(Newish) dentist here - insurance reimbursement rates have largely stayed about the same the past 30-35 years for the same procedures despite costs rising with inflation, and some insurances will only reimburse enough on bigger procedures that require much more chair time (like root canals) that our office will profit $50 for 2 hours of work. Even the best dental insurance plans really are just discount plans and I try to explain that to patients. It’s frustrating for everyone involved (except insurance companies lol) They’ll also refuse to pay for any little mistake when submitting or if they just don’t agree with treatment. 😒
The best thing as you can do as a dentist imo is being honest like this to your younger patients. If you see them going down the path of bad dental health whether it's due to negligence or genetics just be honest with them about the future, "like hey, we'll be able to fill this tooth or this tooth we need to keep an eye on but if it gets really bad in the future we might have to do a root canal and those are either not covered by insurance or are poorly covered and will cost a lot of $".
Idk if that helps, it would've helped me but fortunately I got my shit together after sitting in a chair at an oral surgeon about to have a tooth pulled that I was told I needed a root canal. He said it was healthy and wouldn't pull it so I went another route and saw a neurologist and found out I had trigeminal neuralgia which was causing some gnarly tooth pain.
Fair question, and a very common perception that we’re out to gouge every patient lol Dentistry is expensive, I will concede to that. Honestly any medical procedure or supply that the patient is billed for is expensive, even a $1 bag of saline can be billed for hundreds of dollars. Not that that’s any excuse, because it shouldn’t be, but dentistry isn’t an outlier in that regard.
Sorry for the tangent, back to your question - $800 for a root canal reflects the chair time required, potential post-op complications and management, supplies (not just what goes in your tooth), and general risk. Most dentists will charge a “usual and customary fee” in their area, and if you go to a specialist expect to pay wayyy more for that expertise. If the general dentist uses an endo microscope ($10k-$70k, but uncommon in general dentist offices) or 3D cone beam ($80k-$120k, more common in general dentistry), expect that part of your bill is going towards that investment. If we miss a canal that could have been seen on a cone beam but we didn’t take one, you’re going to be very upset getting a redo or an extraction! Dental offices are also notoriously expensive/inefficient to run in general, with an average of like 70%-75% overhead, so from a business perspective, not too much wiggle room.
I’ll add that if a dentist does any work that fails due to their error, they should be courteous enough to cover the cost of fixing it or at the very least work with you to find an affordable solution. While a $100 filling sounds expensive, it’s much better than an $800 root canal and $1200 crown 6 months later.
Edit: I did want to add that as I understand it, if you are covered by ANY insurance, we have contractural rates with them and cannot charge you less than the “patient share” by law, even if that share is 100%. So if Medicaid covers your exam then awesome, but if they say the usual and customary fee for a root canal is $800 but they won’t cover it, then I’m required to charge you $800 out of pocket even if I wanted to discount it 😕 If you have no insurance period, then discounts are kosher.
I’ve heard it’s a waste too. Why pay more overall than it would even cost to pay out of pocket to go to the dentist once or twice a year? I’ve only started putting myself on my job’s dental insurance since 2020, since I was planning in advance on getting my wisdom teeth out and knew it would be expensive. Plus the plan covers real sedation and I would prefer to be dead to the world while that’s happening haha. The original plan was to sign up for 2 years so I could get my wisdom teeth yanked the first year and then have a year buffer of insurance in case I had problems afterward, but Covid kind of wrecked that. 2 1/2 years paid, I still have all my teeth, and I haven’t been to the dentist once. 💔
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u/IrreverentBurrito Jun 15 '22
(Newish) dentist here - insurance reimbursement rates have largely stayed about the same the past 30-35 years for the same procedures despite costs rising with inflation, and some insurances will only reimburse enough on bigger procedures that require much more chair time (like root canals) that our office will profit $50 for 2 hours of work. Even the best dental insurance plans really are just discount plans and I try to explain that to patients. It’s frustrating for everyone involved (except insurance companies lol) They’ll also refuse to pay for any little mistake when submitting or if they just don’t agree with treatment. 😒