Monday, March 21, 2011


My teeth don't like me. Or, rather, ever since they were introduced to HCG, the teeth and I haven't been best of friends. (NO, I am not pregnant, I'm referring to the past)

Anyone with problem teeth, IE: root canals, extractions, gum issues, endo issues, will know exactly where I'm coming from. Despite the fact that we're lucky to have dental insurance, it still is worthless. Those of you in similar boats, understand.

I swear that the dental insurance industry is just a front for the CIA. You call to ask them questions about the coding system, and they cannot provide you with that information. From my experience these past few years, unless the dental office sends out a predetermination letter of suggested work, the insurance company will not provide you with any pricing, of their own.

See? It's very covert, don't you agree?

I just am frustrated because teeth are so important, and yet we have to let things slide because it's a constant competition or fight between the dentist office and dental insurance. Perhaps like brothers, Cane and Abel. They don't work well together.

I was floored when I was informed that if we should see a dental office that is out of our network, but willing to accept our dental plan, the way the dental insurance determines how much they cover, is based on a % or average between all the usual and customary charges within our region/zip code. When I asked the rep if the usual and customary charges differ, she said yes, they do.

I asked her where I could go that has the lowest region of established fees from their plan, and she couldn't tell me. She said that I'd have to research that myself.

See what I mean? It's like the Hole in a Bucket. No matter what you do, back and forth, you never seem to accomplish what you need.

I could call around to all the different dentists in the area, outside my area, and perhaps within other states. I could call them, as the insurance rep said, and ask them what their own fees are.

The kicker? I tried that. After all, I can shop around for a car, for doctors, for homes, and Realtors, for plumbing work, etc, but apparently the dental offices do not give out their charges over the phone. WHAT? I would need to make an appt, come in, have a consult, and then they'll provide me with the work they feel I need, along with my costs, their fees, and what, if any they estimate my insurance will cover. Typically, in doing my research, those offices that I did call, advised me that they charge a consult fee, but it can be applied as my deductible, towards my insurance.

They get you some how. The fees from offices range from reasonable to, you have got to be kidding me!!
Sometimes I feel like not only are these dental offices a front for CIA work, but some of them must be practicing gastrologists in the midnight hours, because they sure figure out a way to screw you, in your twilight sedated IV haze of a colonoscopy.

Where I grew up, you can find a Church pretty much on every corner.
Where I live now? There are more dental offices then there are Starbucks.
But maybe that will help my poor husband's hard working pay check in the long run.
Maybe, just maybe, the more practices there are in my are, the more they'll compete with one another, lowering their own fees, to keep a steady flow of Decay gumming down their door steps.

I have learned to believe dentists as much as I would the used car salesmen.
Forgive me for that statement, but I'm qualified to say so, after all, I was in the automotive industry, and saw first hand all the things dealerships did, to "keep" their customers.

I'd rather buy a used car then contact another dental practice.
Sadly, the cost that all of this nonsense is adding up to be, is beginning to feel like I was hosed and closed on a 72month automotive loan with a 31% APR. Can you imagine?

Open up and say, "SEALANTS!"

1 comment:

KathyA said...

Sorry you're having dental difficulties. I love my dental plan and my dentist. I hope you find better.