Dentist's charge for PPE

[O2Bfree]

When all "this" is over, I wonder if dentists, hair salons, barbers, etc will drop the added PPE charge?

The insurance companies listed in this document that EastWest Gal posted show end dates for PPE reimbursements:

https://success.ada.org/~/media/CPS/Files/COVID/PPE_Coding_Billing_Guidance.pdf

For example:

Anthem

Anthem will provide in-network dental providers a PPE Credit of $10 per patient, per visit, from June 15th through the end of August.

Cigna

Cigna will reimburse in-network providers in both PPO and Cigna Dental Care® networks at $8 per claim, per date of service.

The allowance is for claims processed between June 15 and July 31, 2020, and is limited to once per patient, per day. During this time period, claims should be submitted with code D1999 for reimbursement consideration.

Reimbursement for dates of service on or after April 1, 2020, is limited to U.S. Commercial and Individual dental plans and may be excluded by certain clients.

Standard policies regarding infection control remain in place as outlined in our Dental Office Reference

Guides which are incorporated by reference into the provider agreement.

But I suppose the charges could become the hidden umbrella.

 

[CardsFan]

Unless it's being cut short by the Mohel.

I had to Google that one. OUCH

 

[HadEnuff]

as a retired dentist, I must say, this thread really makes me glad I'm a RETIRED dentist.

 

[Walt34]

I have to come down on the dentist's side on this one. Maybe I've been lucky, but I've never been subjected to the dental "upselling" tactics that I read about here, just the regular cleanings and fillings as needed, and two crowns. That counts for a lot to me. Since my last dental appt. was in February I'm not due yet but if there's an additional charge for the PPE I won't squawk about it.

ETA: Hey, I'm saving money by staying out of restaurants and commercial airliners. I think I can afford the $25 or whatever it turns out to be.

 

[Gearhead Jim]

The dentists (and their help) were basically unemployed for about 3 months, with almost no warning. Even now they are much more limited in how many patients they will see per week.

My wife got a cleaning/checkup last week and I believe the PPE fee was $23.
We like our dentist and think he earns his money, paying a bit extra for the PPE doesn't bother us a bit.

 

[Rosedala]

Oh my good friend, I'd seriously question him and then would tell him "I'm sorry, doctor, I don't find this charge fair" (which it isn't!). I recently went to see in person 4 providers and none charged me any PPE. In fact, my PCP didn't even charge me for the visit when I went to see her for an opinion! Also, if you happen to have United Health Care insurance, you must've received their latest good news where they decided to waive our copays, coinsurances and other payments on account of the virus crisis. If he insists, I say to you, unless you aren't satisfied with his work, just pay it. But don't allow him to take this as a chance to invent other extra charges.

 

[Rosedala]

Rianne, you must think the world of your dentist because he/she must be super competent and super honest! Two rare animals! You're lucky. I'm looking for a (denturist actually) dentist or prosthodontist and haven't had any luck yet. Many of them lie on their sites and it's hard to get an idea of their real selves. Others have so many bad reviews I'd be wasting my time and energy seeing them. If you and/or anyone in this thread happen to know of a competent dentist I'd be most deeply grateful if you let me know? Thanks a lot!

 

[Rosedala]

Hello, I see some retired dentists in this thread who so kindly gave their valuable opinions...Kudos to them! So, may I also ask for your opinions on a difficult problem? The indecision has kept me eating with all sore gums for the last few years...when I don't have the time to grind my food to a pulp! I emailed the following to several dentists in my NYC area but didn't get any responses:

"I have a full upper, and a lower partial that hooks to my entire 8-tooth bridge. I know from family and friends a full lower is very troublesome so I’m hoping a dentist or prosthodontist could either correct a very bad relining done recently on both dentures, or make new full upper and new lower partial, with the lower built on the existing bridge? Sadly I’m not eligible for implants. I’m an old senior but healthy and strong."

-

Yes it's concise but I figured they'd ask me what they need to know. My dentures are old but of such excellent quality that they are still functional and very natural and aesthetic. If a correct relining had been made I would've been able to continue wearing them without pain.

Will appreciate enormously your opinion and that of the "patients" in this thread.

 

[EastWest Gal]

Just confirmed my cleaning appt. Dentist and asst. will wear plastic face shield with masks. I’m going to put my N99 mask over my nose and eyes. I will be only one in the waiting room. They will take my temperature. I’d pay extra for the protection. I don’t want him to go out of business, he’s great. Anything I can do to help is fine with me.

That's an interesting idea, as it protects your eyes a bit.

My post on 6/18 referred to a website for dentists on PPE billing, check it out. It doesn't seem like enough to me, as a KN95 mask costs about $5 each right now, plus all the other PPE they need. PPE is enormously expensive, especially now.

Remember there were no codes for PPE until the pandemic started. PPE surcharges only to cash pay patients are not allowed, so we will all get charged equally. It depends on the particular contract and your plan whether or not PPE is covered by insurance, and weather the dentist can charge extra. I certainly wouldn't get bent out of shape paying a PPE charge, because it just might keep my dentist and myself alive.

I'm happy with my dentist. I've met all of them in the office, and they and the dental hygienists are incredibly nice and competent. My own dentist fixed a broken tooth on a Saturday morning, after I called about 9PM the night before. He was more available than most of the doctors around here.

 

[Rianne]

Just confirmed my cleaning appt. Dentist and asst. will wear plastic face shield with masks. I’m going to put my N99 mask over my nose and eyes. I will be only one in the waiting room. They will take my temperature. I’d pay extra for the protection. I don’t want him to go out of business, he’s great. Anything I can do to help is fine with me.

I canceled that appt. and booked for Sept. My neighbor is a dental hygienist and her office is installing a Hepa air purifier that cleans the air every 12 minutes. My dentists office has an ion air purifier in each office. I went to the appt. and got scared. The staff and my hygienist were super nice. Said it's only cleaning. I had a cleaning 6 months ago. Did not charge me for the appt. I kept thinking about the virus molecules floating around in the air from the previous patient. I do like my dentist and his staff. I simply want to wait unit we know more about this virus. It's too soon for me. Our HHS person said going to the dentist is rated 4 out of 10 for unsafe activities. Working in an office, eating at an outside restaurant and walking in a busy downtown are all rated 4. I still won't do any of those.

 

[BeachOrCity]

"We are all int his together". Remember that?

I find it odd that on a financial independence community board, people are so worried about a misc charge by a provider that is most likely struggling and trying to figure out how to get out of paying it.

 

[Aerides]

"We are all int his together". Remember that?

I find it odd that on a financial independence community board, people are so worried about a misc charge by a provider that is most likely struggling and trying to figure out how to get out of paying it.

First of all, many people, no matter their own finances, automatically begrudge every extra dollar going out.

And this case is the dentist. Not a place that holds a warm special place - literally no posts bemoaning that their favorite dentist might go out of business. It's not like our local hairdresser or burger joint that we're all rushing to support.

It's also very easy to see that my server at the sushi place never had to wear masks and gloves before, so that's a clear difference. "ah yes now you have a new cost to run your business that you never had before!"

We expect a medical place to have PPE requirements normally (i mean, my dental hygenist already wore nurse gear and a mask so it's less clear the delta causing the up charge).

 

[youbet]

If someone is private paying for their dental services, then they can either choose to accept the new PPE surcharges or shop for another dentist. I am fine with this. It is good to have choices.

My beef is that when my in-network dentist, appears to be violating their contract with the insurance company for what appears to be balance billing for PPE as opposed to direct billing it to the insurance company.

The dental insurance web sites all say that you are subject to balance-billing when visiting an out-of-network dentist. Unfortunately the actual contracts between in-network (ie under contract) dental providers and the insurance company are not publicly available.

I guess I am frustrated in that it appears our dentist is violating the contract but I can't definitely put my finger on it.

I suspect that I will submit the receipt for the PPE bill manually to the insurer to attempt reimbursement and to make them aware of what is going on.

-gauss

Your insurance company is already aware of what is going on, aren't they? When your receive your EOB, you will see exactly what the dentist submitted to them and what they paid. Any amount they did not pay will be labeled as to whether you are responsible for it or not. What does your EOB say?

Or are you saying your dentist did not submit the total itemized charges to the insurance company but rather omitted the PPE surcharge and sent a separate bill for that only to you? Technically, that wouldn't be "balance billing" but would be in that grey area between optional, uncovered services (such as teeth whitening) and a surcharge for a service related to a covered procedure without which the procedure could not be done.

 

[youbet]

"We are all int his together". Remember that?

I find it odd that on a financial independence community board, people are so worried about a misc charge by a provider that is most likely struggling and trying to figure out how to get out of paying it.

I'm sensing that it is more of an issue of the PPE surcharge coming as a surprise post treatment. I suppose the dentists involved figure that patients don't really understand their bills, just grumble and pay. So they tack it on unannounced. The better thing to do, IMHO, would be to hang a very visible notice by the receptionist explaining the new charge patients will incur. Then patients could make an apriori choice to stay or walk.

 

[athena53]

First of all, many people, no matter their own finances, automatically begrudge every extra dollar going out.

And this case is the dentist. Not a place that holds a warm special place - literally no posts bemoaning that their favorite dentist might go out of business. It's not like our local hairdresser or burger joint that we're all rushing to support.

Actually, I had a lot of anxiety because I couldn't reach my dentist when things opened up. (Kept getting the "This number is not in service" message.) He's fantastic- a nice guy and a good problem-solver and works well with the oral surgeon who's done my implants. And no pressure EVER to do work that I might have considered unnecessary or profit-driven. He's 61 and I wondered if he'd just decided to retire and, if so, how I'd ever find a replacement.

I finally e-mailed his wife (we used to belong to the same church) and they'd been having trouble with their phone system. I was able to get through and make an appointment. Huge sigh of relief. Haven't heard of any PPE surcharges but if he has one and it's reasonable I'll pay it.

 

[Rosedala]

I think I've posted the #58 message in the wrong thread, please forgive. Rosedala

 

[sengsational]

I'm sensing that it is more of an issue of the PPE surcharge coming as a surprise post treatment. I suppose the dentists involved figure that patients don't really understand their bills, just grumble and pay. So they tack it on unannounced. The better thing to do, IMHO, would be to hang a very visible notice by the receptionist explaining the new charge patients will incur. Then patients could make an apriori choice to stay or walk.

The dentist I've used most recently is very clear about costs up-front. That's more effective with me than hoping I don't notice when paying (because I will). He's not the cheapest, but he (seems to) listen to me, which is another required attribute. I haven't been in for my cleaning, so don't know if he's got an up charge for PPE. I pay once a year for two cleanings (no insurance involved), so I have a "free" cleaning coming up. We'll see.

 

[BeachOrCity]

I'm sensing that it is more of an issue of the PPE surcharge coming as a surprise post treatment. I suppose the dentists involved figure that patients don't really understand their bills, just grumble and pay. So they tack it on unannounced. The better thing to do, IMHO, would be to hang a very visible notice by the receptionist explaining the new charge patients will incur. Then patients could make an apriori choice to stay or walk.

I do agree it should be atleast posted conspicuously or something.

First haircut today. $5 ppe charge. No issues. They were doing an outstanding job making it as safe as possible.

I think the dentist charge is more because they have to do more coupled with patients are more spaced out time wise.

 

[momoftwo]

I went for cleaning today.
Msny, many screening steps before the work began.
Health questions, temp check, releases to sign.
Release did indicate $10 PPE charge.
Im not sure if Delta Dental will cover it but i wont complain if i have to.

I actually asked hygenist how do i pay the PPE charge since i never pay before the visit is submitted to insurance. They bill me for my share, if there is any.

Her response was "in cookies".

 

[audreyh1]

"We are all int his together". Remember that?

I find it odd that on a financial independence community board, people are so worried about a misc charge by a provider that is most likely struggling and trying to figure out how to get out of paying it.

Same here. It would not bother me a bit. Unfortunately for my dentist it looks like we are going to skip the semi-annual cleaning this time. I’m sure we are not the only ones.

 

[REWahoo]

Unfortunately for my dentist it looks like we are going to skip the semi-annual cleaning this time. I’m sure we are not the only ones.

+1

I had a cleaning scheduled for Tuesday and called to reschedule for September. Not optimistic I won't reschedule again.

 

[athena53]

Same here. It would not bother me a bit. Unfortunately for my dentist it looks like we are going to skip the semi-annual cleaning this time. I’m sure we are not the only ones.

I get cleanings 4X/year because of my implants and because I tend to build up plaque despite flossing, using a WaterPik and a Sonicare toothbrush AND a prescription toothpaste. Last visit was in January and next one scheduled for next month. I really want to keep up the prevention.

 

[braumeister]

I went for my regular cleaning toward the end of May. That was a couple of months later than originally scheduled, and I was just a bit nervous. But it went very smoothly. They took my temperature as soon as I walked in, and asked me to fill out a short questionnaire to eliminate any potential worries. Nobody else in the waiting room, and I was called right in. Everyone in the place wore a mask and they were obviously diligent about sanitizing things.

When I left I felt really good about it, because that was the first major activity I'd done (besides grocery shopping) that felt "normal" and it gave me some hope about coming through this.

No extra PPE charge.

 

[tulak]

Same here. It would not bother me a bit. Unfortunately for my dentist it looks like we are going to skip the semi-annual cleaning this time. I’m sure we are not the only ones.

I skipped mine too in early June. A good dentist is hard to find and mine is excellent. I have no issues paying a reasonable PPE fee.

 

[O2Bfree]

Another data point for PPE charges: My mom's dentist charged $29.70.