my tooth may hurt but my brain still works

[bye-bye Ms. FancyPants]

A little background – I have to have a basic dental surgery (boo!), but I happen to know my husband has kick-ass insurance that pays 100% of this procedure (YAY!)

I head off to the consult my regular dentist set up for me on the “good” side of town. I pull up to this beautiful, new fancy building. Walk in, ogle all the pretty scenery, do the new patient paperwork, wait for my name. So far, so good.
 
Let’s fast forward to the good part, the “financial” part – we sit in this glass room while reviewing my procedure on a big, flat screen TV.
 
Cute young girl: “Because Dr. So&So is a specialist we require all fees paid up front and then bill your insurance.”

Me: “Okay, no problem”

CYG: “The total is a $1095.00, are you sure that’s okay? We have something called care credit card if you need it?”

Me: “No. It is fine.” Credit card points dancing through my head :) “I’m pretty sure my insurance will reimbursement at 100%.

CYG: “Well it looks like you have used $395 of your $1500 for the year maximum. So you will probably have some out of pocket expense but only a few hundred dollars.”

Me: Blank stare ….. “But, why would I have any out of pocket?”

CYG: “Most people only have insurance that covers 70-80% of the charges.  So, you have really good insurance… Umm, I’m just going to be very honest with you, because of our service, you know, the fact that you don’t have to wait to be seen, that we take you right in, well, ahem, I mean, I know you had to wait a little bit today, but we just had a busy morning and I apologize for that.  Blah, blah, blah … Not all of our charges are covered by insurance.”

Me: More confused staring …. “I need you to do a pre-authorization in order to get a little more transparency in what I will be paying out of pocket before we proceed.”

Are you kidding me?? So basically they charge potentially hundreds of dollars more than the insurance allows to pay for their fancy building, fancy computer, and fancy ass glass room.  Oh, and sometimes not having to wait to be called back.  WTH! Obviously she had no idea she was talking to a Mustachian!

That, and how many unsuspecting people go in there and get hypnotized by the glitter? None the wiser they are getting charged hundreds of dollars more?? I wouldn't have realized it if I hadn't know what sort of insurance I have.  Needless to say, I’m pretty flabbergasted.   

**disclaimer – I wouldn't think twice about paying extra if I thought it was about the “skill” of the doctor. I am confident I could find several other doctors who are just as skilled and qualified **

[Goldielocks]

Yeah, same thing happens in some provinces, here too.  The dental college issues price lists, but dentists do not have to stick to them, but you can bet your behind that insurance does.

Often people have two coverages from both spouses, so never notice that the 80% coverage is only 65%.  Eg the second insurance covers the gap.

I asked our insurance about this, and they said to look for a dentist at the covered rates, but as the last list was published 5 years previously, almost no dentists existed in Calgary that used the published list.

Compared to california, where at least half the dentists used the approved pricing.

You definitely need to watch out.

[Primm]

I found out my local dentist charges a different rate for insured customers than non-insured (insured are higher, he thinks they can afford it!) when a friend of mine who didn't have insurance went to see him.

I told him I let my insurance lapse so I'm now uninsured, and now I pay up front and claim afterwards and save the difference. My fund pays a percentage of the fee, so I get less back but the difference is also less. It's an arsehole act from him, but it no longer affects me.

[Sunnymo]

Pretty low act by the dentist Primm. I hope you game the system a bit by paying by credit card, collecting the  points and paying in full like any good mustachian.

[Primm]

Of course. It must work for him, he rents the shop next door to park his Lamborghini in while he's at work. He's really good though, so I keep going back.

[Travis]

I found out my local dentist charges a different rate for insured customers than non-insured (insured are higher, he thinks they can afford it!) when a friend of mine who didn't have insurance went to see him.

That's the US healthcare/insurance system in a nutshell.

[Primm]

I found out my local dentist charges a different rate for insured customers than non-insured (insured are higher, he thinks they can afford it!) when a friend of mine who didn't have insurance went to see him.

That's the US healthcare/insurance system in a nutshell.

Except I don't live in the US. ;)

[The Borgs]

Of course. It must work for him, he rents the shop next door to park his Lamborghini in while he's at work. He's really good though, so I keep going back.

I think I prefer my dentist. He's my and my husbands regular dentist, we go for check ups and so forth. I've also recommended him to friends, given that his prices are comparable to those around, but he's a really nice guy who's averse to doing anything unnecessary. A few times, either my husband or I have had to make an emergency appointment to have something odd checked (pain here or lump there) and he hasn't charged us. Not a cent. If whilst doing a treatment plan, something unexpected pops up that is more work or dearer, again, no charge.

He's not going to be getting a lamborghini any time soon, but he is on my Christmas card list!