Post by kgibbas on Jul 16, 2005 15:28:49 GMT -5
I enrolled in a Dental Plan several months ago. It's called CompBenefits.
The first thing I had to do was to call them and have them send me a list of dentists that accept this plan.
There is one dentist on this plan where I live.
I called the dentist to make an appointment. I talked to his secretary. She said that I have to wait until their office gets a list from CompBenefits with my name on it. CompBenefits sends the list out to the dentists, once a month. I had a molar with a big hunk off the corner mind you.
The secretary told me to call my family doctor and get on anti biotics until I could get in to the office.
I did.
I went in for my dental visit. The dentist said that I need a crown.
The CompBenefits book said that a crown is 370.00 plus lab. Lab usually runs 125.00 or so.
The dentist told me that my crown would cost 910.00. That is for a porcelin crown.
It is 310.00 for a silver crown. The dentist said that the silver crown will last for 3-5 years, then I'll need it replaced.
I turned him in to the Better Business Bureau.
I then called CompBenefits and told them. I told them I need a new dentist. They said that if I make an appointment before the 15th, they can switch me over. I did.
His office is 30 miles away. He's the next closest dentist on the list.
He said I need two crowns. He will charge me 1,100.00 for two crowns. I had the teeth filled with whatever type of filling they use underneath the crowns.
Keep in mind, the book says 370.00 for each crown plus lab (125.00)
120.00 for a silver crown.
He told me 1,100.00 total for two silver crowns.
Does anyone know how much a crown usually costs???
If you guessed between 5 and 7 hundred, you are correct! That is for porcelin crowns.
I had Delta Dental before I switched to this so called 'Dental Plan'. I was so uninformed. I looked at the book and the prices for the dental plan. I thought it was a better deal. I was wrong.
Now, I will just chew on the right side until after the first of the year and hopefully these fillings won't fall out by then. If so, I'm in deep trouble.
After the first of the year I can get my Delta Dental back and go to a real dentist.
So much for Dental Plans ay?
How a Dental Plan Works
Most dental plans charge (as an example) a subscriber fee of $13.00 per person/month. Out of that $12, let's say, the dentist is given $6/month/person. The dental plan keeps $6/month as an administrative fee without assuming any responsibility or liability for the treatment that the person receives. The dentist, on the other hand, usually agrees to provide those patients with free cleanings, exams, x-rays, and other services at a greatly reduced rate.
The dentist assumes all responsibility! To the lay person, this all seems great. Free cleanings! Free x-rays! Free fillings! Hold on! Did you ever go to a free buffet? They certainly didn't serve caviar!
Think about what the dentist has to pay his staff to provide these services. Six dollars a month for twelve months, that's $72.00! When you think about it, it does not add up! So how does a dentist cover his expenses? First of all, you will find that many of the budget multi-dentist facilities accept these dental plans. They usually have young dentists, who work on a commision. The faster they work and the more they produce, the more they earn. Quality dentistry is not the motivating factor .... it's the dollar.
In some plans, because fillings are free, patients sometimes are told they don't have any cavities. Then after a period of time, the small cavitiy becomes something major that requires a root canal and a crown. Now there is a fee for that as opposed to the small cavity. The patient ends up paying for something that could have been avoided. Did they save money on this plan?
What about the quality of the dentistry?
There are many people who follow the logic that all dentists went to dental school and all dentists learned how to do crowns(as an example); therefore, all crowns are made the same, so go to the least expensive dentist. The problem with that logic is that you are not buying a Goodyear P200 x15 tire. The tire will be the same wherever you go, but not the crown.
You are paying for the expertise of the dentist. How the dentist prepares your tooth and takes an impression and the quality of the dental lab. It is very important how a crown fits, feels, functions, and looks. Most patients will bite down and say it feels ok.
What about the marginal integrity (where the margin of the crown fits to the tooth)? Does the crown look like a melted marble? Most dental plan providers are more interested in quantity than quality. There have been many instances where a dental lab was sent a poor tooth impression for a crown, so poor that the lab could not read the marginal area in the stone model. The lab would call the dentist only to be told, "just guess."
Let's talk about specific examples
Not long ago, I had a patient present with a dental emergency. She claimed she was having pain in a tooth next to a crown she had done a year earlier by a dental plan dentist.
My initial clinical examination revealed a crown on a lower molar which had the porcelain ground off the top, exposing the metal underneath. The patient also had sensitivity on the opposing molar above. The molar above had the enamel ground away, exposing the underlying tooth structure. Besides which, the remaining porcelain on the crown was very rough.
This rough porcelain accelerated the wear on the opposing tooth. The x-ray showed that the crown did not fit the tooth properly. The dentist could not seat the crown all the way. So instead of taking a new impression which would have been time consuming, he just ground down the crown and the opposing tooth. After all he wasn't getting paid that much for the crown and time was money.
To make matters worse, in his haste to prepare the tooth, the dentist gouged the adjacent tooth. That tooth subsequently became decayed and infected. Now the patient needed a root canal and two new crowns and a partial crown or onlay on the opposing molar. This was all because she wanted to save two or three hundred dollars on the original crown by using a dentist from a dental plan. Incidentally, the patient was a pharmacist.
Another example: A seven year old child is referred to an oral surgeon who participates in one of these dental plans. The parents are told that they receive a 25% discount off his regular fees. However, what happens is that the doctor inflates his fee by 25% so the patient thinks they are getting a discount.
It gets worse! The child is there for removal of a baby tooth. The parents pay $80 for a consultation and $80 for a panoramic x-ray (type of x-ray that circles the head). A panoramic x-ray was not necessary. All that was required was a small film. The oral surgeon conducts a consultation with the parents and the little girl present. He presents this enormous fee and justifies it by telling the parents that the procedure will only take 10 minutes but he allows an hour just in case of complications.
Complications? He tells the parents, with the girl present, that the forceps could slip and go down her throat, her jaw could fracture, or she could have some cystic structure present, in which case he may have to rush her to the hospital. Understandably, the parents and the young girl were panicked. Meanwhile, the parents who are on a budgeted income, pre-pay $485 to have this tooth removed.
However, before the scheduled appointment, they contacted me for a second opinion. Prepare yourself! The oral surgeon was charging this exorbitant fee to remove a fragment of a baby tooth. The entire tooth was resorbed. All that was left was a piece of enamel and some inflammatory tissue. It took me ten seconds to remove it and I only charged a small fraction of the oral surgeon's fee.
This practice of inflating the fee is a common practice among dental plan providers.
Caveat Emptor, buyer beware. Get a second opinion and remember, all that glitters is not gold!
Mitchell Pohl, DDS
The first thing I had to do was to call them and have them send me a list of dentists that accept this plan.
There is one dentist on this plan where I live.
I called the dentist to make an appointment. I talked to his secretary. She said that I have to wait until their office gets a list from CompBenefits with my name on it. CompBenefits sends the list out to the dentists, once a month. I had a molar with a big hunk off the corner mind you.
The secretary told me to call my family doctor and get on anti biotics until I could get in to the office.
I did.
I went in for my dental visit. The dentist said that I need a crown.
The CompBenefits book said that a crown is 370.00 plus lab. Lab usually runs 125.00 or so.
The dentist told me that my crown would cost 910.00. That is for a porcelin crown.
It is 310.00 for a silver crown. The dentist said that the silver crown will last for 3-5 years, then I'll need it replaced.
I turned him in to the Better Business Bureau.
I then called CompBenefits and told them. I told them I need a new dentist. They said that if I make an appointment before the 15th, they can switch me over. I did.
His office is 30 miles away. He's the next closest dentist on the list.
He said I need two crowns. He will charge me 1,100.00 for two crowns. I had the teeth filled with whatever type of filling they use underneath the crowns.
Keep in mind, the book says 370.00 for each crown plus lab (125.00)
120.00 for a silver crown.
He told me 1,100.00 total for two silver crowns.
Does anyone know how much a crown usually costs???
If you guessed between 5 and 7 hundred, you are correct! That is for porcelin crowns.
I had Delta Dental before I switched to this so called 'Dental Plan'. I was so uninformed. I looked at the book and the prices for the dental plan. I thought it was a better deal. I was wrong.
Now, I will just chew on the right side until after the first of the year and hopefully these fillings won't fall out by then. If so, I'm in deep trouble.
After the first of the year I can get my Delta Dental back and go to a real dentist.
So much for Dental Plans ay?
How a Dental Plan Works
Most dental plans charge (as an example) a subscriber fee of $13.00 per person/month. Out of that $12, let's say, the dentist is given $6/month/person. The dental plan keeps $6/month as an administrative fee without assuming any responsibility or liability for the treatment that the person receives. The dentist, on the other hand, usually agrees to provide those patients with free cleanings, exams, x-rays, and other services at a greatly reduced rate.
The dentist assumes all responsibility! To the lay person, this all seems great. Free cleanings! Free x-rays! Free fillings! Hold on! Did you ever go to a free buffet? They certainly didn't serve caviar!
Think about what the dentist has to pay his staff to provide these services. Six dollars a month for twelve months, that's $72.00! When you think about it, it does not add up! So how does a dentist cover his expenses? First of all, you will find that many of the budget multi-dentist facilities accept these dental plans. They usually have young dentists, who work on a commision. The faster they work and the more they produce, the more they earn. Quality dentistry is not the motivating factor .... it's the dollar.
In some plans, because fillings are free, patients sometimes are told they don't have any cavities. Then after a period of time, the small cavitiy becomes something major that requires a root canal and a crown. Now there is a fee for that as opposed to the small cavity. The patient ends up paying for something that could have been avoided. Did they save money on this plan?
What about the quality of the dentistry?
There are many people who follow the logic that all dentists went to dental school and all dentists learned how to do crowns(as an example); therefore, all crowns are made the same, so go to the least expensive dentist. The problem with that logic is that you are not buying a Goodyear P200 x15 tire. The tire will be the same wherever you go, but not the crown.
You are paying for the expertise of the dentist. How the dentist prepares your tooth and takes an impression and the quality of the dental lab. It is very important how a crown fits, feels, functions, and looks. Most patients will bite down and say it feels ok.
What about the marginal integrity (where the margin of the crown fits to the tooth)? Does the crown look like a melted marble? Most dental plan providers are more interested in quantity than quality. There have been many instances where a dental lab was sent a poor tooth impression for a crown, so poor that the lab could not read the marginal area in the stone model. The lab would call the dentist only to be told, "just guess."
Let's talk about specific examples
Not long ago, I had a patient present with a dental emergency. She claimed she was having pain in a tooth next to a crown she had done a year earlier by a dental plan dentist.
My initial clinical examination revealed a crown on a lower molar which had the porcelain ground off the top, exposing the metal underneath. The patient also had sensitivity on the opposing molar above. The molar above had the enamel ground away, exposing the underlying tooth structure. Besides which, the remaining porcelain on the crown was very rough.
This rough porcelain accelerated the wear on the opposing tooth. The x-ray showed that the crown did not fit the tooth properly. The dentist could not seat the crown all the way. So instead of taking a new impression which would have been time consuming, he just ground down the crown and the opposing tooth. After all he wasn't getting paid that much for the crown and time was money.
To make matters worse, in his haste to prepare the tooth, the dentist gouged the adjacent tooth. That tooth subsequently became decayed and infected. Now the patient needed a root canal and two new crowns and a partial crown or onlay on the opposing molar. This was all because she wanted to save two or three hundred dollars on the original crown by using a dentist from a dental plan. Incidentally, the patient was a pharmacist.
Another example: A seven year old child is referred to an oral surgeon who participates in one of these dental plans. The parents are told that they receive a 25% discount off his regular fees. However, what happens is that the doctor inflates his fee by 25% so the patient thinks they are getting a discount.
It gets worse! The child is there for removal of a baby tooth. The parents pay $80 for a consultation and $80 for a panoramic x-ray (type of x-ray that circles the head). A panoramic x-ray was not necessary. All that was required was a small film. The oral surgeon conducts a consultation with the parents and the little girl present. He presents this enormous fee and justifies it by telling the parents that the procedure will only take 10 minutes but he allows an hour just in case of complications.
Complications? He tells the parents, with the girl present, that the forceps could slip and go down her throat, her jaw could fracture, or she could have some cystic structure present, in which case he may have to rush her to the hospital. Understandably, the parents and the young girl were panicked. Meanwhile, the parents who are on a budgeted income, pre-pay $485 to have this tooth removed.
However, before the scheduled appointment, they contacted me for a second opinion. Prepare yourself! The oral surgeon was charging this exorbitant fee to remove a fragment of a baby tooth. The entire tooth was resorbed. All that was left was a piece of enamel and some inflammatory tissue. It took me ten seconds to remove it and I only charged a small fraction of the oral surgeon's fee.
This practice of inflating the fee is a common practice among dental plan providers.
Caveat Emptor, buyer beware. Get a second opinion and remember, all that glitters is not gold!
Mitchell Pohl, DDS