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Old 11-11-2008, 06:42 PM
 
549 posts, read 1,566,194 times
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Quote:
Originally Posted by anifani821 View Post
Wonder if Wake Forest has a dental school? Just have never had occasion to check that out . . .
No. ECU is pushing for one 'though.
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Old 11-11-2008, 06:47 PM
 
Location: Up above the world so high!
45,269 posts, read 88,605,943 times
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Quote:
Originally Posted by Damemeow View Post
loves,

Don't skimp on your teeth...you will end up with more damage down the road.

I have had only good experiences with Care Credit. It's a line of credit for medical costs. If you make monthly payments and pay it off before the year (or 18 months depending on your terms) is up then there is no interest.

Another option to consider...many dental Colleges offer low cost teaching clinics. The dentists are completely trained and in the process of completing required hours for certification. Maybe there is something like that nearby? My brother had his crown done at the one in Fort Lauderdale.
You are right of course, but still...it just ticks me off this stuff has to cost so dad gum much. There is so much I'd rather be doing with my money than taking care a tooth! Wish we did have a dental clinic in town, I'd go!
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Old 11-11-2008, 06:51 PM
 
1,350 posts, read 3,312,475 times
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Quote:
Originally Posted by lovesMountains View Post
You are right of course, but still...it just ticks me off this stuff has to cost so dad gum much. There is so much I'd rather be doing with my money than taking care a tooth! Wish we did have a dental clinic in town, I'd go!
It may be worth the drive to a dental school even if its a few hours away. I had a procedure done that would have cost $800 in a dentist office and was only charged $300 at the school.
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Old 11-11-2008, 07:56 PM
 
Location: The 12th State
22,974 posts, read 58,637,346 times
Reputation: 14932
Quote:
Originally Posted by lovesMountains View Post
You are right of course, but still...it just ticks me off this stuff has to cost so dad gum much. There is so much I'd rather be doing with my money than taking care a tooth! Wish we did have a dental clinic in town, I'd go!

Im with you especially considering the size of the actual porcelain; I mean I dont even have porcelain cup worth as much as a crown

but hey least what Charlotte made that one time Best Smile list .

I always have to double think when I see Peanut Brittle and think .. I dont want to damage this grill.

Dental school seems like an affordable option but I know they probably have an experience dentist in there with the students but I think would be a nervous wreck seeing on and why isnt the professor running a dental shop wouldnt he want to make the profit off these crowns and other stuff?
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Old 11-11-2008, 08:34 PM
CVP CVP started this thread
 
581 posts, read 1,600,319 times
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I appreciate everyone's suggestions. I may just get one tooth done now and hold off a bit on getting the second one done. Spread the financial pain out a little! I'm grateful I at least have insurance that pays half. I suppose I'm paying the price now for the many visits I made as a kid to the corner gas station for pixie sticks, jawbreakers, candy cigarettes, bazooka gum, red hots, pop rocks, wax lips (does anyone remember those??), etc., etc., etc. Oh those were glorious days...and those old silver fillings only last so long!
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Old 11-11-2008, 09:49 PM
kk1
 
17 posts, read 47,998 times
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Default $1200 crown

Before I start, I will let it be known that I am a dentist so before you think that this response will be subjective, I will try to explain as objectively as possible.
Okay lets start with the fee. $1200 is on the high side for the greater charlotte area, however it is far from overpriced. there are more expensive offices and less expensive offices, however $1000-1350 in the Charlotte area is fair. (note: be very leary of the $600 crown. not all crowns are made of the same materials and laboratory overhead cost can vary greatly.)
Since i brought up overhead, it should be noted that most general practice offices operate at about 65% overhead. these costs, some obvious, like salaries, rent, mal-practice insurance, etc. and others not so obvious like material costs, laboratory costs, and chair time (or doctors working time). so, lets just look at one crown for example: the initial appointment is called the prep, temporary, and impression visit which usually is about 1hr. (at this appointment the dentist "prepares" the tooth, makes a provisional restoration (also known as a temp), and makes an impression of the prepared tooth which goes to the laboratory for the crown to be fabricated. the second appointment is the insertion appointment and usually takes 30min. (some dentists break the crown into three visits: 1. prep and temp, 2. impression, 3. insert)
So we will assume 90 minutes of actually working time for a $1200 procedure. now take 65% out for overhead: $420. and now pay your taxes at about 32%: the dentist nets $286 for 1hr 30min of work. (this is where I start to get subjective) please put into perspective that for this $286 the dentist is physically performing a service for 90 minutes. (plumbers make more for their time, but i will not go that direction) medical doctors bill insurance $350 for 5 minutes of face to face time with their patients (their nurses do all the work). the main reason you will not hear people complain about their physician is because medical insurance pays for the visit.
Dental insurance is nothing like medical insurance. it is provided for mostly preventative situations dealing with the teeth and acts to supplement costs. remember you have choices when it comes to your teeth, you do not have choices when it comes to your heart!!
As far as your dentist wanting to be paid in full at time the services are rendered is not uncommon at all. many offices have this policy as it helps reduce accounts receivable. i have worked in offices where accounts receivable has been well over $100,000 because insurance would send their portion and the patient would never send their balance. Please let me know where you can go and get a service performed and not pay on the way out.
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Old 11-12-2008, 06:46 AM
 
Location: State of Being
35,885 posts, read 67,212,814 times
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KK1 - really appreciate your post!

However, I have a problem w/ your scenario re: AR. Any medical practice that allows $100,000 in AR to occur . .. well . . . they need expert assistance from a consultant. A practice can be turned around (I have done it) but much better to have systems in place from Day One than run into financial pressures down the road.

A well-run practice would help patients w/ finding credit sources for payment UPFRONT. Plain and simple. A key component of running an efficient (and profitable) practice is making sure the financial side is being run properly. Patients typically come into a dental office w/ much trepidation to begin with . . . (fear of pain, for one thing) . . . and add to that the cost . . . it is up to the practice to make sure that fees are reasonable and collectable. This is where proper customer service training w/ staff - along w/ expert financial guidance - can make the difference not only for the dentist and his/her practice - but for the patient, as well. After all, you want to KEEP your clients. If they are skipping out w/o paying, never to return, you have lost ground on several levels.

ETA: I have seen dentists try to make up for the AR "shortfall" by over charging on other services. This is a poor strategy. Better to have fees set at reasonable rates overall than rely on making up the $$$ by overcharging regular, good paying clients/patients.
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Old 11-12-2008, 07:21 AM
 
Location: Moon Over Palmettos
5,975 posts, read 17,602,900 times
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To add on to this, I can understand being billed at POS for unestablished clients, but to treat your regulars the same is really bad for business. I think that after a certain amount of time and after evaluating the patient's payment history, you need to trust your customer as one who would pay when billed the balance. I've never had this experience in CT. It's only when we got here that they bill us for their estimated balance, which more often than not is more than what they are due. Our dentist (and associated specialists...oral surgeon, periodontists, etc.) always end up returning money to us due to overestimating my share. Is it fair they get to keep my money for a time and not pay me interest? Conversely, if I took over 30 days to pay, I get charged interest?
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Old 11-12-2008, 07:38 AM
 
Location: State of Being
35,885 posts, read 67,212,814 times
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Quote:
Originally Posted by bibit612 View Post
To add on to this, I can understand being billed at POS for unestablished clients, but to treat your regulars the same is really bad for business. I think that after a certain amount of time and after evaluating the patient's payment history, you need to trust your customer as one who would pay when billed the balance. I've never had this experience in CT. It's only when we got here that they bill us for their estimated balance, which more often than not is more than what they are due. Our dentist (and associated specialists...oral surgeon, periodontists, etc.) always end up returning money to us due to overestimating my share. Is it fair they get to keep my money for a time and not pay me interest? Conversely, if I took over 30 days to pay, I get charged interest?
Totally agree w/ you thoughts, Bibit. And I will add - never have seen this except here in NC, as well. There are a LOT of things that have to do w/ practice management that I have never seen except here in NC!!! And since I see practices all over this country . . . I think I am qualified to make that statement.

Honestly, having worked in healthcare management in other regions . . . I feel like Alice Through the Looking Glass at times here in Charlotte. I get so frustrated w/ how things are done here. What I find strange is - the bulk of docs here are NOT from NC so where are they getting these ideas about how to handle their practices? Seems it is all word of mouth on the golf course cause it sure would not fall under "best practices" if a consultant had been called in to evaluate management/customer service/accounting processes.
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Old 11-12-2008, 08:58 AM
 
Location: Up above the world so high!
45,269 posts, read 88,605,943 times
Reputation: 39870
Quote:
Originally Posted by kk1 View Post
Before I start, I will let it be known that I am a dentist so before you think that this response will be subjective, I will try to explain as objectively as possible.
Okay lets start with the fee. $1200 is on the high side for the greater charlotte area, however it is far from overpriced. there are more expensive offices and less expensive offices, however $1000-1350 in the Charlotte area is fair. (note: be very leary of the $600 crown. not all crowns are made of the same materials and laboratory overhead cost can vary greatly.)
Since i brought up overhead, it should be noted that most general practice offices operate at about 65% overhead. these costs, some obvious, like salaries, rent, mal-practice insurance, etc. and others not so obvious like material costs, laboratory costs, and chair time (or doctors working time). so, lets just look at one crown for example: the initial appointment is called the prep, temporary, and impression visit which usually is about 1hr. (at this appointment the dentist "prepares" the tooth, makes a provisional restoration (also known as a temp), and makes an impression of the prepared tooth which goes to the laboratory for the crown to be fabricated. the second appointment is the insertion appointment and usually takes 30min. (some dentists break the crown into three visits: 1. prep and temp, 2. impression, 3. insert)
So we will assume 90 minutes of actually working time for a $1200 procedure. now take 65% out for overhead: $420. and now pay your taxes at about 32%: the dentist nets $286 for 1hr 30min of work. (this is where I start to get subjective) please put into perspective that for this $286 the dentist is physically performing a service for 90 minutes. (plumbers make more for their time, but i will not go that direction) medical doctors bill insurance $350 for 5 minutes of face to face time with their patients (their nurses do all the work). the main reason you will not hear people complain about their physician is because medical insurance pays for the visit.
Dental insurance is nothing like medical insurance. it is provided for mostly preventative situations dealing with the teeth and acts to supplement costs. remember you have choices when it comes to your teeth, you do not have choices when it comes to your heart!!
As far as your dentist wanting to be paid in full at time the services are rendered is not uncommon at all. many offices have this policy as it helps reduce accounts receivable. i have worked in offices where accounts receivable has been well over $100,000 because insurance would send their portion and the patient would never send their balance. Please let me know where you can go and get a service performed and not pay on the way out.
I'm sorry, when one TOOTH has to cost more to take care of than my mortgage payment, something is not right.

I believe these ridiculously high costs are due to a dentist having too much overhead, too glamarous of an office, too many new expensive gadgets and pieces of equipment and too much office staff to have to pay salaries to.

I like my dentist personally and I think he's great at what he does, but I am going to leave him now. There has got to be at least one good dentist in this city who knows how to better manage his office so that his patient's don't have to pay such high prices. Any recommendations folks? When I find one I will definitely be switching over.
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