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They billed my insurance $750 for a cleaning, I had to pay $0. Healthcare really is Monopoly money.

crankylinuxuser 7y ago
And the fraud there is that they claim it's the dentist whom does it. Why don't insurance companies crack down on fraud like that?
- ghaff 7y ago
  I'm pretty sure that my insurance company has a standard rate that they will pay out for procedures. And I'm also pretty sure they wouldn't pay for a $750 cleaning.
- FireBeyond 7y ago
  There needs to be a report, a lot of times. I used to work for a company that did claims benefits management. For all their (many) faults, insurance companies are often very interested in hearing about provider fraud. Oftentimes, there may be no direct action from _your_ report, but it might help establish a pattern, versus "oops, we mis-coded the procedure/who provided it".
ghaff 7y ago
That sounds bizarre. Lots of people with medical insurance don't have dental insurance. I do and it covers cleanings but, as I recall, a cleaning is around $100 or so. (I get 3 cleanings a year and at different times the insurance I've had sometimes covered the third and sometimes didn't.) Crowns are around $1200 which I end up covering half of. In my experience, dental is actually relatively free market. Some providers (like mine) charge a bit more than insurance covers for things like fillings and I just pay it. But, even if you don't have insurance, rates are pretty reasonable for 30-60 minutes of a professional's time. My accountant certainly isn't any cheaper.
lostapathy 7y ago
Dental insurance, especially, is a scam. The amount of "benefit" you get really is pretty low if $bad_things happen - a few thousand at most. It's more like a pre-payment plan that lots of people don't pick up the item the care they pre-paid for. I was going to go without because I saw what my insurance had been paying out. I figured I'd save a bit and I could "self-insure" in case of bigger problems. Joke was on me - I got billed about 6x as much as the insurance company. So now I pay for dental insurance because it gets me access to the "real" prices, not because I really want "insurance".
- jessaustin 7y ago
  You can call dental clinics and ask for their prices. The prices quoted ITT are blowing my mind. For reference, see Fair Health [0]. [0] https://www.fairhealthconsumer.org/ https://www.fairhealthconsumer.org/
- _JamesA_ 7y ago
  I pay $119 a year for dental insurance through Costco. That's less than I used to pay for two cleanings per year without insurance.
  - TylerE 7y ago
    Call your insurance and see what they'll pay when you need a $10,000 implant or $3,000 root canal.
delfinom 7y ago
You have a overpriced dentist. I pay mine $300 for 2 cleanings + xray a year in cash. And this is in a high COL area.
- rayhendricks 7y ago
  The dentist was overpriced, but cleanings were free to new but delta was paying $750 hence Monopoly money. Then they charged me $350 for fixing a cavity but refunded me $140 after their accountant told them to. So yes Monopoly money. I’d hate to get cancer even though my insurance is relatively good with at $1050 out of pocket max.

And the fraud there is that they claim it's the dentist whom does it. Why don't insurance companies crack down on fraud like that?

ghaff 7y ago
I'm pretty sure that my insurance company has a standard rate that they will pay out for procedures. And I'm also pretty sure they wouldn't pay for a $750 cleaning.
FireBeyond 7y ago
There needs to be a report, a lot of times. I used to work for a company that did claims benefits management. For all their (many) faults, insurance companies are often very interested in hearing about provider fraud. Oftentimes, there may be no direct action from _your_ report, but it might help establish a pattern, versus "oops, we mis-coded the procedure/who provided it".

ghaff 7y ago

That sounds bizarre. Lots of people with medical insurance don't have dental insurance. I do and it covers cleanings but, as I recall, a cleaning is around $100 or so. (I get 3 cleanings a year and at different times the insurance I've had sometimes covered the third and sometimes didn't.) Crowns are around $1200 which I end up covering half of. In my experience, dental is actually relatively free market. Some providers (like mine) charge a bit more than insurance covers for things like fillings and I just pay it. But, even if you don't have insurance, rates are pretty reasonable for 30-60 minutes of a professional's time. My accountant certainly isn't any cheaper.

lostapathy 7y ago

Dental insurance, especially, is a scam. The amount of "benefit" you get really is pretty low if $bad_things happen - a few thousand at most. It's more like a pre-payment plan that lots of people don't pick up the item the care they pre-paid for. I was going to go without because I saw what my insurance had been paying out. I figured I'd save a bit and I could "self-insure" in case of bigger problems. Joke was on me - I got billed about 6x as much as the insurance company. So now I pay for dental insurance because it gets me access to the "real" prices, not because I really want "insurance".

jessaustin 7y ago
You can call dental clinics and ask for their prices. The prices quoted ITT are blowing my mind. For reference, see Fair Health [0]. [0] https://www.fairhealthconsumer.org/ https://www.fairhealthconsumer.org/
_JamesA_ 7y ago
I pay $119 a year for dental insurance through Costco. That's less than I used to pay for two cleanings per year without insurance.
- TylerE 7y ago
  Call your insurance and see what they'll pay when you need a $10,000 implant or $3,000 root canal.

delfinom 7y ago

You have a overpriced dentist. I pay mine $300 for 2 cleanings + xray a year in cash. And this is in a high COL area.

rayhendricks 7y ago
The dentist was overpriced, but cleanings were free to new but delta was paying $750 hence Monopoly money. Then they charged me $350 for fixing a cavity but refunded me $140 after their accountant told them to. So yes Monopoly money. I’d hate to get cancer even though my insurance is relatively good with at $1050 out of pocket max.