Re: Question on bridge pricing

Matt wrote:
Steve, I appreciate the reply - you really seem to hit the nail on the
head. Now I understand more where my dentist is coming from. In my
opinion, If he doesn't like the fee schedule, he should quit the group
and not take it out on his clients.

I'll ask my dentist politely to verify the estimate. If it doesn't
change, I suppose I will calmy go elsewhere. It might be worth
checking into a dental ppo when I am eligable. I hope my tooth doesn't
abcess again in the mean time!

Thanks again,

Matt

Matt--

I don't want to misrepresent. There is no way I can tell you what's going on in your dentist's mind. I can just tell you my feelings about how I judge whether I can live with a plan or not.

Good luck,
Steve

On Tue, 14 Aug 2007 17:39:44 GMT, Mark & Steven Bornfeld
<bornfeldmung@xxxxxxxxxxxxxxx> wrote:


Well, that's an ethics question, not a dental question. I have participated in insurance PPOs where there is a contracted fee schedule. If I can't live with the fee schedule, I drop off the group.
I have never belonged to an HMO and I never will. I see no ethical problem with an HMO facility where doctors are salaried, and needed care is provided. However, a dentist in private practice joining an HMO puts the practitioner in the position of being the insurer, and the people running the HMO are mere administrators. I cannot consent to that on principle. In practice, the only way to "save money" is to set capitation fees at a level where major treatment will be furnished at a loss. This is a powerful disincentive to treat, or otherwise skirt the contract by trying to collect fees in violation of the contract.
If the dentist is good, you may consider this to be something you can agree to. However, you may wish to consider whether this apparently dishonest (ie: violation of the contract) act may reflect on other areas of the practice. That's a judgement you must make for yourself.

Steve


Matt wrote:
I certainly understand your point regarding varying fees due to
region. There is no question I am getting a price break.

I really do appreciate everyones repsonse. I respectfully thank you
all again.

I seem to be essentially getting the message here that "it is still a
good deal, so don't worry about it" with regard to the inflated
co-pay. I would like to ask again about the dentist charging more than
the set co-pay fees. Acording to the benefit provider they are *not*
supposed to do that. What to do?

Thanks,

Matt

On Tue, 14 Aug 2007 00:09:56 GMT, nox@xxxxxxx wrote:

Hey Matt,

Gotta tell you that Bornfeld is a straight shooter,
and always a gentleman.

Agree that a 3-unit porcelain to high noble metal bridge
will run you anywhere from 2K to 4K and up depending
on your specific geographical area.

Dental treatment fees vary widely from state to state
and county to county.

Would expect to pay much more in Manhattan, NY than
Manhattan, KS.

That $600 fee for a "provisional" is the HMO dentist desperately trying to make a minimal profit.

A wise sage that visits SMD has said:
"you get what you pay for, sometimes you get less".

I say: "Caveat Emptor".

On Mon, 13 Aug 2007 21:23:49 GMT, Matt
<pleasereplyinthisgroup@xxxxxxxxxx> wrote:

Hi Steve,

Thanks for the suggestion. I called my HMO provider they told me that
I am supposed to pay the exact prices as outlined in the fee schedule.

I do realize the price I was quoted is not bad compared to other
plans, and especially those without insurance. However, if I am
correct, the difference is $465.00, and that amount is of money
significant to me.

Matt

On Mon, 13 Aug 2007 20:26:01 GMT, Mark & Steven Bornfeld
<bornfeldmung@xxxxxxxxxxxxxxx> wrote:

Matt wrote:
Hi HerrDrZahnMed,

Thanks for the reply, I am in Maryland.

I suppose the fees aren't too bad. I have received good quality
dentistry from this dentist and his staff for about 10 years. This is
the most expensive work to date.

The rates I quoted are co-payments and I am in a HMO plan. I suppose
overall I am surprised that they would inflate the co-payment fees
like that. I didn't think they could do that.

Matt
In a "pure" HMO there are generally no copays. But some contracts may allow copays for certain services. Check your contract.
Unless the dentist is getting some other payment for the bridge (over the capitation fee) that is a very, very low fee indeed.

Steve


--
Mark & Steven Bornfeld DDS
http://www.dentaltwins.com
Brooklyn, NY
718-258-5001
.

Relevant Pages

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