How do I find out the difference I'd have to pay my dentist with my insurance. What are things to consider when using my insurance, will the doctor charge the insurance more than if I paid in cash? So far I paid in cash for two root canals and paid $450 per each one but the insurance game me a number of $560. Did the doctor charge me less because I paid in cash? This doctor is in-network.
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Your dentist should give you a treatment plan after they have submitted and received the pre-determination from your insurance co. This will tell you what the dentist charges, what your insurance will pay and what part of the balance is your responsibility. Whether they give a break for people who pay cash is up to each individual office and how they like to run their business. We treat clergy for free, if that is unethical, than so be it. We also give breaks to large families, friends and colleagues. Sometimes we won't charge depending on the procedure that was done. Root canals in our area can range from approx. $650-$800 for an anterior tooth, $800-$1000 for a bicuspid (two roots), and $1000-$1250 for a molar root canal. Most insurance plans will pay approx 80% of a root canal, but it also depends on what your insurance co. considers "reasonable and customary" which means, Dr. A could charge $800 for a root canal but the insurance co. only allows $500.00 for that tooth, so they will pay 80% of the $500.00.(not the $800 charged) Also, a root canal is one of those procedures that does NOT require a predetermination, mostly because patients can't wait one month before having a root canal because they are in pain. Ask for a treatment plan of all the work you need to have done, and including insurance estimates. This will give you a better idea of what is really charged and what you owe, and what your insurance co. will pay.
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