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Old 01-07-2016, 12:49 PM
 
1,982 posts, read 996,967 times
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Who is right :

I have to get a fair amount of treatment for my dental issues . Namely, one root canal and crown upper left, two root canals bottom left, two implants upper right and one crown upper right to replace missing bridge. Some sensitivity and pain on upper left when eating and drinking cold or hot liquids. Tooth on upper right requiring crown is as one dentist put it "naked" and could cause major pain really fast if not treated asap.

1. Dentist wants to work on implants only first and foremost and leave root canals etc. for later.

2. Second opinion dentist wants to finish work on existing issues such as root canals etc. before working on implants.

Both are aware of increasing pain on upper left tooth requiring crown. Which of the dentists is moving in the right direction in view of correct prioritization of dental procedures stated above?

any thoughts or opinions would be really appreciated at this time

thx
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Old 01-07-2016, 10:29 PM
 
1,552 posts, read 1,939,048 times
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Quote:
Originally Posted by scirocco View Post
Who is right :

I have to get a fair amount of treatment for my dental issues . Namely, one root canal and crown upper left, two root canals bottom left, two implants upper right and one crown upper right to replace missing bridge. Some sensitivity and pain on upper left when eating and drinking cold or hot liquids. Tooth on upper right requiring crown is as one dentist put it "naked" and could cause major pain really fast if not treated asap.

1. Dentist wants to work on implants only first and foremost and leave root canals etc. for later.

2. Second opinion dentist wants to finish work on existing issues such as root canals etc. before working on implants.

Both are aware of increasing pain on upper left tooth requiring crown. Which of the dentists is moving in the right direction in view of correct prioritization of dental procedures stated above?

any thoughts or opinions would be really appreciated at this time

thx
In my office I generally address symptoms first by "putting out fires". Implants generally come last after the fires have been put out. I don't like placing shiny new implants next to infected areas.
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Old 01-07-2016, 11:25 PM
 
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You , me and the second dentist are not in agreement about putting out fires first.

Truly amazing that first dentist is an assoc prof of dentistry at a good dental school in my city. Why he almost in a dopey fashion, did not address these obvious and very pressing issues still is a puzzle to me.

Also, dentist number one has a staff not really up to par on giving plain and above all else correct advice concerning how my ins company will pay and how much I will be out of pocket.

Needless to say I have made an appt now to begin work on the upper left issue next week.
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Old 01-08-2016, 05:59 AM
 
Location: In a house
13,253 posts, read 38,143,135 times
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What your insurance company will pay is between you and your insurance company. It's really not the dentist office's job to get that information for you. They do it as a courtesy, because it's good business practice to do so - not because they have any obligation to do so. Ultimately, you are the responsible party for the entire bill, and therefore you are the one responsible for finding out what that bill is going to be.

As far as the actual amount, they won't know til the work is done. They can only offer an estimate. If they say "well two implants, 4 root canals, 6 crowns total, and one quarter-panel scaling on an infected area, plus anasthesia local and IV, plus propophol = $42,000.19 - and it turns out they didn't need to use as much propophol as they had assumed and one of the root canals didn't need to be done afterall - thus eliminating the need for one crown as well..

then you'd be stuck with $42,000.19 right? Because that's the cost they said it would be and the amount you agreed you'd be responsible for.

But it doesn't work that way.

They say it will PROBABLY cost $42,000.19 but they don't know for sure. And the insurance company says that based on the $42,000.19 estimate, they'll cover $10,000. But if the bill only comes to $35,000 then the insurance company isn't obligated to pay that $10,000 they agreed to initially, and you are still stuck paying whatever the insurance company doesn't pay.

Further - if they say $42,000.19 and when they get to one of the implants, they discover bone loss that didn't show up in the x-rays, they'll have to add the cost of grafting to that total. And then they still have to submit the *actual* bill to the insurance company, which will tell them how much (if any) they'll cover of the NEW total cost, and then you're still stuck paying the balance, whatever it happens to be.
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Old 01-08-2016, 06:53 AM
 
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Well it sounds like you want to continue with worsening pain on the left while addressing other problems on the right then your priorities are indeed different from mine. The good thing is that there is a dentist on every corner and you have the opportunity to find the dentist of your dreams.


As far as the insurance issues, it's YOUR insurance, not the dentist's insurance. They can try to help you figure it out but it's ultimately up to you. The dentist does not have a copy of your policy, only you do. But remember that the insurance company is not your friend. They are in the business of denying payment, that's how they stay in business. If they don't pay as much as you hoped for, then you will be responsible for the difference. I send people to collections all the time who don't remember they signed a financial agreement at the beginning noting the total fee that has to be paid by someone. I had one guy going to jail for theft of services before he decided to pay at the last minute when the police got involved.
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Old 01-08-2016, 10:49 AM
 
1,982 posts, read 996,967 times
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Originally Posted by toofache32 View Post
Well it sounds like you want to continue with worsening pain on the left while addressing other problems on the right then your priorities are indeed different from mine. The good thing is that there is a dentist on every corner and you have the opportunity to find the dentist of your dreams.


As far as the insurance issues, it's YOUR insurance, not the dentist's insurance. They can try to help you figure it out but it's ultimately up to you. The dentist does not have a copy of your policy, only you do. But remember that the insurance company is not your friend. They are in the business of denying payment, that's how they stay in business. If they don't pay as much as you hoped for, then you will be responsible for the difference. I send people to collections all the time who don't remember they signed a financial agreement at the beginning noting the total fee that has to be paid by someone. I had one guy going to jail for theft of services before he decided to pay at the last minute when the police got involved.
Oh not at all. The growing pain is on the upper left , a cracked filling is causing the discomfort. This is the one we will be working on first , then moving onto lower left (root canal maybe two), next is crown to top off the "naked" tooth left after the bridge was dislodged from its location.

After all is taken care of , then it is onto the implants. Exciting stuff.


Also, vis a vis the first dental office estimate of costs, did not take into consideration one of the biggest basics i.e maximum paid by the insurance company in a year period . In fact, I was there when the office admin was totting up the figures before my eyes. Total cost for two implants = $8200 - 50% ins co portion = $4200 my out of pocket expenses. In actual fact it should have been the total of $8200 - $2000 ins co maximum = $6200 out of pocket expenses. Important to note that both implants were originally scheduled in the same month. Interesting to note there is now a new office admin at the first dental office.
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Old 01-08-2016, 11:51 AM
 
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I see, I must have misunderstood your previous post. Was the first dental office in our out of network with your insurance?
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Old 01-09-2016, 02:50 PM
 
1,982 posts, read 996,967 times
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Originally Posted by toofache32 View Post
I see, I must have misunderstood your previous post. Was the first dental office in our out of network with your insurance?
The first dental office (assoc prof of dentistry ) is in my network, although the dentist doing the implants referred by this office was not. I still find it amazing to hear this dental office continually circle back to the implants work to be done first and the other operations later on . Right now, my top upper left tooth (cracked filling) is becoming increasingly painful , as I have told them in the past few days, but they must feel it less of a priority.

The other dental office (second dentist) from the get go wanted to start work on the "fires" and then move onto the implants later on . I will be starting work on the current upper left issue as the first order of business next week. Actually looking forward to getting rid of the niggling discomfort at last.

What I have learned is this : never be afraid to explore second opinion advice. And just because your dentist like to tell about his teaching credentials ?????....it does not always translate to the best dentist for you.
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