I recently had to visit a dentist on an emergency basis, as I had lost some of a
filling on a back molar, and the gum had gotten sore and a little inflamed (this
was another dentist in the office of my old dentist, who had retired since I had
last seen him). The current dentist accepts the same insurance, which in my case
is like a PPO, not an HMO. The dentist gets paid for each service performed -
it's not like those HMO dentist plans popular today.   I can go to any dentist
in the book, they file an insurance form, etc, just like at a doctor's office,
and get paid whatever the contracted amount is for each procedure. Some
procedures have copays, others don't.

So, when I get there, I'm told the charge is $45.00 to see him. I point out to
the girl that the schedule shows a code of 9110 with a small co-pay on my end.
She checks with the dentist, and the tells her that's only if he just sees me to
give me pain meds (the schedule says "emergency care (palliative treatment)" ).
I acquiesced, since I needed to see him.

He x-rays it, says I have an infection, and sends me home with meds (pain and
antibiotic) and schedules me to come back in 3 days to fix the broken filling.
As I'm leaving, he hands me an insurance form to sign, and as I am paying the
girl, I see he fills it out himself, and puts in the codes for the x--ray, the
regular exam, and the ER visit (9110).

So, if he's going to now bill for the 9110 code, why isn't he allowing me to pay
my copay for that code (it's less than a third of that $45.00)? The insurance
company told me he must stay ON SCHEDULE if he's gonna accept my insurance, and
they offered to call him and tell him, but I declined, figuring I'd piss him off
that way.

Is there some other reason I'm not seeing why he thinks he can get paid twice
for the same code? I should note that I could have waited until later that day
to see him on a regular appointment, but I only had the earlier time available,
thus the ER (squeeze me in) visit. Is going off schedule for this type of visit
common, or otherwise acceptable?