TOPIC: Horrible experience from Dentist in Triangle area

Hi All,

I'm glad to find this website with so much info.
Surprisingly I didn't find much help with the dentist related questions.

We recently had a horrible experience with local dentist - I would like to share it with you all, in detail - so you don't go through any.

We have recently moved from India and are shocked to see the price difference in treatment plan by local dentist.
Root canal + crown from best dentist in Mumbai costs only Rs 4000 = $ 88. Whereas here I was given a treatment estimate of $ 910 (root canal) + $ 289 (pre post core) + $ 210 (pulpotomy) + $ 996 (crown) - This estimate is from a local non-endodontic doctor and that too for a non-molar single canal tooth. = Total in Rupees equals 1,08,225. What a difference !!!! and even after Metlife insurance which covers some at 80 % and others at 60 % I have to pay around $ 1700.

since it's health related - we still decieded to go ahead with this treatment for my wife.

We visited a dentist Kavita Ghai for pain on that particular tooth. But on knowing it was our first visit - took full mouth x-ray which is only allowed once in 3 years as per my insurance plan.
I was never asked or told about this by the receptionist nor the dentist.
It got covered 100% so without my consent charged Metlife $ 425 for all x-rays and cleaning.

Then for every procedure like in the start, middle and end of root canal procedure 3 x-rays were taken for that particular tooth. We were charged for those 3 X-rays on top of the root canal. Why is this not mentioned in the root canal costs? When ever questioned - I was told that my insurance will cover 100% so i need not worry.
But then it tops up the maximum limit - i realised this much later.

I was advised strongly to remove all my wisdom tooth - even though i have no pain at all - because wisdom tooth's are not much of use anyways and receptionist would once again point out that it's covered 80% - so it's a good deal.

This doesn't end here.
When my 8 year old had his first visit - for only cleaning and flouride treatment - they gave us a treatment plan for sealants on 3 permanant tooth and 2 baby tooth. and assured that it's covered 100% by my insurance so I need to get it booked straight away.
I had lost trust with this dentist by now and called Metlife directly.
They confirmed that through my benefit plan - sealants for children are not covered at all.

I called up my dentist and discovered that if my insurance company doesn't pay for the claim - they would chase me for the actual costs as well as interest on late payments.
If the receptionist is not sure how much insurance company is going to pay - how can she give a typed treatment estimate with all costs involved ?

I'm sure most of you have insurance and with most dental preventive care like check ups covered 100% - everyone in AT has visited the dentist once a year. I find them overbooked anyways.

Do you find dentist very very pushy, over expensive, giving out wrong information about insurance coverage and then chasing for overdue's?

How come it's not common to use the pre treatment Claim form ?

What should we do - if the dentist would take extra X-rays and then without our consent file it with the insurance company ? Shouldn't we aware of every details before they file with the insurance provider ?

We eventually visited 3 dentist - one of them being the "triangle family dentistry" and all of them seem to have the same style of practice.

After lot of research and pre claim forms forcing on the dentist - I got my wife's full treatment done well within my maximum limits for this calender year. But it was like an adventure and we spent more time making sure they don't ripe off than getting involved in the actual treatment.

Expensive treatment plan is one thing but giving wrong information and forcing patients for unwanted treatment for health reasons is pathetic.

We dont have any friends around so I'm very eager to hear your experiences, comments and advice.

Regards,
- Suhas.

Suhas,

First, welcome to USA.

Always take a written estimate from a dentist, like you would at an auto repair shop. Ask them to get approval from the insurance company. Most dentists will do that anyway, whether they tell you or not. Then, agree to pay the the difference or negotiate further.

Don't pay anything beyond the agreed amount. If they bill you for more, just dispute it. It will drop off.

Suhas,

Welcome to Triangle and AT.

My experience with Dentists were initially was same. As Manoj mentioned, you have to get estimates and get approvals for insurance plan.

I have changed my Dentist recently and I will let you know if he is good.

Thanks
Satish

But Manoj, whenever I get an estimate from a dentist - they have it mentioned on the same page that it's just an estimate and any monies not received from the insurance company should be paid by the patient. They also get the same stuff signed on another sheet of paper on the day of the treatment.

I would like to hear from someone who had their dentist chase them when their insurance company refused to pay ?

My insurance plan also has strict frequency limits - like full mouth X-ray is only once every 3 years. Dentist would only check Metlife's webpage which doesn't say much about individual policy. New dentist wouldn't know what work I've already done from another dentist in last 3 calender years. When the insurance won't pay, I'll be surprised if they can write off amount like $ 425 for full mouth xray's.

Satish I would be thankful, if you can recommend anyone.

Come on AT members, visiting a dentist every 6 months is a common practice.
Let us know your experience.

Suhas wrote:

When the insurance won't pay, I'll be surprised if they can write off amount like $ 425 for full mouth xray's.

Then, you'll be surprised to know how much doctors and hospitals write-off.

You just have to be tough with refusing payment and maintain the argument that you were not told. They will threaten to send it for collection and if they do, you repeat the story with them. If it goes to a credit rating agency, write to them with proofs of dispute and they will remove the negative report from the collection agency.

Suhas

Its sad u have to go through and thanks for sharing your experience , in the end u told u got ur wife treated in your estimate....could u share where ? As, i m looking for a dentist too.

vist india and get it done there.. its worth it ..but yes if family and wrk responsibilities permitt..the expense incurred is equivalent to 1 person india trip

Suhas,
I also had a bad experience with this dentist(Kavitha Ghai). I was new here in triangle and went to her for a regular cleaning and they took x-rays and said I have a cavity in 2 of my front tooth. I told them that I don’t have any pain, but they told me some times we don’t feel any pain since it is deep inside and it must be treated. I agreed for the treatment without any 2nd thought. After spending 2 hours she told me that she couldn't find any cavity and she filled the first tooth and referred me to some other orthodontist. After couple of months I went to other dentist and they said I don’t have any cavity and I need to get root canal and a crown because my tooth was drilled deep and it may break at any time.To save my tooth I ended up paying hundreds of dollars for somebody's mistake. Now my family is afraid to go to a dentist .

It's hard to believe Dentist. I am also afraid of losing original due to unnecessary treatment.

Shiva wrote:

Suhas,
I also had a bad experience with this dentist(Kavitha Ghai). I was new here in triangle and went to her for a regular cleaning and they took x-rays and said I have a cavity in 2 of my front tooth. I told them that I don’t have any pain, but they told me some times we don’t feel any pain since it is deep inside and it must be treated. I agreed for the treatment without any 2nd thought. After spending 2 hours she told me that she couldn't find any cavity and she filled the first tooth and referred me to some other orthodontist. After couple of months I went to other dentist and they said I don’t have any cavity and I need to get root canal and a crown because my tooth was drilled deep and it may break at any time.To save my tooth I ended up paying hundreds of dollars for somebody's mistake. Now my family is afraid to go to a dentist .

After hearing this story,I am now scared that if my dentist have treated my tooth which was not necessary.I had my fillings some years before and I was told that those fillings are breaking down and also more cavity is forming beside the filling.During my visit I just didn't get treated for replacing the old filling, but ended up getting the crowns.I have no idea how much bill I am going to receive from my insurance.

God! Hi Suhas, welcome to USA. I was writing a book on my experiences in this country...your discussion had made me think that maybe I should give out a passage from my book and help out fellow desis a little bit. So I started a new discussion myself: Medical experiences in the USA". I think you will enjoy that too.

Ironically, I too have similar experience but with McCrimmon Dentist office in RTP.
I went to them for dental checkup and was told that there is a notch on side of my teeth and they will treat it. So, I said it is fine but I asked them to verify with my insurance (Metlife). The lady at the front-desk told me that the insurance is ok to pay with and I had to pay $15 as co-pay. I paid that $15 and got the notch filled up. Later after 3 months, I received a bill from the same office saying my insurance declined because there should be 6 months for treating preexisting conditions. I had this notch since 5 years. So, I asked the Dentist office that why she did say that the insurance will pay them? for which she responded saying that it is upto the insurance company and she can't control it. And finally I had to pay the bill myself $265 otherwise, she threatened me that they will send the bill to collection agency as this is not their fault.
So, I recommend everyone to talk to your insurance company even if the dentist office says so. Infact, get in writing that the insurance company will pay for any fillings. Otherwise, you will be in trouble.