort of change-

Most insurance charters sign the doc into a contract. This contract has rates of pay, co-pay information, behavior standards as well as billing and collection standards that they have to follow. You might be able to talk to your insurance over the phone, ask them if this is allowed behavior and use that to get the doctor’s office to change their stance.

Sam

When I went to the dentist last week I was told that a simple and painless root canal was not an option. A more expensive and painful extraction and bone graft were needed.

So I agreed, reluctantly.

During the procedure, the nurse told me “You’re not feeling pain, you’re just feeling a liitle pressure.” Thanks. I’m so glad you set me straight on that. Because it felt like pain. Hot, searing, brutal pain. Good thing I was mistaken on that.

When it was over, I was in a general state of “pressure”, I was drinking my own blood, and I was exhausted. The receptionish cheerily asked “Would you like to put that on a credit card?” And she actually had the nerve to get offended when I gave her the finger and walked out! The nerve!

This reminds me of two stories from my sisters about the joys of the dentist.

Number 1: Let me know if this hurts.
Sister: That hurts.
Dentist: Well there’s nothing I can do about it.

Number 2.
Sister: That hurts.
Dentist: No, it doesn’t.

Just a few weeks ago, I got a toothache. Went to the dentist knowing I wanted it pulled. She agreed it needed to be pulled. Spent 80 buck for an exray, a consultation and a script. But she didn’t want to pull it - the wuss. Referred me to an oral surgeon. Who wanted me to come in for another consultation. Then come back for the extraction. I hung up on them.

Ended up going to the community health center hear and getting it pulled for 50 bucks since I’m one of the working poor. Should have done that to begin with.

Someday hordes of starving uninsured underemployed masses with toothaches will storm the castles of the professionals and underemployers. I wait impatiently.

Now, that’s gonna be interesting.

I’m going for a crown next week, too (broke a tooth last weekend), and they made it very, very clear that payment is expected before the procedure commences. The way your dentist’s office did it is very unprofessional, cornflakes.

What really sucks is that I like these folks and they really seem to have their act together, except for this one issue. It’s a lot like eating a perfectly ripe apple, enjoying every bite of it, and then looking at the core when you’re finished and seeing half of a worm sticking out of a hole.

People make mistakes, and if they had to mess something up then I’d rather it be the billing than be the teeth. This dentist seems good, and it’s possible that he didn’t know that the billing office would handle things in this manner. Time will tell, and I’m going to keep in touch with him if it does take a while to get the money together (very likely at this point, but I’m not certain.)

They aren’t a contracted provider, though I wonder if the insurance company really wants to pay for services not yet rendered. My take, however, is that a deal’s a deal. If they want to play by these rules then we will. It may just take a little longer to finish, and they’re going to hear about it.