I just went to a new dentist for a new patient exam and they want to charge me $1000 for a cleaning and cavity filling, am I being scammed?

Robin

Restless Insomniac
Member
Oct 25, 2017
2,984
I'll try to be as comprehensive as possible, my head is spinning a little bit and I feel like a big dumb idiot because I know I'm vulnerable to being taken advantage of because I'm so anxious and a pushover.

Anyway, A few days ago I had a filling fall out of my mouth, which has never happened before. My last dentist's visit was back before I found employment and when I was on state medicaid about a year and a half ago. Now I have had my own dental insurance so I booked an appointment with a closer dentist.

Anyway, they took X-Rays and there was a consultation with the dentist and hygienist. The dentist immediately told me that I had a baby tooth that shouldn't be there, which I told him yeah that I've known about that and my older dentist's all said that it was OK. New Dentist says it has to come out, and the tooth that has the fallen out filling also needs to be extracted and replaced with an implant. They also told me I had a small cavity that needed a filling too. Then the hygienist came in and basically told me I had early stage warnings for gingivitis and that I need to floss more, scheduled a cleaning, sent me to the office manager. Office Manager gives me a huge itemized list and showed me a couple papers totaling things for like, 1500-2000 dollars. I think it might have said more actually, like 3000-4000 but that might have been before insurance, I was a little confused and didn't feel like they were explaining things to their best ability. There were also charges in there like 130 dollars for an electric toothbrush which they "removed for me as a courtesy as you already said you have a toothbrush". I basically said that I couldn't pay that out of pocket right now but that in the long term if I need to do it, I need to do it but I'd need to wait for my tax return and my Christmas bonus to come in, I asked if I could schedule it out a few months in advance because I could pay it down the road, I just need time. They said they can't schedule anything without an immediate upfront payment.

They were pretty quick to put it on the back-burner and wanted to schedule me in for a cavity filling and tooth cleaning, which I assumed would end up happening with the fixing the broken filling, but I was surprised at how they were encouraging me to put it off and worry about the implant and extraction later. Then they gave me the bill for the cavity filling and tooth cleaning, which came out to 977 dollars. It makes sense to me that a full tooth implant is going to cost a lot of money even with insurance, but I've never heard of a filling and cleaning costing upwards to a thousand dollars.

Anyway, I felt really uncomfortable and ended up agreeing to pay 60% of the bill up front and they charged me for 600 dollars, they want the other 400 dollars when I come in next week for the cleaning. I asked for the itemized billing and it looks like the overwhelming majority of the charge is multiple charges for "Arestin", which I looked up and appears to be an antibiotic. The fine print says I can request a refund at any time for services that haven't yet been rendered, so I think I can still call and get my money back. Do you all think I need to go in for a second opinion?
 

Fury451

Member
Oct 27, 2017
6,911
That seems absurdly high to me. I had lots of fillings after I got my braces off when I was younger, and all told I think I only spent maybe $1200 on all of them. And by lots, I mean maybe around 10, with X-rays.

There’s no way that a filling and a cleaning should cost nearly $1000

Did they tell you they were administering that antibiotic? It seems really strange that they may have given you that without informing you, or that they gave Multiple doses. It may be true that you had an infection but was it necessary to repeatedly charge for each administration of it?
 

Creatchee

Member
Oct 26, 2017
1,228
Sarasota, Florida
What codes were you billed? I'm a dental practice manager and I'll let you know what we charge so you can compare and let you know if their fees were beyond reasonable.
 

BDS

Banned
Oct 25, 2017
13,845
Get a second opinion. I would ask for your money back, they should not be charging you up front like that.
 
Nov 23, 2017
4,302
What codes were you billed? I'm a dental practice manager and I'll let you know what we charge so you can compare and let you know if their fees were beyond reasonable.
This is why I post shit like this on Era, you never know who's gonna come by with some great insight and ability to help. I'm guessing OP's bill is gonna be substantially higher than what it should be.
 

Deleted member 8583

User requested account closure
Banned
Oct 26, 2017
8,708
A lot of people from San Diego come to my town, Tijuana, Mexico, to do any dentist procedure because of how expensive and sometimes scammy it can be in the US. But yeah, that is a lot for something like that. Anyways, it is always better to have second opinions.
 

whatsinaname

Member
Oct 25, 2017
12,011
Yeah, some dentist offices kinda bundle in various tests on the first visit and get very pushy. Mine, that has been decent previously, is slowly morphing into that, may need to find a new one.
 

Kirblar

Banned
Oct 25, 2017
30,745
That's ridiculously high. If you're uninsured see if there's a dental school locally.
 

boxter432

The Fallen
Oct 28, 2017
4,487
just the way they presented everything, you should change clinics

edit: looks to me like most things are doubled up?? 8 quadrant cleanings etc...
 

Landy828

Banned
Oct 26, 2017
9,424
Clemson, SC
This is why I post shit like this on Era, you never know who's gonna come by with some great insight and ability to help. I'm guessing OP's bill is gonna be substantially higher than what it should be.
"But, but, but...it's a "gaming forum!#$!"

Like none of us have day jobs/careers..lol.

This place is a great resource for many situations.


Edit* Also, welcome to United States Medical Practice (if you're in the US that is).
 

Dyle

One Winged Slayer
The Fallen
Oct 25, 2017
17,543
Doesn't seem that ridiculous with the filling, I'm getting two filled next week and it would have cost me $1000 out of pocket after insurance if I wasn't able to push my late December 2020 cleaning to January 2021. Shit sucks but that's America for you
 
Nov 23, 2017
4,302
"But, but, but...it's a "gaming forum!#$!"

Like none of us have day jobs/careers..lol.

This place is a great resource for many situations.


Edit* Also, welcome to United States Medical Practice (if you're in the US that is).
Yeah, I've met people from all walks of life from all over here, with people directly being able to help me with career or even emotional advice. Or just even as a place too vent.
 

TMC

Member
Oct 27, 2017
882
That itemized bill shows more than just a regular routine cleaning. Periodontal maintenance stuff is usually pretty expensive (and typically not part of just a regular cleaning). If you got periodontal maintenance procedures on all four quadrants, it seems right.
 

Wereroku

Member
Oct 27, 2017
2,486
They are charging you to treat your periodontal disease. So it's not just a filling and cleaning. You could get a second opinion. Did they tell you how much gum loss you had?
 

amon37

Member
Oct 27, 2017
1,794
I've never seen an itemized dental bill before, if cant believe they charge for anytime they spray water in your mouth and tell you spit into that tube.
 
OP
OP
Robin

Robin

Restless Insomniac
Member
Oct 25, 2017
2,984
They are charging you to treat your periodontal disease. So it's not just a filling and cleaning. You could get a second opinion. Did they tell you how much gum loss you had?
I think they said it was a scale of 10 and most of them were like 2-4 but I didn't really understand and it mostly sounded like what the dentist always tells me.
 

Matsukaze

Member
Oct 25, 2017
3,605
OP, have you received any Explanation of Benefits from your insurance carrier showing how they processed those claims and what your patient responsibility should be?
 

Fright Zone

Member
Dec 17, 2017
2,126
London
Fucking hell. I've been meaning to go to the dentist for months but I'm scared of the cost, even though it would only be about £50 or something here. That's insane.
 

TaySan

Member
Dec 10, 2018
17,348
PHX, AZ
Just for a basic cleaning? That's insane. I got one for $40 with no insurance yesterday.
They wanted me to get a crown filling for $2000, but i politely declined that.
 
OP
OP
Robin

Robin

Restless Insomniac
Member
Oct 25, 2017
2,984
OP, have you received any Explanation of Benefits from your insurance carrier showing how they processed those claims and what your patient responsibility should be?
No, to be completely honest. When my filling fell out I checked my HR Self Service, figured out the name of my insurance, asked my mom where she goes to the Dentist (Aspen Dental), checked their website to see if they took the insurance (Delta Dental), saw that they did, and booked an appointment. I'm very much in over my head.
 

bonch00ski

Member
Oct 25, 2017
2,710
Providers shouldn't be charging a 4910 and 4342.....


There is so much wrong with this bill I used to work for a dental insurance company. You got fucked over.


Where did you go, a chain?
 

DJ_Lae

Member
Oct 27, 2017
4,540
Edmonton
I hate dentists. The way their practices are constructed gives them strong incentives to bill for more services than are actually needed. I don't trust them as a result, but I also don't completely blame them as the system is set up to screw the patient.

That itemized list is a hell of a thing - the periodontal treatments are expensive but usually aren't performed immediately on your first appointment (and they are rarely covered by insurance). The scaling/planing also jump at me even though they don't hit you that much...I don't think I've ever seen them billed by tooth - here in Canada, anyway. Both are generally billed by units of time.
 
OP
OP
Robin

Robin

Restless Insomniac
Member
Oct 25, 2017
2,984
Providers shouldn't be charging a 4910 and 4342.....


There is so much wrong with this bill I used to work for a dental insurance company. You got fucked over.


Where did you go, a chain?
Aspen Dental. Also to be clear, all they gave me was a consultation and then asked me to pay the bill for the scheduled cleaning / filling which is booked for the 18th.
 

BDS

Banned
Oct 25, 2017
13,845
Aspen Dental. Also to be clear, all they gave me was a consultation and then asked me to pay the bill for the scheduled cleaning / filling which is booked for the 18th.
I've heard of them. They're like a chain dentist thing or something like a Walmart of dentists, basically. You should ask for your money back and go to an actual practice.
 

bonch00ski

Member
Oct 25, 2017
2,710
Aspen Dental. Also to be clear, all they gave me was a consultation and then asked me to pay the bill for the scheduled cleaning / filling which is booked for the 18th.
Ok whew!!!
Aspen Dental is one of the worst, I used to get calls from people in your same situation. I’ve never seen them do a simple Prophylaxis (regular cleaning code 1110)

They always do perio codes that spike the price. Stay away!
 
Nov 9, 2017
3,269
Most insurance provided by companies/corporations should allow you fillings at no additional cost. I just got one for free about 6 months ago. Did you make sure this Dentist is in your network?
 

Filipus

Avenger
Dec 7, 2017
3,358
Yea i was going to say something like this, those should be close to 100-150 euros in Portugal. A cleaning is 60 euros max.

OP, you can legit fly to Europe, get all your dentist stuff done (and WELL done) and come back and you would have saved money. There is no way the US system is THAT broken.
 

Matsukaze

Member
Oct 25, 2017
3,605
No, to be completely honest. When my filling fell out I checked my HR Self Service, figured out the name of my insurance, asked my mom where she goes to the Dentist (Aspen Dental), checked their website to see if they took the insurance (Delta Dental), saw that they did, and booked an appointment. I'm very much in over my head.
Here's the thing. You should never be asked to pay up-front for services that have not yet occurred. That is super sketchy. Billing should only ever enter the equation after services have been performed and the insurance carrier has been provided with a claim.

If your dental provider is in-network with your insurance carrier, they should be waiting until after services are performed to submit a claim. If your dental benefit is a copay, they would ask for that at time-of service, but otherwise, you shouldn't be forking over money just yet. The dental provider needs to submit a claim to your insurance carrier to confirm how/what the insurance will cover. Once the insurance carrier has processed a claim, regardless of whether benefits were allowed or denied, you should receive an Explanation of Benefits showing how and why the insurance carrier made the determinations they did. Part of that EOB will identify Member/Patient Responsibility (the amount that the insurance states is what you correctly owe). Even if benefits were denied, not all denials are Member/Patient Responsibility.

Insurance carriers typically also make a note if they determine that billed charges exceed what is appropriate to be charged for specific procedures (or at least, major insurance carriers do).
 

bonch00ski

Member
Oct 25, 2017
2,710
It's really not that hard to tell them not to do stuff and just to do a cleaning
Aspen Dental won’t do it, Dental chains like this thrive off of people not knowing what’s being done and do work that isn’t necessary.

If the OP goes back and just tells them they want a cleaning Aspen won’t do it because they say they need the perio work. They get next to no money for a regular cleaning so they do the perio stuff to add all of those other codes that drive the price.
 

Kunka Kid

Member
Oct 27, 2017
2,006
You got scammed man. I've gotten fillings that were like $200 max. A cleaning should be around $50.

And I go to an expensive dentist in an expensive city.
 
Oct 27, 2017
26,313
Aspen Dental won’t do it, Dental chains like this thrive off of people not knowing what’s being done and do work that isn’t necessary.

If the OP goes back and just tells them they want a cleaning Aspen won’t do it because they say they need the perio work. They get next to no money for a regular cleaning so they do the perio stuff to add all of those other codes that drive the price.
I guess I've never been to Aspen Dental or anything like it before. I kind of just find a local dentist office, find out if they accept my insurance, and they're pretty friendly and professional about everything and just perform what I asked for in my appointment
 
OP
OP
Robin

Robin

Restless Insomniac
Member
Oct 25, 2017
2,984
Thank you so much for your advice everyone. I'm going to call the dental office and request a refund and cancel the appointment.
 

whatsinaname

Member
Oct 25, 2017
12,011
Aspen Dental won’t do it, Dental chains like this thrive off of people not knowing what’s being done and do work that isn’t necessary.

If the OP goes back and just tells them they want a cleaning Aspen won’t do it because they say they need the perio work. They get next to no money for a regular cleaning so they do the perio stuff to add all of those other codes that drive the price.
How can OP get the $600 back? Go through the insurance company or the credit card company?