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Respected Contributor
Posts: 3,281
Registered: ‎03-15-2010

So there is a local periodontist that I have used in the past and really like.  One practitioner in the office and most state of the art imaging equipment than I have seen at any other office.

 

He is a young doctor very nice and top-rated.

 

I was referred to him again by a dentist and an endodontist and when I went to schedule the appointment I was promptly informed that they no longer participate in any insurance.  They are self-pay but will provide a receipt so that I can deal with my insurance company for reimbursement.

 

Apparently he built up enough of a practice that he can no opt-out of the insurance game.

 

His next opening is the first week in MAY!!!!  aughh

 

Although we have dozens of periodontists in our area but this one is hands down recommended by friends, family, dentists and dental surgeons.  My DH and I have used him before and he is very good.  

 

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Esteemed Contributor
Posts: 7,610
Registered: ‎03-27-2010

Re: Periodontist ugh!

[ Edited ]

It doesn't seem to matter if you have insurance or not...everything is out of pocket.  I have what is considered good medical/dental insurance through work.  Last year we spent over 10K on my husband's mouth....desperately needed.  And our excellent dentist provided documentation...nope, not a penny.  Our through deep cleanings are not even covered.  It is a farce. The restrictions on the dental insurance and what they will cover make dental insurance meaningless.  Tried a cheaper insurance through my work one year and was sent to mill with incompetent doctors.  So there is no winning.  We now just expect to pay.

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Respected Contributor
Posts: 4,639
Registered: ‎03-19-2010

If you have to buy dental insurance out on the open market, it's a huge joke.  They claim to cover all sorts of things, but when it comes down to it, they decide what you need, not the dentist, and they will only pay for what they have decided you need which is almost always the cheapest option.  

 

I have had to pay lots of money in the last few years for crown replacements.  I trust my dentist to know the best option for me instead of the cheapest crown material available.  

 

Luckily, when I had Periodontal work done I was still with my company's very good insurance plan which included dental (long before the ACA came along).  

 

My dentist will file my insurance for me, but he is not in-network with any dental plan.  

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Esteemed Contributor
Posts: 6,615
Registered: ‎03-09-2010

I don't care how well recommended he came, first week in May?  I'd be looking for other recommendations.

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Super Contributor
Posts: 484
Registered: ‎03-11-2010

Dental coverage is strange. I've had it all through my employment and into retirement as well.  If I want a crown, I have to pay it upfront with my dentist because they're are not in-network. OK, that's fine, but I'm liable for 80% so the dental office does submit to insurance and I get the 80% back.  If I want a filling, the insurance doesn't cover the newer materials they use for fillings; so again, out of pocket then reimbursement.  

 

We stay with the dentist because they have state of the art equipment and have been with them for over 25 years.  

 

 

Helen852
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Trusted Contributor
Posts: 1,297
Registered: ‎10-14-2016

Whoa.....what a way for him to keep his costs down.....he doesn't have to employ anyone to work with the insurance groups.  Puts all the work on the patient who isn't normally well versed in that area.  I hope other doctors don't start to do this.  What a nightmare.

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Respected Contributor
Posts: 3,281
Registered: ‎03-15-2010

@travone wrote:

Whoa.....what a way for him to keep his costs down.....he doesn't have to employ anyone to work with the insurance groups.  Puts all the work on the patient who isn't normally well versed in that area.  I hope other doctors don't start to do this.  What a nightmare.


You will typically only see this in doctors that are in high demand because they are top of their field.

SOME actually charge less for a cash-based system because the practice is saving a LOT of money. 

I have not noticed any price advantage for self-pay in the dentistry world. 

 

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Super Contributor
Posts: 282
Registered: ‎06-02-2010

@mememe wrote:

@travone wrote:

Whoa.....what a way for him to keep his costs down.....he doesn't have to employ anyone to work with the insurance groups.  Puts all the work on the patient who isn't normally well versed in that area.  I hope other doctors don't start to do this.  What a nightmare.


You will typically only see this in doctors that are in high demand because they are top of their field.

SOME actually charge less for a cash-based system because the practice is saving a LOT of money. 

I have not noticed any price advantage for self-pay in the dentistry world. 

 


@mememe  - You are on to something.  It costs a lot of money for providers to bill insurance companies.  Some providers see it as a cost of business but more aren't.

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Posts: 3,281
Registered: ‎03-15-2010

@phoenixbrd wrote:

It doesn't seem to matter if you have insurance or not...everything is out of pocket.  I have what is considered good medical/dental insurance through work.  Last year we spent over 10K on my husband's mouth....desperately needed.  And our excellent dentist provided documentation...nope, not a penny.  Our through deep cleanings are not even covered.  It is a farce. The restrictions on the dental insurance and what they will cover make dental insurance meaningless.  Tried a cheaper insurance through my work one year and was sent to mill with incompetent doctors.  So there is no winning.  We now just expect to pay.


Dental insurance is a bit of a joke.  Even for things that are supposed to be covered they fight tooth and nail (no pun intended) to not pay.  Anything other than a cleaning a battle ensues.

For the last 3 years, we have spent an average of $8400 out of pocket a yr on dental expenses!!  Every year my DH says "what do people do who can not afford this?"  My answer everytime- 'you lose your teeth.'

Thank heavens we do not have any major problems like some people.  We both take very good care of our teeth.

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Valued Contributor
Posts: 922
Registered: ‎03-12-2010

We are both retired but still carry our Delta dental insurance through the company he retired from.  I just had to have one of my permanate bridges replaced as my old one broke.  The insurance covered 80%, my share of cost was just under $800.00.