Unfortunately, my son didn’t have the best luck recently with his teeth. He had 4 cavities and a painful abscess in 2019 and 3 cavities in 2021. (1) The procedures to fix them were stress free, done by a fantastic children’s dentist. The main difference in the experience was that in 2019, my work insurance paid. In 2021, I paid directly. When I went to look at the recent bill, for $2100, I was really surprised at the price. $200 for a filling, $50 for dental sealant, times 3. Also, over two sessions, nitrous oxide for both sessions at $130 each.
I was curious.
I went back and looked at my insurance statement from 2019. The fillings were charged at around $200, but the insurance company only paid about $130. The dental sealant also wasn’t on it. Overall, googling the billing codes like 02392, I was able to find an insurance table from Joint Benefits Trust, that showed what JBT pays. Again, $200 reduced to $130, about a 50% up-charge for the unwitting.
Now, this is old news for the indoctrinated in the insurance industry. For me, a 20 year health IT leader, with some time spent at a giant medical coding company, I’ve only experienced this tangentially, and it still is a charge I put on a credit card before I went looking. I can imagine if I was disadvantaged and had less time or education to inspire and allow me to do such a search. I might pay it or I might not take my kids to the dentist.
Theres a philosophical argument that will come up at this point in US politics. Is this just a case of “buyer beware” or “personal choice,” “freedom,” or “personal responsibility?”
First I think dental care is essential, not a luxury. (2)
Second, In my case, I can say my situation was “buyer beware.” Yet, I have every advantage, including time, education, and financial security to ask the questions. I would not project that onto other parents who don’t have insurance, who don’t have the advantages.
Third, I fully intend to engage my dentist and discuss this. I strongly assert, healthcare and business in general, work best when based on a foundation of trust. (3) I need to trust that my dentist is thinking about my situation, without insurance, and giving me the same treatment he is giving an insurance company.
If I were financially stressed and unaware of medical billing codes, I would want someone helping me. As I tend to believe in the golden rule and that society doesn’t work if we don’t trust and help each other, I am willing to pay a little extra or live under a law, not to help a dentist buy a Porsche, but to help a poor family take care of their kid’s teeth.
- Luckily all the work was on baby teeth. Thanks for asking.
- I won’t argue this here, but am willing to discuss with anyone who thinks otherwise
- Again, this assertion is beyond the scope of this, but if you read any of the top business books, this is a core theme (4.)
- I’m not going to really defend this either. I may be full of it… But the business books I’ve read are definitely pro-trust.