Tuesday, July 12, 2011

Dental system in US - is this how it works?

My wife had a bit of bad gum in her mouth and she got some deep cleaning stuff done. Since then when she goes to get her regular cleaning done, the dentist office categorizes her cleaning as Periodontal Maintenance which my insurance doesn't cover unless some sort of Periodontal surgery was performed before while she was covered by this insurance company. Like I said, she got some sort of deep cleaning done last year but we had different insurance company, so I am guessing my current insurance company won't be covering this Periodontal Maintenance. This much I can accept... However, when I called my dentist office and ask them to perform just a regular cleaning instead of this Periodontal Maintenance because my wife tells me she doesn't see them doing anything different from regular cleaning and since insurance doesn't cover the periodontal maintenance, but then the dentist office tells me that just because the dentist labeled her as someone needing Periodontal maintenence, they cannot just do a regular cleaning even if the regular cleaning is what we want! Is this how the US dental system works? Or are we getting ripped off? We are the one that's paying the money, so why can't we get the service that we want? I don't get that??? So I am thinking about switching to a new dentist and not transferring any of her record and start fresh, and if she gets identified as someone needing Periodontal Maintenance, I am hoping they will be doing something first so that the Periodontal Maintenance will get covered.. Does this sound like a good idea? So.. 2 questions here.. 1. Is his how US dental system works? 2. Does switching to a new dentist sound like a good idea?
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If you tell them that your insurance will not pay with that designation, they will generally change it to meet your needs. If the receptionist is stubborn, talk to the Dentist.
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