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Medical Forum / General / Dentistry / April 2007Dentist billing
I have gone to a dentist and recieved a written estimate as to what my out of pocket expence would be.I had a full upper bridge placed,teeth pulled ctc.the day my teeth were pulled a temporary bridge place.My bill had jumped to two times the cost of the original estimate.Can a dentist do this without any prior notification of what was happening.(cost went from $3500 to $7500 ) > I have gone to a dentist and recieved a written estimate as to what my out of > pocket expence would be.I had a full upper bridge placed,teeth pulled ctc.the > day my teeth were pulled a temporary bridge place.My bill had jumped to two > times the cost of the original estimate.Can a dentist do this without any > prior notification of what was happening.(cost went from $3500 to $7500 ) This is a legal, not a dental matter, and probably hinges on contract law in your state. Of course, an estimate is an estimate, and not a contract. At the very least, this is IMO poor business practice, and I think you have every right to be steamed. I would have a serious talk with the dentist--you deserve an explanation. The point of an estimate is to give the patient an idea of what is going on. Seems that a surprise like this defeats the intent. Steve  SignatureMark & Steven Bornfeld DDS http://www.dentaltwins.com Brooklyn, NY 718-258-5001 My only addition would be: Are you sure that this fee represents added cost (especially out of your pocket!), or is it merely the fees billed to the insurance company before they pay? It is routine for my patients to get a bill listing the total fees often before the insurance company has paid a dime. If they do not understand, we will often get a phone call asking what's up. Once they have everything explained (again), thinks calm down a lot. D >> I have gone to a dentist and recieved a written estimate as to what my >> out of [quoted text clipped - 15 lines] > > Steve That would make sense if the patient remembered the out-of-pocket co-pay, has 50% coverage, and the total fee is $7.5K. However, I don't have any patients with $3.5K annual maximums. So......... I remain confused. {No wise cracks, Newbie ! :-) } Signature/ Amatus / > > My only addition would be: [quoted text clipped - 32 lines] >> >> Steve You can tell that I don't work much in the front office! 'Course I don't have that many cases way over the max pay anyway. Though it is becoming more and more common with inflation of everything except the dental insurance payout. Lowballing a bid to get the business and then hitting them with a larger bill at the end shows a lack of ethics. D > That would make sense if the patient remembered the out-of-pocket co-pay, > has 50% coverage, and the total fee is $7.5K. However, I don't have any > patients with $3.5K annual maximums. So......... I remain confused. {No > wise cracks, Newbie ! :-) } > You can tell that I don't work much in the front office! > [quoted text clipped - 11 lines] > > patients with $3.5K annual maximums. So......... I remain confused. {No > > wise cracks, Newbie ! :-) } It is possible that during all of this there were unforeseen things that came up which were not included in the original estimate such as nee for root cANAls posts, etc... Or there may have been certain upgrades that were offered to you and you did not understand this was going to cost extra. >> You can tell that I don't work much in the front office! >> [quoted text clipped - 7 lines] >upgrades that were offered to you and you did not understand this was >going to cost extra. Ther were no unforseen problems that he mentioned.As he pulled teeth he decided that the original way would not work.This is how he explains things today.Also at this time my gums are still receding. (originally only 6 teeth were to be pulled,he took out 12)this is where the extra cost comes in.Yet he never informed me,or my wife who was waiting for me. So,,,,,,,,,,,, what is the actual treatment plan--specifically.?>?>?>? Signature/ Amatus / >>> You can tell that I don't work much in the front office! >>> [quoted text clipped - 17 lines] > for > me. >So,,,,,,,,,,,, what is the actual treatment plan--specifically.?>?>?>? > [quoted text clipped - 3 lines] >> for >> me. The Dentist on the 2nd visit took x-rays of my entire upper teeth.I don't remember at this time if he did the same for the bottom.We then took his recomendations to the office manager,and she gave me what myout of pocket payment would be according to the doctors recemendations.After insurance my payment would be $3500.00.This would be for removing 5 or 6 teeth(don't have papers in front of me) and the placement of a bridge using the remaining teeth as pillers.The day HE removed teeth,as the story goes today.What HE wanted to do would not work the way he had informed me from the start.So without informing me HE removed 6 more teeth.(by the way my wife was waiting to drive me home because I wsa given medication to relax).Upon coming out to see the office manager,this is when I was given a bill for (out of pocket) $7500.00.This is almost 100% more then estimate. Sometimes we get surprised in the middle of treatment, but I would think a treatment plan of this size would be carefully reviewed prior to beginning treatment. Are you describing a bridge that is cemented in place, or one which is removed for cleaning every day? Somewhere,,,,,, communication has broken down in your case. Signature/ Amatus / >>So,,,,,,,,,,,, what is the actual treatment plan--specifically.?>?>?>? >> [quoted text clipped - 19 lines] > see the office manager,this is when I was given a bill for (out of pocket) > $7500.00.This is almost 100% more then estimate. >Sometimes we get surprised in the middle of treatment, but I would think a >treatment plan of this size would be carefully reviewed prior to beginning [quoted text clipped - 8 lines] >> see the office manager,this is when I was given a bill for (out of pocket) >> $7500.00.This is almost 100% more then estimate. The bridge is permanent on the upper.There was NO discussion whatsoever on the extra work done.I came out and was handed a bill for $4000.00 more then what was talked about.I am now being sued by this dentist for the balance. I think i messed up typing/////the bridge is permanent,There was no discussion whatsoever concerning the extra work.The dentist did that on his own.It was when I came out to the front office I was handed a bill for $4000. 00 more then what we had talked about.I am now being sued by collections and the dentist for the balance... >>Sometimes we get surprised in the middle of treatment, but I would think a >>treatment plan of this size would be carefully reviewed prior to beginning [quoted text clipped - 4 lines] >the extra work done.I came out and was handed a bill for $4000.00 more then >what was talked about.I am now being sued by this dentist for the balance. "Sued" ?>?>?>???? I thought the work was just started? There is definately a breakdown in communication. This is the biggest problem in any relationship between humans. Why and how the difference comes up, I cannot comment on since I don't know. My normal fee for such a procedure would be roughly one thousand dollars for every tooth being crowned or replaced with the bridge. So, the fee you have sounds cheap to me. Signature/ Amatus / >>Sometimes we get surprised in the middle of treatment, but I would think a >>treatment plan of this size would be carefully reviewed prior to beginning [quoted text clipped - 13 lines] > then > what was talked about.I am now being sued by this dentist for the balance. no the prcedure was done in August.I had no problem with the fee,it's when I am expecting $3500.00 and get a bill for $7500.00 without any (as you say) communication.Again this is out of my pocket,after the insurance paid there part.My entire question was based on can a dentist do what he did without talking to me first.. >"Sued" ?>?>?>???? I thought the work was just started? > [quoted text clipped - 11 lines] >> then >> what was talked about.I am now being sued by this dentist for the balance. If there was only a verbal contract,,,,, yes he can. If you have a written contract signed by you and him, then, no he cannot. (Assuming I understand contract law properly). Signature/ Amatus / > no the prcedure was done in August.I had no problem with the fee,it's when > I [quoted text clipped - 24 lines] >>> what was talked about.I am now being sued by this dentist for the >>> balance. While I am not an attorney, I think oral contracts can be binding in some cases (just might be hard to prove). Of course, if the 'contract' was for 6 units of crown and bridge, and the patient ended up with 12 units of crown and bridge, that was not in the original oral agreement and the original oral agreement might be void at that moment. We have all had to alter treatment plans in the middle of a case. However, I always try to prepare the patient for such an eventuality. *Most* borderline situations are evident before treatment is begun. I then tell patients the estimates if everything goes perfectly, and I tell them how much more it will cost if x,y, or z happens. Any treatment more than a few fillings, should have a clear, written estimate that the patient can understand. Surprises like this should not occur. Steve > If there was only a verbal contract,,,,, yes he can. If you have a written > contract signed by you and him, then, no he cannot. (Assuming I understand > contract law properly). All I have is the original estimate the office manager filled out showing what the dentist was going to do.This was right after the x-rays and the oral exam.The office manager was going by what the dentist had given to her.This is when I was given te first and only out of pocket payment.There was NO discussion relating to ant other work. >While I am not an attorney, I think oral contracts can be binding in >some cases (just might be hard to prove). [quoted text clipped - 19 lines] >> contract signed by you and him, then, no he cannot. (Assuming I understand >> contract law properly). > >> You can tell that I don't work much in the front office! > [quoted text clipped - 17 lines] > -- > Message posted viahttp://www.medkb.com There you go he told you his original plan which included the estimate did not work for whatever reason. so if something else was done it is possible for the bill to change. It's hard to pass up such a golden opportunity ! >That would make sense if the patient remembered the out-of-pocket co-pay, >has 50% coverage, and the total fee is $7.5K. However, I don't have any >patients with $3.5K annual maximums. So......... I remain confused. {No >wise cracks, Newbie ! :-) } The dentists replying to this thread seem to be ignoring the obvious. To extract teeth without the patient's permission, without prior informed consent, without informing that patient at all, as this patient suggests, is considered a big no-no in dentistry. Technically, a case can be made for the dentist committing assault and battery. On top of this, the dentist, is according to the patient is slamming the patient with an extra $4,000 charge. Maybe the patient liked those teeth the dentist ripped out. Maybe the patient had other financial priorities in mind besides coughing up an extra $4,000 for teeth. Maybe he wanted to buy a big flat screen TV instead. What right does the dentist have to rip out the guy's body parts without express informed consent (written) along with a (written) plan of how much $$$ the guy would need to fork over? Nope, the OP is only complaining about the cost. There has been no clear statement about whether or not there was any sort of informed consent on extra extractions. You are not being fair or considerate in your assumption. > The dentists replying to this thread seem to be ignoring the obvious. > To extract teeth without the patient's permission, without prior [quoted text clipped - 9 lines] > express informed consent (written) along with a (written) plan of how > much $$$ the guy would need to fork over? Yes I am talking about cost.The dentist as I have stated before had NO written or oral consecnt to pull the extra teeth.The only written agreement for the 5 teeth to be pulled.And for the amout of $3500.00.Again the dentist pulled the extra teeth ON HIS OWN ACCORD.And then billed me for the extra work >Nope, the OP is only complaining about the cost. > [quoted text clipped - 7 lines] >> express informed consent (written) along with a (written) plan of how >> much $$$ the guy would need to fork over? Please forgive us, but there is no way to comment on your specific case without more detail about what exactly was done, what the diagnosis was, what the anticipated outcome was, etc. Signature/ Amatus / > Yes I am talking about cost.The dentist as I have stated before had NO > written or oral consecnt to pull the extra teeth.The only written [quoted text clipped - 15 lines] >>> express informed consent (written) along with a (written) plan of how >>> much $$$ the guy would need to fork over? > Yes I am talking about cost.The dentist as I have stated before had NO > written or oral consecnt to pull the extra teeth.The only written agreement [quoted text clipped - 16 lines] > -- > Message posted viahttp://www.medkb.com This is not the place to ask legal questions........We are not in your state and obviously we are not licensed to practice in your state. So get some help from local dentists. You are the first person to admit that something is not right here. >The dentists replying to this thread seem to be ignoring the obvious. >To extract teeth without the patient's permission, without prior [quoted text clipped - 9 lines] >express informed consent (written) along with a (written) plan of how >much $$$ the guy would need to fork over? > I have gone to a dentist and recieved a written estimate as to what my out of > pocket expence would be.I had a full upper bridge placed,teeth pulled ctc.the > day my teeth were pulled a temporary bridge place.My bill had jumped to two > times the cost of the original estimate.Can a dentist do this without any > prior notification of what was happening.(cost went from $3500 to $7500 ) Best way to deal such problems in future is Dental Insurance.Several types of Dental Insurance is available,Visit my site to get all information,so that in future you can avoid such incidents. http://www.ssmedicare.ws/page4.html Hey Sun999, is this spam. You know full well that dental "insurance" is not really insurance, but a benefit provided by an employer with limitations and maximums on care. To buy an individual policy from a reputable "insurer" costs almost as much as the yearly benefit derived therefrom. I didn't look at your posted URL, but I'll bet that you are selling some sort of cockamamie product that allows patients to see only certain dentists on your plan at the risk of trading quality for quantity as well as bait/switch tactics in the dental office. Yes, SPAM. > > I have gone to a dentist and recieved a written estimate as to what my out of > > pocket expence would be.I had a full upper bridge placed,teeth pulled ctc.the [quoted text clipped - 5 lines] > types of Dental Insurance is available,Visit my site to get all > information,so that in future you can avoid such incidents.http://www.ssmedicare.ws/page4.html sun999 you do not know what you are talking about. Dental insurance will add a middle man to the treatment plan nothing else. Best dental insurance is putting some money away every month into an investment account for a rainy day such as this. |
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