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Medical Forum / General / Dentistry / July 2005

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fair charge for dental work?

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kolibri - 29 Jun 2005 01:32 GMT
My husband has only 12 teeth left. He needs a lot of dental work.
Deep cleaning, Periodontitis treatment with Arestin.  1 too
exctraction. 3 Captek crowns, and new lightweight, soft uppe
partial.  Also x-rays, couple of fillings.  Dental office charge
$12,000 and change.  They said that $6,000+ will be covered by hi
HMO. We will have to pay $5.500 balance.  I know the description i
not very detailed, but I presume dentists have an idea how much wor
is involved.  Did we get screwed or we got a deal

Thanks a lot
Kolibr
Jacob - 29 Jun 2005 05:21 GMT
It really is impossible to say what a reasonable fee would be without seeing
the patient.  Anyone who says they can give you an estimate without the
patient is probably a fool.  I would suggest that you get another opinion
from another dentist, as well as discuss the fees in detail with the present
dentist.  When a patient is spending a significant amount of money for
dental care, I would think that the dentist would be more than happy to
explain the fee in as much detail as you require; if not, I'd consider
finding another dentist.

> My husband has only 12 teeth left. He needs a lot of dental work.
> Deep cleaning, Periodontitis treatment with Arestin.  1 toof
[quoted text clipped - 7 lines]
> Thanks a lot.
> Kolibri
Dr Steve - 29 Jun 2005 13:57 GMT
No one ever gets a deal with HMO dental insurance.  Every dental office I
have ever encountered that participates with HMO schemes utilizes
bait-and-switch methods.

Signature

~+--~+--~+--~+--~+--
Stephen [What's a Temporary?], D.D.S.
Michigan, USA
....................................................

This posting is intended for informational or conversational purposes only.
Always seek the opinion of a licensed dental professional before acting on
the advice or opinion expressed here.  Only a dentist who has examined you
in person can diagnose your problems and make decisions which will affect
your health.
......................

> It really is impossible to say what a reasonable fee would be without
> seeing
[quoted text clipped - 18 lines]
>> Thanks a lot.
>> Kolibri
jwn dds - 29 Jun 2005 15:35 GMT
I wish dental fees were fair.  If the patients would pay on a per hour basis
I think I'd see alot fewer patients with "sensitive teeth".

Lets see:
Assistant #1 = $20/hour
Assistant #2 = $20/hour
Office manager = $18/hour
Receptionist = $15/hour
Dental hygienist = $38/hour

Salary total per hour = $111/hour
Supplies per hour = ??
Overhead per hour = ??

Hmm I'm curious now.  What does it cost for me to run the practice.  I'll be
right back.

> My husband has only 12 teeth left. He needs a lot of dental work.
> Deep cleaning, Periodontitis treatment with Arestin.  1 toof
[quoted text clipped - 7 lines]
> Thanks a lot.
> Kolibri
james - 29 Jun 2005 16:25 GMT
> I wish dental fees were fair.  If the patients would pay on a per hour basis
> I think I'd see alot fewer patients with "sensitive teeth".
[quoted text clipped - 12 lines]
> Hmm I'm curious now.  What does it cost for me to run the practice.  I'll be
> right back.

You mean you have no idea what your average monthly expenses are for
anything besides salaries?  Hmmm.  Well, I certainly hope your office
manager does.

Limit everybody's spending powers to what they absolutely need for
business purposes, make them all get approval for every expense over a
certain amount, and make your office manager keep detailed records of
EVERY expense (not just the ones you have to approve).
jwn dds - 29 Jun 2005 17:49 GMT
I know that I run about 60% overhead.  I was wondering what that was "per
hour" though

>> I wish dental fees were fair.  If the patients would pay on a per hour
>> basis
[quoted text clipped - 23 lines]
> certain amount, and make your office manager keep detailed records of
> EVERY expense (not just the ones you have to approve).
james - 29 Jun 2005 20:59 GMT
> I know that I run about 60% overhead.  I was wondering what that was "per
> hour" though

BTW, do you actually pay your employees that much, or are you including
health insurance, 401(k) contribution matches, and other employee
related stuff?

If you actually pay them that much, then you are very generous.  Either
that, or you only work them about 30 hours each week and you pay them a
high hourly rate to make up for the low hours...  Which still makes you
kind of generous.

> >> I wish dental fees were fair.  If the patients would pay on a per hour
> >> basis
[quoted text clipped - 23 lines]
> > certain amount, and make your office manager keep detailed records of
> > EVERY expense (not just the ones you have to approve).
jwn dds - 29 Jun 2005 21:21 GMT
Those are Canadian wages.  I'm not sure what the American wage would be.
Yes, it is what they get paid.

>> I know that I run about 60% overhead.  I was wondering what that was "per
>> hour" though
[quoted text clipped - 36 lines]
>> > certain amount, and make your office manager keep detailed records of
>> > EVERY expense (not just the ones you have to approve).
clifffreeling@yahoo.com - 29 Jun 2005 16:53 GMT
> I wish dental fees were fair.  If the patients would pay on a per hour basis
> I think I'd see alot fewer patients with "sensitive teeth".
[quoted text clipped - 12 lines]
> Hmm I'm curious now.  What does it cost for me to run the practice.  I'll be
> right back.

Let me get my hanky...<sniff sniff>

--
Cliff
jwn dds - 29 Jun 2005 17:50 GMT
Was something I said sad?

I'm personally happy as a clam.

>> I wish dental fees were fair.  If the patients would pay on a per hour
>> basis
[quoted text clipped - 19 lines]
> --
> Cliff
carabelli - 29 Jun 2005 19:04 GMT
> Was something I said sad?

Allergies?

> I'm personally happy as a clam.
>
[quoted text clipped - 21 lines]
> > --
> > Cliff
jwn dds - 29 Jun 2005 21:21 GMT
> Allergies?

/agree

I'm a fan of Benadryl myself.
kolibri - 30 Jun 2005 09:32 GMT
[[quote:bcb7455dd6]  I would suggest that you get another opinio
from another dentist, as well as discuss the fees in detail with th
presen
dentist.  When a patient is spending a significant amount of mone
fo
dental care, I would think that the dentist would be more than happ
t
explain the fee in as much detail as you require; if not, I'
conside
finding another dentist.[/quote:bcb7455dd6

Thank you for advice.  It would be nice to get 2nd and even 3r
opininon.  But it's not like shopping for shoes.  Appointments
waiting in the office, broken partial in the mouth, and have to go t
work too. Besides, I don't think dentists appreciate patients tha
come to the office to get an estimate, without actually getting wor
done. It's obviously inconveniet and time consuming for all involved
The office manager spelled out all services and prices to me.  
realize, it's not cheap to run the business.  And I don't mind to pa
for services rendered.    I just would like to know what is fair pric
for instance for  Captek crown? Is $900 too much, too little or jus
right

Thank you all for the replies, hope to see more

P.S
Jacob - 30 Jun 2005 10:32 GMT
You seem to be penny wise and dollar foolish.  Why on earth would you not
want another opinion after you were upset about the first one?  If you think
you are going to find the answer to your question from people who haven't
examined your mouth or seen your radiographs, etc., well, you will get what
you pay for!  If you really are serious about this, you should do what I
suggested in my prior email.  You said this is "not like shopping for shoes"
and yet I'll bet you don't buy shoes without seeing the salesman and trying
them on.  How can you expect to get any sort of meaningful answer to your
question via the newsgrouop???  You need to see your dentist, or another,
and have him/her answer all your questions about the fee.  ANY reputable
dentist would be happy to discuss the fee with you.  What, exactly, are you
expecting people to say?  Anyone who gives you a reply about fees without
seeing you is really a fool.  And anyone who accepts someone's advice
without having been examined also is a fool.  Don't you understand this?  It
seems pretty basic/obvious to me.

> [[quote:bcb7455dd6]  I would suggest that you get another opinion
> from another dentist, as well as discuss the fees in detail with the
[quoted text clipped - 22 lines]
>
> P.S.
Steven Fawks - 30 Jun 2005 14:58 GMT
$900 for a Captek crown is certainly within a reasonable range in most
areas of the US.

However, determining 'value' of dental treatment isn't that easy.

Is a Captek crown the best for your particular situation?  Are there
better choices for materials?  Are the rest of the teeth going to last
long enough to make this whole treatment money well spent?  Were
alternative treatments discussed with advantages and disadvantages of
each discussed?  Will the treatment deliver a comfortable, long lasting
solution to your dental problems?

As most people have stated, 'we' can't tell you the best treatment
for your case.  This sounds like a significant decision.  I shop around
a little just to buy a washing machine (and not just for the lowest PRICE).

Sometimes you get what you pay for and sometimes you get less.  Even if
you do get what you pay for, is that what you want or need?

JMO,
Fawks

>  The office manager spelled out all services and prices to me.  I
> realize, it's not cheap to run the business.  And I don't mind to pay
[quoted text clipped - 5 lines]
>
> P.S.
W_B - 30 Jun 2005 15:35 GMT
>Besides, I don't think dentists appreciate patients that
>come to the office to get an estimate, without actually getting work
>done.

Doesn't bother me a bit.

>    I just would like to know what is fair price
>for instance for  Captek crown? Is $900 too much, too little or just
>right ?

Depends largely on your geographical location.
--

W_B
Take out the G'RBAGE
wubbabubbazG@RBAGEyahoo.com
kolibri - 30 Jun 2005 09:32 GMT
I would suggest that you get another opinio
from another dentist, as well as discuss the fees in detail with th
presen
dentist.  When a patient is spending a significant amount of mone
fo
dental care, I would think that the dentist would be more than happ
t
explain the fee in as much detail as you require; if not, I'
conside
finding another dentist

Thank you for advice
kolibri - 30 Jun 2005 09:32 GMT
> Dr Stevewrote
[quote="Dr Steve"]No one ever gets a deal with HMO dental insurance.
Every dental office I
> have ever encountered that participates with HMO schemes utilizes
> bait-and-switch methods.--
~+--~+--~+--~+--~+-
Oh, Oh..
You really scaring me now... Do they really do that!?!?
Bait-and-switch..
Does that mean, after all dental work is done, I will have to take m
husband to another dentist to check if they relly put Captek crown
in his mouth? No, seriously, I am out of $5.000 here. Please have
mercy!!
The Real Paul - 30 Jun 2005 14:29 GMT
You already paid?

> > Dr Stevewrote:
> [quote="Dr Steve"]No one ever gets a deal with HMO dental insurance.
[quoted text clipped - 9 lines]
> in his mouth? No, seriously, I am out of $5.000 here. Please have a
> mercy!!!
Rich - 01 Jul 2005 00:53 GMT
>>Dr Stevewrote:
>
[quoted text clipped - 12 lines]
> in his mouth? No, seriously, I am out of $5.000 here. Please have a
> mercy!!!

As I understand "bait & switch" in this context is exactly what was
attempted on me after I relocated to another area of the country &
sought a new dentist when a tooth broke. I had been going to a dentist
in NJ for years with regular cleanings and maybe a replacement filling
every 2 years or so. As soon as I sat in the chair of the new dentist, I
was immediately informed that I was not a candidate for a routine
cleaning(free under my dental plan), but would need a once in a lifetime
debridement followed by deep cleanings done by quadrants under local
anesthetic in four separate appointments. Naturally, these treatments
were not covered fully under my insurance as routine dental care & would
cost me hundreds of dollars. The "bait" was the free cleaning covered
under my plan. The "switch" was the debridement & deep cleaning not
fully covered. Back in NJ I had many free cleanings which were very
thorough. I am 51 years so I can understand where I might need this if I
never had my teeth cleaned or it was done superficially. The irony is
that a colleague of mine at work, who had relocated like I did, went to
a different dentist under our insurance & was told the exact same thing.
When he asked to have have a regular cleaning none the less, the
hygienist told him she could not for ethical reasons. A dentist in the
office was then called in for back up when he asked for his x-rays and
laid on the heavy sell. My friend ultimately relented & was debrided &
deep cleaned. Oh yeah, I forgot to mention, he is 27 years old & also
was a regular visitor to his dentist back home.
I did not get the debridement & deep cleaning. My dentist lost me & my
other 3 family members as patients when she looked into my mouth and
determined that I needed 7 crowns immediately which, under my insurance
plan, allowed her to add $125 to the cost of the 1 crown I wanted &
needed urgently. I knew it was unethical but I do not believe in arguing
money with a health professional, so I paid for the one crown(already
started)and never went back after it was completed. Ironically, her
office called my home the other day asking when I would be scheduling my
additional work. I had already switched my family & myself to a new
dentist. I hope he is forthright.
Rich
Steven Fawks - 02 Jul 2005 13:42 GMT
She didn't really want *you* or your family as patients anyway.  All
she wanted was a big hit on your bank account for the initial treatment
plan and then hoped you would disappear.  (She wouldn't make any money
for routine care)

You did the right thing.

Fawks

> I did not get the debridement & deep cleaning. My dentist lost me & my
> other 3 family members as patients when she looked into my mouth and
> determined that I needed 7 crowns immediately which, under my insurance
> plan, allowed her to add $125 to the cost of the 1 crown I wanted &
> needed urgently.
> Rich
Rich - 02 Jul 2005 15:52 GMT
> She didn't really want *you* or your family as patients anyway.  All
> she wanted was a big hit on your bank account for the initial treatment
[quoted text clipped - 11 lines]
>> wanted & needed urgently.
>> Rich

Yes, I understand what you mean. But under an HMO dental plan, since I
had listed her as the dentist for 4 different patients, wasn't she
receiving some small stipend each month whether she saw us or not?
Thanks,
Rich
Dr. Steve - 03 Jul 2005 00:05 GMT
>Yes, I understand what you mean. But under an HMO dental plan, since I
>had listed her as the dentist for 4 different patients, wasn't she
>receiving some small stipend each month whether she saw us or not?
>Thanks,
>Rich

With an HMO plan the dental office get's about $10 per month for way
patient assigned to the office. The office does NOT get any more money
if they treat you. they make money by making it difficult for you to
get covered care.
..
Stephen
Troy, Michigan, USA

I am writing on a Tablet-PC,so forgive me if the PC misreads my handwriting.
kolibri - 03 Jul 2005 01:31 GMT
>  All she wanted was a big hit on your bank account for the initia
treatment plan and then hoped you would disappear.  (She wouldn'
make any money for routine care

Let's say I go to 3 different dentists and get 3 different opinions o
the same dental problem?  I am not a dentist, not even close. How ca
I determine which of the three suggesting a right treatment for me?
Most dental insurances do not have much coverage.  Do I always hav
to settle for what is covered by my insurance?  What if I really nee
some dental care that is not covered by my insurance or covered ver
little? How does the ordinary (dentally uneducated) person like me t
make the right descision? Always go for the cheap treatment? Spend
lot of money and hope it will be worth it? Go with my instinct
Jacob - 03 Jul 2005 02:23 GMT
You will need to read your insurance contract.  That is what spells out
exactly what you are entitled to for the premiums you are paying.  Keep in
mind that the insurance is a contract between YOU and the INSURANCE company.
It is NOT a contract between you and the dentist or between the dentist and
the insurance company.  If you have any questions about your coverage, you
should contact your insurance company and discuss it with them.  If you are
covered through your union or your employer, and you are not satisfied with
your coverage, then also discuss it with them and say that you want better
coverage.

> Let's say I go to 3 different dentists and get 3 different opinions on
> the same dental problem?  I am not a dentist, not even close. How can
[quoted text clipped - 5 lines]
> make the right descision? Always go for the cheap treatment? Spend a
> lot of money and hope it will be worth it? Go with my instinct?
Steven Fawks - 04 Jul 2005 15:11 GMT
You bring up some very real and very tough questions.

Certainly diagnosing dental disease and treatment based upon
what an insurance company will help pay for is not always a
good idea.  If an implant is better treatment than a fixed
bridge for a particular missing tooth, it is sad to 'settle'
for a bridge simply because the insurance will pick up part of
the cost.

Insurance companies may not cover onlays or crowns, or may pay
at a very low rate for these treatments.  Depending on the insurance
company can leave you with less than ideal treatment that may
not last very long or may even cause you to lose a tooth.

Determining which dentist is recommending the best treatment and
can deliver that treatment comfortably, skillfully, and affordably
is probably impossible for the average person to accomplish.  How you
'feel' about the dentist, office, staff, and treatment recommendations
will be a factor.

If there were major differences between treatment plans,
I would consider not taking the cheapest treatment or the most
expensive.  Then I would not sign anything obligating myself
financially for the entire treatment before it was even begun.
Start with obvious problems (active decay, pain, broken teeth)
and see how satisfied you are with the results.   If the treatment
was comfortable, looked good, and felt good, then you could finish
treatment with more confidence.  If something did not go well, you
could start over with another dentist.

Sorry for not having a concrete answer,
Fawks

> Let's say I go to 3 different dentists and get 3 different opinions on
> the same dental problem?  I am not a dentist, not even close. How can
[quoted text clipped - 5 lines]
> make the right descision? Always go for the cheap treatment? Spend a
> lot of money and hope it will be worth it? Go with my instinct?
kolibri - 06 Jul 2005 01:31 GMT
> Sorry for not having a concrete answer
> Fawk

This is a great answer
You gave best answers of all
Thank you very much
carabelli - 06 Jul 2005 02:25 GMT
>> Sorry for not having a concrete answer,
>> Fawks
>
> This is a great answer!
> You gave best answers of all.
> Thank you very much.

Well, he's always been like that.

carabelli
Steven Fawks - 08 Jul 2005 22:33 GMT
That's what happens when I take a few days off.  I better go
check the ribs.

:-)
Fawks

> Well, he's always been like that.
>
> carabelli
Dr Steve - 07 Jul 2005 12:55 GMT
Do you need us to explain what is meant by bait-and-switch??

Signature

~+--~+--~+--~+--~+--
Stephen [What's a Temporary?], D.D.S.
Michigan, USA
....................................................

This posting is intended for informational or conversational purposes only.
Always seek the opinion of a licensed dental professional before acting on
the advice or opinion expressed here.  Only a dentist who has examined you
in person can diagnose your problems and make decisions which will affect
your health.
......................

>> Dr Stevewrote:
> [quote="Dr Steve"]No one ever gets a deal with HMO dental insurance.
[quoted text clipped - 9 lines]
> in his mouth? No, seriously, I am out of $5.000 here. Please have a
> mercy!!!
kolibri - 01 Jul 2005 09:32 GMT
[[quote:4e9512c2db]quote="Steven Fawks"]$900 for a Captek crown i
certainly within a reasonable range in mos
areas of the US.[/quote:4e9512c2db

Thank you.  This is the answer I was looking for
 
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