Unnecessary additional costs - what to do?

I have found dentists are notorious for trying to charge you more for something “insurance doesn’t cover.” I have had a few over the last 20 years and most had some form of this.

How do they know insurance doesn’t cover it? Is it really necessary?

It’s a racket

Dentists have become the most untrustworthy professionals in my book the past 10-15 years.

Upselling you every single time you come in - charging for this, for that, changing the price.

I understand the office, staff and equipment cost money - but this is disgusting.

I feel like they've been consulted by teams of sales reps for add-ons: fluoride rinses, expensive 'speciality' toothpaste, overpriced sleeping guards that suddenly EVERY ONE must have.

I don't trust any of them anymore - and that's a shame.

Go back to your general dentist and ask why you are being referred to this particular endodontist. He might not even be a licensed endodontist.

There is no need for a "scan" to do a fucking root canal, I've had ten and I know what I'm talking about. Do not open your mouth to this man.

It is a total scam. I prefer dental cleanings with the high powered jets...which is much more tolerable to my teeth and the hygienist's hands than those sharp tools (yes, i know they have to scrape certain parts with said tools after the jets). Insurance charges me $20 for it. I'm convinced this dentist I go to, as kind as he is, fucks shit up in my mouth to make a dime. So frustrating. I brush, floss and water pick my mouth on the regular. Always something when I have a cleaning. I now need a crown replaced they say.

Dentists are not being paid well by dental insurance companies (known fact) but they can't afford not taking dental insurance for they wouldn't be in business. So they add on 'extras' such as this - which 'the insurance doesn't cover' - and it's 100% profit. It makes up for what thy lose in insurance. For the record, when dentists refer a patient to a 'specialist' (just like doctor referrals), the one's gaining the new patient give a kick-back to the referring dentist / doctor. This is why you were referred to this specialist by your dentist. $$$$$

MY ADVICE - do not make the appointment with him. Do not ask your dentist for any more referrals. There are enough tools at your disposal (starting with Google, and reading references and reviews on there) for you to find a specialist who will do the root canal with no extra fees on nonsense.

If you belong to FB, post the question there that you are looking for an endodontist, and see if any friends / coworkers / relatives can recommend someone (I would trust them). Also, if you belong to a neighborhood / community FB page, that's another good source (if you don't - join them!). If you have any questions about a certain doctor, you can PM someone via FB and get more info. Along with referrals, you will also be told who to stay away from.

Good luck!

[quote]Go back to your general dentist and ask why you are being referred to this particular endodontist. He might not even be a licensed endodontist.

This is a useless move. The patient will never get the true answer from him which is, "I get monetary kick-backs from him."

The answer he will get is the standard answer (or variation) : 'I've known him professionally for many years, and through my patients' experiences with him, I can say he does great work. I refer all my patients to him.'

If you ask about other specialists which you found on your own, your dentist most likely will say something along the lines of, "I hear he's good, but I've never seen his work, so I can't really recommend him."

My last appointment for a cleaning, which I have decent insurance coverage for, the dental tech asked me when he finished with the scaling if I wanted fluoride. I said sure. He then asked if I wanted polishing. I said sure again. The bill was $320. I was flabbergasted. I had to pay a chunk of this, but it wasn’t that long ago that the fluoride and polishing were automatically included and the bill was nowhere near this amount. I have no coverage now (since retired) and I know I won’t be having these “extras” done regularly anymore.

Fifteen years ago, a dentist informed me that one of my front teeth needed a root canal, even though it had no cavities. The dentist told me that the tooth would turn black if I didn't have it done. They referred me to a specialist. At the time I was undergoing radiation for a brain tumor and a root canal wasn't high on my list of priorities. I never had the root canal done, that tooth is still white and the same shade of the surrounding teeth. I never returned to that dentist and no other dentist has said anything about it nor have I asked.

Glad you recovered from the brain tumour, R8. That sounds scary.

Both dentists and vets face the same problems.

Previously, when a dentist/vet was getting ready to retire he would bring in a “new man” and eventually pass over excess patients to him. The new guy had all the bad patients—sick animals needing euthanasia, extractions, dentures, fillings. The older guy focused on high profit cosmetic work, yes for dogs, too.

Soon, groups of dentist / vets bought up the profitable practices and paid new guys a la carte, with strong cross-selling the only way to make money. That dog needs the euthanasia comfort package. The older vet with rich patients made house calls, so the whole family could be next to Fifi when the time came. The middle class purchased an imaginary comfort package and stayed with their pet while it happened.

Group practices are now purchased by private equity for the real estate the practice is sitting on. All dentists and vets are employees. The rich pay exorbitantly for procedures they don’t need and concierge services neither they nor the animals appreciate. The mid class struggles with guilt (vets) and fear (both) deciding what to pay.

The poor lose their teeth and ‘old Yeller’ their pets.

I was sent to a cosmetic dentist by my regular dentist for a consultation. As I was leaving I was told at the front desk that the visit wasn't be covered by my insurance and that it would be a couple of hundred dollars or whatever. I raised a bit of a stink and said the insurance company told me it would be covered. She said she would check with them. I never got a bill. So it's good you questioned them, OP.

Go back to your general dentist and ask why you are being referred to this particular endodontist. He might not even be a licensed endodontist.

[quote] This is a useless move. The patient will never get the true answer from him which is, "I get monetary kick-backs from him."

It is not useless. The client can establish, depending on his general dentist's answer, if he can trust his general dentist.

My previous dentist was part of a referral scam for specialized care with an endodontist and periodontist. (He also committed fraud regarding insurance, but that's another thread.) He referred me to an endodontist for a root canal. When I showed up, his assistant told me she needed to take new X-rays. I stopped her and asked if my dentist had not sent over the ones he just took a couple weeks before. Yes, they had them, but they needed new ones. I asked if my insurance covered them and she said she would look into it. A few minutes later, she told me that they cover X-rays only once a year, so I would have to pay $275 out of pocket for the ones she wanted to do. I got up and left. I went to the dental school at a local university and had it done for no copay; insurance covered it 100%.

The periodontist was supposed to extract a tooth, do a bone graft, and put in an implant. His staff came in and started mixing the goop they use to make molds of the mouth. I asked what she was doing; she needed to make a mold of my entire mouth. I asked her why, since my regular dentist would be doing the crown on top the implant when it was healed. Anyway, I asked if my insurance plan covered it and she flatly said no. So I asked how much it would cost me. $400. I refused it. The periodontist did the extraction, bone graft, and implant. Had the crown done. A few months later, the endodonist's office called me to schedule a follow up. I went. Then I got a bill from them. They charged me for a full office visit, teeth cleaning, and fluoride treatment, none of which they did.

Six years ago, I found a new dentist in a small, two-doctor practice. Sure, the waiting room is kind of ghetto and the exam rooms look dated, but he has done a great job and has never upsold me on anything. I guess I did not need the ice-cold Voss water, "free" lip balm, and goodie bag at every office visit. And I do not miss the $25/hour parking at the former dentist's building.

This is sort of related...

I've been going to my mechanic for 15 years. He runs a small shop about fifteen minutes away, and is very fairly priced and does great work. I've sent many, many referrals to him which he is very thankful for. He's about 20 minutes north of where I live (easy to get to). Anyhow, every 5,000 - 6,000 miles I go to him for my oil change. His niece ran the front desk so she'd make the appointment when I called, and they take me in and I'm usually out in about 45 minutes. I always ask for this particular (cute) mechanic named Alan because he seems to know my cars pretty well. The oil change is usually about $45 for the oil and filter (I always bring a box of local bakery donuts for the crew as a thank you).

I called to make an appointment last week. Someone other than his niece answered the phone. I told them who I was, and let them know I needed an oil change. The guy brings up my account and asks if this is for my 2021 Crosstrek. I tell him no, this is for a new 2025 which I just bought about six months ago. He then tells me for cars they have never worked on before, they need to do a 'full inspection from front to back'. I can't just drop it off for an oil change - that's not their policy. I need to drop it off in the morning and they will call me when its ready later in the day. WHAT ? I told him the car is brand new, I don't need a full inspection, and I'm not wasting money on it. I ask if Mike still owns the place and he says he does, but can't come to the phone when I ask to speak to him. I ask for his niece - I'm told she doesn't work there any more. I ask for Alan (I've made appointments with him on the phone before) he tells me he no longer works there. I ask for Mike to call me back and hang up.

A few hours later, I get a call from Mike's daughter (whom I've dealt with before and has always been nice). She has an attitude and tells me that it's always been 'shop policy' that new cars they never worked on before need to have a full inspection - not just an oil change. I let her know that I've been coming to them for fifteen years, this is my fourth car with them, and the policy has never been enforced on me before so I'm not going to start now. I let her know the car is brand new - no need to have it checked, and I can't have it left there the whole day. I then ask her if I'm coming for an oil change for a brand new car, and they need to do a full inspection - is the inspection done for free ? (Of course not - it's an extra $100 plus the oil change). I tell her if I can't have just an oil change and be in and out within 45 minutes like I've done for 15 years, then that's the end of our business relationship. I let her know I'll just as soon go to the dealership which is the same distance from my house.

There's dead silence on the other end, and then she says she'll book me for just an oil change - but this is the last time ! Next time I bring a new car to them, they will enforce the policy ! I tell her thanks for the warning, and I will start shopping around for a new mechanic after my oil change is done.

Why on earth would you need new X-rays? What could have changed in a few months? I am the OP. I called back the office asking if they had anymore information on the scan. She sounded confused. She said you need to get the scan. I asked why? I was put on hold. The Doctor got on the phone. She spilt some nonsense about needing a 3d scan to make sure they do it correctly. I pressed again, if you cannot do the Root canal without the scan, why is it not covered? She paused. Silence. She said, Perhaps you should ask your dentist for another referral and hung up lol.....

I think the OP misunderstands the relationship between dentists, patients and insurers. There are two questions here: Do you need the procedure? Is the procedure covered by your insurance? It's the dentist's job to determine if you need the procedure, and secondarily, to communicate with insurers about whether their clients are covered for the procedure. It's the insurer's job to either cover or not cover a procedure, in compliance with the plan they advertise and sell. It's not the dentist's fault that your insurer won't cover a procedure your dentist views as necessary. Talk to your insurer about why they won't cover it, or move to a different insurer who covers (perhaps at a higher annual cost) the procedures you need.

If I were OP's dentist and got a call from OP demanding to know why something isn't covered by OP's insurance, I would have fired OP as a client just like their dentist did.

Dentists used to do root canals themselves & didn't refer the patient to a specialist because no specialist was needed for that basic service. They treated root canals just like filling cavities or pulling teeth. Times are changing.

The last time I went to a new dentist for X-rays and cleaning my FIRST STOP was the "credit office" where a lady took my insurance card and ran it through the computer, then (I'm sure) checked my credit rating and estimated income.

After the X-rays, an assistant ran a camera around inside my mouth before the cleaning.

Then, while I'm still flat on my back in the chair, the dentist comes in with his partner, introduces himself, and turns on a screen to show what the inside of my mouth looked like. They double-teamed me like a pair of car salesmen, pointing out this needs to be fixed, this needs to be redone, etc. At the end they said I couldn't get my teeth cleaned because I needed to see this particular periodontist first and gave me his card.

Fortunately I recognized the hustle, thanked them, agreed, said I was going on a trip and would schedule when I got back, then got out of the office pronto.

It's ridiculous. I have both health and dental insurance. Last year I had a hospital stay that cost six figures; I paid $200. You're telling me that even with insurance a root canal is more expensive than a hospital stay?

If you don’t have a personal history of thinking everybody else is ripping you off, yet you do have these doubts about your own dentist… switch dentists.

My husband’s dentist was pressuring him to do all kinds of work that didn’t seem necessary and would have been both painful and expensive.

He switched to mine, longtime excellent local reputation, and mine reviewed the X rays and said things looked fine . He saw no reason to do any of the procedures that the other dentist was pushing. Just regular cleanings and two specific areas to keep watching in case they worsen.

The dentist did a panoramic scan each visit when my partner got an implant. Each time it cost $250. After the third one, my partner had to ask him to stop doing them

My brother's dentist starting doing panoramic scans. My brother told him he doesn't want them, the dentist said, "Then I can't treat you any longer." This after 25 years of twice-yearly visits.

R16 I understand just fine. I have had a root canal before. I didn't need a special scan last time. Just an X-Ray. The dentist determined I needed a root canal. From that, why does the oral surgeon need to perform a special scan again, and why tell me ahead of time that it is not covered? It is an obvious money grab

R8, chiming in with R7/R9--very glad your brain tumor is a thing of the past. 🙏