My dental bill seems way excessive. Have I been billed correctly?

[impatient patient]

I have a temporary acrylic bridge on teeth 7, 8 and 9. The middle part (8) broke. I came to this out-of-network dentist lured by a promise of a free 20-minute consultation.

The dentist spent all the consultation time trying to upsell me into a massive "crown lengthening" for cosmetic reasons on at least 6 teeth. I repeatedly said I am not interested, and he said: "OK, it's your choice if you want to look like this". No other dentist had ever suggested anything like that, and I honestly can't see where he is coming from.

He did not answer any of my other questions on the grounds of not having the time.

He did very quickly cement the broken part of the bridge, gluing it to 7 and 9. I wish he added antiseptic or something, because I fear infection.

Here is the bill

So, he attempted to bill $122 for palliative treatment which was declined by insurance. What palliative treatment? I was in no pain and did not ask for an urgent treatment.

He also billed me for two "recement crown", $82 each. There were no crowns, just a bridge which he cemented to adjacent teeth with two dabs of cement.

The whole thing took him maybe 10 minutes.

Is this a fair bill? Please help me with this, 'cause I am harassed by his front desk several times a day.

 

[Zuri Barniv]

Why don't you contact the insurance company, tell them what happened and let them help you sort it out.

 

[impatient patient]

Tried it. They ignored it.They offered me to fill in a Quality of Service Complaint Form, and short of that, they say they are not qualified.

Is $286 a more or less appropriate amount for a quick temporary cementing job? Is it just me? Am I being unreasonable?

 

[Zuri Barniv]

Well, the short answer is, yes, $286 is probably pretty reasonable to get you in, evaluate your problem, offer treatment options then reattach a broken piece of the temporary. But that is NOT what the dentist charged. He charged you for recementing two crowns and your portion is $118.40, the dentist got another $45.60 from Delta Dental. Delta Dental is not allowing the "palliative treatment" charge (see item 1 in the notes), so neither you nor Delta pay for that part. The dentist has to write off $122.

It sounds like the chemistry with this dentist was not good so you need to find someone new. But to pay $118.40 for what you got is pretty fair in my book.
Dr. Barniv

 

[impatient patient]

Thank you for your response Dr. Barniv! Maybe I'll just pay the guy tomorrow and forget about it.

Still confused though: after a free 20 min consultation (which was useless to me, because his email is broken, so he could not receive my xrays), he spent 5 minutes cementing. I can maybe believe 5 minutes of his time is worth $164, but why did he also attempt to charge the insurance company $122 for palliative treatment? What palliative treatment could have been provided in these 5 minutes, given that I was not in pain? Does not it come across to you as an attempt to overcharge the insurance company? Yes, I know, it was declined, so no big deal, but just how trustworthy is the doc? Or is this common?

I mean, if he spent 20 minutes..

For comparison, in my city, $160 buys me a comprehensive perio evaluation with a periodontist (as per Delta). Why would 5 minutes with a non-specialist cost more than a comprehensive eval by a specialist?

 

[Zuri Barniv]

Why would 5 minutes with a non-specialist cost more than a comprehensive eval by a specialist?

Because actual treatment costs more than a consultation/exam. Think about it: if the fix he did fell off the next day, you would be right back in his office and he would most likely redo it for free on his own time using materials that do cost money. So part of what you are paying for is a little warranty that is not there when only an exam occurs. Yes, he billed it incorrectly, he was just trying to recover whatever money from the insurance he could for the time he spent. It is a game and it happens a lot. Most likely, a billing person made that decision and that person was probably not very experienced as Delta never pays for more than x-rays when palliative treatment is billed. So I would not focus so much on the actual line items and more on what is fair compensation for the service you received. Hope that helps.
Dr. Barniv

 

[impatient patient]

It does help. Thank you. I'll pay him tomorrow.

I was also annoyed with the way his office wanted to have my credit card on file, so that they can automatically bill me for the balance after insurance, without sending me the bill first. I refused, because that's a little unusual, is not it? Then the front desk called me the same day the insurance payment came back, and kept calling me once or twice a day every day since. No grace period at all. Threatening to pass it to collections "next Tuesday".

That aggressive accounting, coupled with aggressive upselling, is what had raised the red flags with me. Is this unusual?

 

[Zuri Barniv]

That is not typical. Just pay him and move on...I wonder if you could have read some Yelp reviews before going and seen this coming?

 

[impatient patient]

Yelp reviews were just fine. 5 reviews, average 4 stars, the one-star review complaining about long wait. Some of the 5-stars seem kind of cheesy, I don't know.. two additional reviews collapsed. Not much information..

I'll do just like you said.

 

[impatient patient]

Correction, FOUR reviews out of 9 collapsed by Yelp. That's unusual is not it?

 

[Zuri Barniv]

What is a "collapsed" review?

 

[impatient patient]

"4 other reviews that are not currently recommended"