Is a $202 Full Mouth Debridement was an overcharge? or just average?

Question

I went to a dentist, and was ordered a Full Mouth Debridement (D4355) for $202.00. I have no idea of what exactly they have to do but they explain that it's different from a regular cleaning and my insurance will not cover such thing. I have no idea of how much is it cost on average dentist and I said yes to have it done on me. When I went home, I realize that some dental office offer it less than what I'm paying. Should I file a complain? If I should, where can I bring my complaints to.? I live at area code 92126.

Answer 1

I was in the dental field for over 9 years. A FMD is a MUCH deeper cleaning than an average cleaning. There is a alot more involved and also they take longer than a regular cleaning (prophylaxis 1110). The fees either depend on your dental insurance fee plan or the doctors fee based on wether you had insurance or paid cash. It sounds about right as far as the price goes especially of you paid cash and didn't have insurance covering it.. Also, I think it is rare that insurance didn't cover this. In my experience most insurances did cover this. This cleaning is more for people with perio problems. Such as gum disease and what not. Hope I was some help.

Answer 2

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RE:
Is a $202 Full Mouth Debridement was an overcharge? or just average?
I went to a dentist, and was ordered a Full Mouth Debridement (D4355) for $202.00. I have no idea of what exactly they have to do but they explain that it's different from a regular cleaning and my insurance will not cover such thing. I have no idea of how much is it cost on average dentist and...

Answer 3

Unfortunatly, there is nowhere for you to file a complaint. The dental world is a business, just like any other business. They have a right to set their own fees, you have a right to pay them or go elsewhere. The only way you could possibly be able to file a complaint, is if that dentist is a contracted dental provider with your insurance company, and the insurance company has a U&C fee for a full mouth debridement (Like you said, code D4355), and the dentist charged you over that fee. Even if you individual policy doesn't cover that code, the insurance should still have a U&C fee for it, and from what I understand, even if it isn't a covered benefit, you are supposed to only be charged that U&C fee. If they are not contracted with your insurance, they could charge you $300 and it is your choice if you want to pay it. Kinda like you can't complain on Dillards or JCPenny for charging you $100 for a pair of jean. You chose to pay it.

That is higher than my office charges for a full mouth debridement. We charge $150.00.

Answer 4

At least they asked you! My husband went in for an annual cleaning to a new dentist. I told them when I set up his appointment that if they needed to do anything more than the routine cleaning and basic xrays that our plan pays for every 6 months they were to get his permission and inform him of the cost first. We found out about the "full mouth debridement" when our insurance rejected it. He didn't have a chance to approve it or even check if it was covered! They also took extra xrays than were not allowed and didn't mention that to him either. If you need that procedure and you are informed of it and then approve it you agreed. But I am finding lots of people online who got hit with this AFTER they were in the dentist chair. We still don't know if he even got a FMD or not, they could be just trying to fleece people.

Answer 5

I manage a dental office and if your insurance does not cover ADA code 4355 then you will have to pay out of pocket. At my office we charge $110. The first thing you should do is call your insurance, give them the code, and ask what you should be paying for this procedure. A prophylaxis is a regular light scaling (scraping of calculus/tartar) and polish. If it has been a long time since youve been to the dentist or have excessive amounts of build-up then it makes since that the Dr diagnosed a FMD.

http://www.tierrasantadental.com/

Call this office for a second opinion, they dont charge for exams, xrays, or consultations.

Answer 6

I would recommend one to try this internet site where you can get rates from different companies: http://insurancetocompare.info/index.html?src=5YAcVAsgY99axx1

RE :Is a $202 Full Mouth Debridement was an overcharge? or just average?
I went to a dentist, and was ordered a Full Mouth Debridement (D4355) for $202.00. I have no idea of what exactly they have to do but they explain that it's different from a regular cleaning and my insurance will not cover such thing. I have no idea of how much is it cost on average dentist and I said yes to have it done on me. When I went home, I realize that some dental office offer it less than what I'm paying. Should I file a complain? If I should, where can I bring my complaints to.? I live at area code 92126.
Follow 10 answers

Answer 7

Go to the dentist office that offers it for less. They can charge what they want. To file a complaint:

Healthcare / Medical / Dental

California Department of Managed Health Care (DMHC)
Mailing Address:
Department of Managed Health Care
California HMO Help Center
980 Ninth Street, Suite 500
Sacramento, CA 95814-2725
(888) HMO-2219 (general information)
(888) HMO-2219 (independent medical review requests)
[phone] (health plans and providers)
www.hmohelp.ca.gov/
The DMHC’s policy experts provide benchmarks for Health Maintenance Organizations (HMOs) and their regulation, healthcare policy, patent advocacy and consumer awareness.
http://www.consumercal.org/consumerdirectory/

Answer 8

Get insurance quotes

Answer 9

I THINK THE DENTIST CAN CHARGE WHAT HE WANTS. IF THIS SEEMS TOO MUCH, YOU ARE FREE TO GO ELSEWHERE.
A COMPLAINT WILL BE FUTILE.
IF YOU THINK THAT'S EXPENSIVE FIND OUT WHAT THE CHARGE IS FOR A D4341 OR A SCALING WITH CURETTAGE?
REMEMBER, YOU GET ONLY WHAT YOU PAY FOR.

Answer 10

you agreed to pay it, and could have asked what it was, then looked around if your insurance didn't cover it. you paid it, so there is nothing more you can do.