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Dental Insurance Dental Fraud

Marianne Wolff

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I started to write an article on how to buy good dental insurance but after my experience I changed my mind and decided to write about dental fraud. I am self-employed and have had to provide my own dental insurance for the past 15 years. Recently I was the victim of what I would call “dental fraud" or what the media calls “drilling for dollars. " I was fortunate that I had a friend who was a dentist. When I told her what my dentist was recommending, she tipped me off that this might be a case where the dentist was prescribing unnecessary dental procedures.

After my experience, I begin to research the topic. An article I found on dental insurance gave this advice “try and avoid dental discount plans and DMOs. " A dental discount plan is the only kind of plan I could find being self-employed. The reason the article advised against these plans was because a “bait and switch" tactic commonly employed by dentists on this plan. The dental plan promises discounts for dental treatments. Typically the cleanings and x-rays are very low cost. The insurance company knows that if you have routine dental care you are much less likely to require expensive dental procedures. So in this case the insurance company is serving your best interests.

Unfortunately, this does not work out so great for the dentist. If you have good teeth and do not need additional dental procedures, your dentist does not make money. So some dentists try to increase their profits by telling you that you need a more expensive or unnecessary dental procedures. They count on the fact you won't want to go outside your dental network and pay $100 to get a second opinion.

My dentist used a “special" camera to show me that I had cracks in my teeth. These cracks were his evidence that I needed four new crowns. My friend who is a dentist explained that the cracks were only crazing and if I wasn't having pain I probably didn't need the dental crowns.

I had not had a cavity since I started with that new dentist about two years ago. After refusing the crowns for about a year, I was informed the dentist was no longer taking my insurance. I found a new dentist on the same discount dental plan who told me I didn't need any new crowns and my teeth looked pretty good.

Not all dentists are just in it for the money but some are. My advice is get dental insurance. It is best in the long run but, if you suddenly need a lot of expensive dental procedures, get a second opinion.

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