Wednesday, December 18, 2013

Here's a fun plan

When I went to the dentist to have the temporary crown fitted, he said that there was a growth or something on my gum that hadn't been there two weeks before when I had my first appointment with him. He was very careful to tell me that he didn't think it was anything to worry about, but that it could be in the future, and he thought I should have it looked at. So after the next appointment, when he put the permanent crown on, he gave me a referral to a periodontist. I had the appointment with her today.

I didn't really know what to expect, except that the dentist said the periodontist would probably remove it (it just looks like my gum is kind of swollen or overgrown or something in one spot). So today she just looked at it, and poked and prodded around in my mouth, then said she was going to go make some notes and would come back in and talk to me.

After awhile, she came back in and her office assistant had apparently called my insurance company, and they had come up with this whole "treatment plan." She said that she needed to remove the thing, and send it to the lab for biopsy, and she "would be shocked" if it was cancer, but it could be, in which case we would have to talk about a treatment plan. But she assured me that she thought the likelihood of that was small, but still possible.

She said it could be a couple of things, one of which is caused by hormones, and if it's that thing, then even if she removes it, it could come back, but she won't know until the labs are done. And then she said I probably grind my teeth at night because I have some gum recession, and my bite isn't ideal, and my teeth are crowded, and in order to fix that, she thinks I should have braces (aside: her husband/partner is an orthodontist), but I would need to have them before I get an implant for the tooth that was pulled, because an implant won't move, blah, blah, blah. I kind of tuned out at that point. I'm sixty years old, I'm not going to get braces. But I nodded, and said, okay, okay, okay.

Then she showed me how much it is all going to cost, and my head sort of exploded.

And, while they will submit bills to the insurance company, they expect me to pay up front, then have insurance reimburse me, which I have never had done. I said that, and she said, well, we're not in network, so they won't pay us, which I know for a fact is not true.

So I said, well, okay, but I'm not prepared to pay for this now, today, and she said, oh no, it won't be today, I'm not doing anything today, you'll have to make another appointment. And I said, okay, but even then, I don't see how I'm going to pay for this in one lump sum, and she said, well, talk to the office assistant, maybe you can work something out, and she shook my hand and left.

Oh, and if you pay in cash, they give you a 10% discount, which, I'm sorry, that just struck me as odd. I made an appointment for the first week in January, and the office person reiterated that I wouldn't get a discount if I didn't pay in cash, but if I gave her a credit card number she could divide it up into three payments ("we don't usually do that for such small amounts, though," she said) and they would auto-charge it ("we don't send out invoices").

I know that it's a business like any other, and they weren't mean or anything, and of course they expect to get paid, I understand that.

And there was apparently a charge for the consultation today -- she didn't tell me how much it was -- she said she would submit it to insurance and have them send the check to them, and then bill me for the remainder, so obviously what the doctor told me earlier about insurance not paying them (and what the assistant said about not sending invoices) wasn't true.

I went out and sat in the car and cried. Bob was off today and he was out Christmas shopping, and he called to see how it had gone, and I couldn't even really talk. He was walking around Costo, and he was giving me a running commentary, trying to cheer me up. He's so good about stuff like that. I know I'm kind of crazy sometimes, but he's awfully good to me.

I had told my dad that I might come out this afternoon if I felt like it after the appointment, thinking that they were actually going to do something other than upset me, so I drove out there, pretty much crying all the way, but trying to get it together. He made me lunch (chili) when I got there, and we sat and talked, and I teared up a little bit when I told him (and I am now, thinking about it again), but it wasn't too bad.

Mom is doing great -- she's back home now -- and while I was there the visiting nurse came, so I was glad I was there for that.

My inclination about the periodontist is to call and cancel the appointment, and think about finding someone different. I didn't dislike her personally, but I just don't feel right about it. And the whole thing, of course . . . I know it's not my fault, but really, it kind of is. If I had kept up going to the dentist all along, maybe it would have happened anyway, maybe it wouldn't. No way of knowing, but it's like now I have this whole lifetime plan of going to the dentist every two weeks and it's awful.

At one point she said, I know it seems like a lot, you go along for a long time and everything is fine, and then everything sort of happens at once. But you can save for it . . . and I thought, wow, yeah, I really want to start putting money aside for dental work, that sounds like fun.


Anonymous said...

Hi Willa,

If possible, try to get a second opinion, and maybe with a Dr. that is in your network. My mom went to a dentist to have an implant (that she really didn't need). She paid almost $7000.00 upfront and then the dentist screwed up and put the implant into her sinus cavity. Long story, short, if I had been with my mom I wouldn't have let her pay upfront for work not done. Also, her insurance declined the payment because they said it was cosmetic and not necessary. So my mom was out over $7000. To this day, I feel so bad that I wasn't there to caution her.


Willa said...

That's an excellent point, Terri, thank you. That's what I will do.

Mary C said...

Look into Care Credit for large dental bills. I used it this year for a surprise root canal, etc. It gives you 6-12 months to pay without interest, as long as you pay it all off by the end of the timeframe. Still a nuisance but not QUITE as much of a burden. The same card can be used for large vet bills, which I've also done.

I think you're correct to get a second opinion. Something doesn't "feel" quite right.

Chel said...

DEFINITELY get a second opinion. I've heard thats since the economy took a dive, dental care is the first area that people (voluntarily) gave up as far as health care, so those who do seek dental care are paying up the wazoo for it. It sounds like you got the works, and it's not fair. Ask around, check online, and see if you can find a less intense doctor.

Sharon King said...

Willa, I know exactly how you feel. I had a similar experience a few years ago. My dentist sent me to a periodontist who was very similar to the one you described. I went in with one problem and came out with periodontal disease and she said the only way to fix it was to peel my gums back and do a deep cleaning, which was going to be a very painful procedure, plus being expensive. It was near the end of the year and the dental technician said I needed to get it done this year before my dental money ran out that I need to milk the insurance company. I almost said, "You mean the way you all are milking me?" After that, I went into a deep depression and denial. I still haven't done anything about it. There is a procedure I can have done called LANAP, which is not nearly as invasive or painful as the first procedure, but I can't have that done either because my dentist uses epinephrine during the procedure. I can't have that because I have afib and a hear murmur. I do hope you get a second opinion.