I need a little help and/or advice. I'm 72 & am having major dental problems. I went to my dentist

[Booster]

and they drilled out cavities on 4 teeth and put on temporaries while they ordered crowns & said they would call for a follow-up visit to install the crowns. They sent a claim to my dental ins carrier for over $7,000, and when I confronted them with this claim, they said that was normal procedure to see what the ins carrier would pay. I got angry & said to the girl "and that makes sense to you?" and she said it made perfect sense to her. I said "so you're telling me I should get a lawyer" and she said I could easily find one on the internet. Also, after being in the chair almost upside down for 3 hours, they talked me into applying for a Smile Generation loan, which is like a credit card for dental work with no interest to pay & you just make monthly payments. I agreed to apply & was accepted. I admit I was tired, confused and angry & did not totally understand everything that was going on. Then I got a statement from Smile Generation saying I owed over $5000 & needed to pay the monthly charge now. My question is what do I do now? Should I get a lawyer and/or contact my state Dental Board. If I need a lawyer, what kind of lawyer am I looking for. Oh, and it's been over a week & they have not contacted me re: a follow-up visit. I get the feeling they would like for me to go away. Any help/advice would be greatly appreciated.

[NV Whino]

1. Most of those "no interest" loans have a limited time for no interest

Read the stuff carefully. Have no idea about the attorney.

And it sucks that dental insurance pays so little. I feel your pain and frustration.

[Booster]

6. I admit I was stupid & in no shape to read that stuff correctly.

I wish Obamacare had included something about dental insurance and hope maybe that will be next. thank you for your empathy. I was considering going to Mexico where dental expenses are 70% less than the U.S., but then I read where they kind of do the same thing, like telling you that you need more work than you actually do which is the same thing they do here so decided against it. It seems the dental industry has you by the gonads and there's nothing you can do about it.

[NV Whino]

9. Yeah, I got caught the last time I had a crown because I didn't read first

I had used CARE credit previously, and it allowed a year interest free to pay it off. This time it was only six months. And then they added interest on the full amount if you paid off most of it but left a couple of payments over the six months. And somehow, even though I paid it off a month early, they managed to throw in a $25 late charge.

I'm sick and tired of these damned insurance companies ripping you off.

[IADEMO2004]

2. 3yrs ago my crown cost $1200.00 in SW iowa and dental ins. pd half.

Dentist told me the cost before starting. Sounds like questions should be asked. Good Luck.

I have three seniors in nursing homes and I get many offers for dental care for them at $160-180/ month. How is that for a good deal? Nursing home costs have devoured their savings and real estate and when Medicaid starts dental eye and hearing are covered.

[DURHAM D]

3. What is your question?

You had dental work done and you are scheduled for more. Crowns are expensive.

Many dentists make you file your own claims as they won't file for you. It is also up to you to determine what your insurance will pay for, not the dentist.

If you think your temps will last for the rest of your life don't return for the crowns. That should save you a lot of money.

Good luck.

[Nay]

4. It's been a while since I had a crown put in, but $7000 for 4 crowns sounds about

what I was charged, adding in inflation. It may be slightly high, but.....

First, I would call your insurance company to see what an adjustor thought of those charges. You will get an idea if it was high, low, or in between. From what you said, it sounds like the ins company paid $2000 of your $7000 bill?

They have to give you a followup appointment because you need those crowns! Generally, they will call you when the crowns are delivered to the office, and that can take up to 2 weeks. It won't hurt to call to find out if the crowns have arrived yet.

As far as the payments, look on your Smile Generation paperwork; it should tell you exactly what your payment schedule is.


What exactly makes you think that you need a lawyer? Do you think the charges are way too high?

[Booster]

5. The reason I thought I might need a lawyer is because they

sent a claim for over $7000 to my insurance before the work has been done. That seems like a false claim to me. In what other case would you send a claim to an insurance company for work that hasn't been done?

[Nay]

11. I don't think they are being unreasonable, really. Unless they don't finish the job! They know

what it will cost (unless you have complications), They've prepared your teeth with temp crowns, they have ordered the permanent crowns, and when they come in (which should be soon), they'll be put in. I truly can't see the need for a lawyer unless they don't fulfill their contract to put the crowns in.

[Booster]

12. You may be right. My dentist did call & ask me if I had been able to get an appt with

a local dental Univ & when I told her not yet, she said she would call the Univ & see if she could get them to take me in. That would be for work that needs to be done after she puts the crowns in. That impressed me - that is if she actually calls them. Thanks for your input. I'm beginning to calm down just a little now. lol

[Paper Roses]

7. For reference, read my post in thread indicated below.

What a rip-off, I feel for you. It may not be a help now but check this out for the future.

The info. is relevant for anyone who does not have a dental plan or insurance of some type.

http://www.democraticunderground.com/11831153

[Booster]

13. Now, that might help. Thanks for the info. I will look into it.

[Big Blue Marble]

8. It is always best to ask for a treatment plan with fees prior to your treatment.

A well-managed dental office will offer this info without prompting. Your dentist has a problem with patient communication. They should have fully informed you of the treatment and what would be covered
by your insurance. Only accept treatment in the future with this information in hand.

Whether you were overcharged would depend on the normal charges in your area and
what services you actually received. You may have had root canals or crown buildups with
post and cores or pins for better retention. I have worked in dentistry for over 25 years
and I have never seen a plan that covered more than $2000 in service each year. All dental
plans are capped. Most are more likely to cover $1000-$1500. Again the office should have
informed you of this cap. You, too, should understand your coverage and its limitations
before you seek treatment.

Finally, many offices will file insurance after the preps, especially if they are filing a
pre-authroization. I see little benefit from employing a lawyer. Definitely, have your
permanent crowns placed as soon as they are available.

[Warpy]

10. That's actually reasonable for 4 crowns

Since the crowns have to be made to fit your mouth, it's a fairly expensive procedure. I know a lot of dentists who want at least part of the money up front.

That's about all I can tell you. Dental insurance in this country is a bad joke. I'm sorry you're finding that out the hard way.

My best advice is that if this is a good dentist and he didn't send you into orbit as he drilled the teeth out, to pay this off ASAP and enjoy your new crowns.

There is nothing worse than a mouthful of teeth that hurt.