Carl Hutzler's Blog

Not sure about the rest of the world, but usually when my daughter and I go to our dentist for our routine 6 month cleaning it takes about 20-30 minutes each. You sit down and they ask you about your mouth and any issues you might have. Then they check some things in your mouth and under your tongue before they begin the cleaning.

For me, a cleaning usually begins with 10-15 minutes with the scraping tool as they try and get the plaque from between the teeth and other places that we all miss when brushing/flossing. After this, they brush your teeth with a rotary tool which only takes about 5 minutes. And finally, at least at my dentist, the hygenist that did all the work yields a final check to the doctor who comes in to look around for a minute or two before the appointment is over.

Fascinating stuff! you must be thinking. Well, it is considering that I just took my little brother in to a new dentist today (Dr. Anwar Ahmad of 201 Elden Street Herndon, VA 20170) and the total visit lasted 5 minutes!

My little brother (from scouting) has not seen a dentist in 2 years roughly. So today was likely going to be a big day in terms of cleaning and talking about the problems he has in his mouth – sensitivity to cold and some bleeding gums after he brushes. I figured it would be a longer visit than normal accompanied by some lecture at the end to try and get Paul to brush more thoroughly and more often.

But after just 5 minutes in the examination room, he was finished! I prodded the dentist a bit as to why it was so quick? I asked him if he had any ideas on why Paul had sensitivity to cold, etc. The dentist gave us some quick “he needs to brush more, plaque” thing and that was it.

I walked out and then decided to go back and ask for a bill as I was not given one initially which was strange for a doctor visit. They printed one after telling me I did not need one as “you do not have to pay”. Of course I knew I did not need to pay as my little brother is now covered by VA State Healthcare (FAMIS). But I still wanted to see a bill.

Well they printed one out and it showed $353 in charges for this visit. I asked if that included an x-ray or not. The dentist said no. I asked if it was normal to have an x-ray every so often and the dentist said it was up to the doctor and not a normal routine practice (which is contrary to what I have always experienced – I think it is usually once a year). The dentist then got very defensive and upset with me. He told me that “he has been in dentistry and doing this for many years and why am I questioning him”. To be honest, I was just politely asking questions that any patient might ask. But he got defensive and unprofessional almost immediately which got my suspicions up to say the least.

Anyway, they also had two items on the bill for “Behavior Management” in the amount of $90 each. I talked to the insurance company and they said these would normally be billed for a patient who was having issues with the appointment – crying, etc. But there was none of that. The only thing my little brother asked before he went back to the room was whether it would hurt. No crying. No delay. And not only did they bill $90 once, but they billed it twice.

On the bill, they list that the insurance company would pay $173 which is the cost of the cleaning and flouride and examination. And this seems normal to me if the appointment had lasted more than 5 mins. But the two charges for $90 each were listed under “patient pays” and then crossed out when they handed me the bill.

So I don’t know what the deal is.

- Does the dentist usually bill the other $180 and when they can’t get reimbursed, they write it off and sort of cheat their taxes?
- Was the dentist going to eventually try and bill me for the extra $180 that the “insurance did not cover”? Maybe they still will try?

Either way, this was a terrible experience. A boy who had not seen a dentist in two years got a superficial cleaning and can not see a dentist for another six months now.

I called the insurace company (smiles4children) run by the state of VA and while they were very nice and helpful, they have no recourse to take. They will pay for the appointment, can not take any information from the patient in terms of the quality of the visit, and will not even question the services rendered. I guess I feel for them as how can they just believe one person. But if they had a way for people to register complaints and enough people complained about certain doctors, maybe they would get some better intelligence on the doctors they are hiring to see their patients…the poor of Virginia.

I can’t help thinking about our health care debate in light of this experience. $353 for 5 minutes with a doctor and his assistant.

What do you think? Am I being overly sensitive? Is this what I should expect?