My issue is more of a cost related one. My benefit plan doesn't cover Fluoride application on adults. This used to be like $20, one of my family members last rejected claim was a fluoride charge of $42. At this point i'm thinking we should just buy our own and apply it after we leave (when needed). I'm trying to find stuff the dentist would use, anyone ever do the same? Was looking at something like this - looking for fluoride experts to chime in
Why not just pay the $42 for the fluoride at your dentist / hygienist separately so your claim doesn't get rejected?
You probably don't want to be applying it yourself lest you use it too much. It's particularly a concern if you have kids, since forming teeth are susceptible to dental fluorosis.
My issue is more of a cost related one. My benefit plan doesn't cover Fluoride application on adults. This used to be like $20, one of my family members last rejected claim was a fluoride charge of $42. At this point i'm thinking we should just buy our own and apply it after we leave (when needed). I'm trying to find stuff the dentist would use, anyone ever do the same? Was looking at something like this - looking for fluoride experts to chime in
Why not just pay the $42 for the fluoride at your dentist / hygienist separately so your claim doesn't get rejected?
You probably don't want to be applying it yourself lest you use it too much. It's particularly a concern if you have kids, since forming teeth are susceptible to dental fluorosis.
It's only the $42 portion that gets rejected. It seems like a pretty expensive cost, especially when its foam stuff they just put in two trays and leave you there for 2 minutes. My assumption is the whole bottle of foam probably costs about the same and would be good for lots of applications (maybe pointless if the stuff expires though)
With that said, i think our dentist is likely on the high end of charging. Like i said, it use to be a bit of an eye raiser at $20, but $42, seems pretty high. Just to put it in perspective, my family is paying about $500/yr for fluoride (12 applications) - the insurance pays the kids portion so obviously not my actual cost; but if we were paying for everyone out of pocket a pretty substantial number, when perhaps one $40 bottle might cover those same applications.
It's only the $42 portion that gets rejected. It seems like a pretty expensive cost, especially when its foam stuff they just put in two trays and leave you there for 2 minutes. My assumption is the whole bottle of foam probably costs about the same and would be good for lots of applications (maybe pointless if the stuff expires though)
With that said, i think our dentist is likely on the high end of charging. Like i said, it use to be a bit of an eye raiser at $20, but $42, seems pretty high. Just to put it in perspective, my family is paying about $500/yr for fluoride (12 applications) - the insurance pays the kids portion so obviously not my actual cost; but if we were paying for everyone out of pocket a pretty substantial number, when perhaps one $40 bottle might cover those same applications.
Have you tried negotiating with the dentist? Some dentists have an individual out of pocket rate and a rate when charging to benefits. If the dentist doesn't budge, nothing changes, DIY fluoride. But if the dentist is willing to drop the price to something reasonable to you, then it's worth considering.
I mean, I'm not going to go into ethics or anything, but I'm going to assume that some dentists would say, "I'll chuck it in for free!" then bump something else up by the same amount and benefits rubber stamps the claim. They're not supposed to do things that way, but I know that there's plenty of dentists that push the envelope in terms of what they can charge to benefits for work done without getting the individual in trouble.
Have you tried negotiating with the dentist? Some dentists have an individual out of pocket rate and a rate when charging to benefits. If the dentist doesn't budge, nothing changes, DIY fluoride. But if the dentist is willing to drop the price to something reasonable to you, then it's worth considering.
I mean, I'm not going to go into ethics or anything, but I'm going to assume that some dentists would say, "I'll chuck it in for free!" then bump something else up by the same amount and benefits rubber stamps the claim. They're not supposed to do things that way, but I know that there's plenty of dentists that push the envelope in terms of what they can charge to benefits for work done without getting the individual in trouble.
you're not going to go into ethics, but instead just do a quick smear of the profession. nice.
An environment in which a person encounters only beliefs or opinions that coincide with their own, so that their existing views are reinforced and alternative ideas are not considered.
you're not going to go into ethics, but instead just do a quick smear of the profession. nice.
That comment was more along the lines of how the benefits paperwork might be filled out. I wasn't trying to smear the profession. It was more a comment about the individual who is filling in the information and whether someone might be comfortable with it.
All professions should be scrutinized. Dentists seem to get away with a lot at times considering it's a business.
He didn't say it judgingly.
perhaps, you're right.
but to me it did come across as a cheap shot towards dentists to say plenty of them intentionally game the system to pad their billing.
especially by prefacing it by saying I don't want to talk about ethics, but...
like any other profession, there are bad apples, but it's not standard practice for dentists to pad billing to scam more money from benefit coverages.
perhaps, you're right.
but to me it did come across as a cheap shot towards dentists to say plenty of them intentionally game the system to pad their billing.
especially by prefacing it by saying I don't want to talk about ethics, but...
like any other profession, there are bad apples, but it's not standard practice for dentists to pad billing to scam more money from benefit coverages.
That wasn't my intention, but I can see how it could have been interpreted that way.
My apologies. I wasn't making a swipe at the dental profession, and I could have worded things better.
perhaps, you're right.
but to me it did come across as a cheap shot towards dentists to say plenty of them intentionally game the system to pad their billing.
especially by prefacing it by saying I don't want to talk about ethics, but...
like any other profession, there are bad apples, but it's not standard practice for dentists to pad billing to scam more money from benefit coverages.
I've briefly complained generally about poor practice from healthcare practitioners in Canada and I would wager to bet that dentists are among the worst.
I don't believe many are malicious (and I could never prove it even if I did) but many dentists' practice involve things such as over treatment and over assessment (ie xrays) that go directly against scientific evidence.
This is all off topic, however, because I feel like a dentist helping me get something covered is being a patient advocate.
An environment in which a person encounters only beliefs or opinions that coincide with their own, so that their existing views are reinforced and alternative ideas are not considered.
Let's talk about Fluoride (again)
