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2023: I just have standard option plan.
2024: I upgraded my plan from Standard Option to High Option, and premium is almost double.
For both claims, it is just regular cleaning to me, why it was processed with different codes? On 1/27/2024, it was just cleaning, and it is quick and took less than 30 minutes.
The thing I don't like: I paid almost double on insurance premium, to me, they are just cleaning, no extra dental work, but I have copayment this year.
Serious question: Do I need regular dental deep cleaning? Dentist suggests me 3 times of deep cleaning each year. Now I have good dental hygiene on my own, if there is only dental cleaning claims, it is somewhat expensive to pay premium. It costs more than $200 per cleaning (more than $50 premium per month, more than $600 on premium/year and there is copayment too). Or do I need to buy dental insurance plan every single year?
To OP: Search for the dental procedure codes online and read carefully.
If you feel that the dental practice did not perform the Periodontal Prophylaxis service indicated in D4910, speak with them and have them explain why this was not the Prophylaxis you had previously received.
To OP: Search for the dental procedure codes online and read carefully.
If you feel that the dental practice did not perform the Periodontal Prophylaxis service indicated in D4910, speak with them and have them explain why this was not the Prophylaxis you had previously received.
With D4910, Insurance company pays more, and I also pay $28.20
It is only $28.20, I don't want to question dentist. I am concerned it could make dentist have "bad" impression on me, or "ruin" doctor-patient relationship.
With D4910, Insurance company pays more, and I also pay $28.20
It is only $28.20, I don't want to question dentist. I am concerned it could make dentist have "bad" impression on me, or "ruin" doctor-patient relationship.
Don't question the dentist. Ask the practice office/patient accounts manager about it! They probably understand billing codes better than the practitioner does. Patients ask these types of questions all the time and they deal with the answers all the time too. It shows you're paying attention. That's not a bad thing. No one is going to think badly of you because you pay attention to your billing statements!
If you really can't handle asking the practice, don't you think your insurance company might be able to answer this too?
TBH OP, so many of the questions you post here can be answered with a phone call or email to the entity (business, doctor, local agency, insurance company, whatever) you're dealing with directly. Most of your questions are so specific no one here can answer them. Learn to step up and deal with the horse's mouth that probably knows the most about the subject from the get-go.
Don't question the dentist. Ask the practice office/patient accounts manager about it! They probably understand billing codes better than the practitioner does. Patients ask these types of questions all the time and they deal with the answers all the time too. It shows you're paying attention. That's not a bad thing. No one is going to think badly of you because you pay attention to your billing statements!
If you really can't handle asking the practice, don't you think your insurance company might be able to answer this too?
TBH OP, so many of the questions you post here can be answered with a phone call or email to the entity (business, doctor, local agency, insurance company, whatever) you're dealing with directly. Most of your questions are so specific no one here can answer them. Learn to step up and deal with the horse's mouth that probably knows the most about the subject from the get-go.
Quote:
Originally Posted by Baike
It is family own business (dental clinic), two dentists (couple) and two front desk ladies. Whatever questions will go to dentist.
I don't want to ask them the question, and make them feel that they charged me too much.
In general, I have good relationship with the dentist, and plan to stay there as long as possible.
Then I guess you'll never know. None of us know your dentist or the front desk ladies. So we can't ask them on your behalf.
As for the three deep cleaning, it really depends on the situation. If you have extensive buildup under the gums of all flour quads, they might want to split up the cleaning into multiple visits. Do one quad one time, another quad another visit, and then the rest of it in the third.
You shouldn't need it every year though. But again, these are things you should be asking your dentist, not strangers on the internet.
Did you have Scaling and Root Planing? That is the actual "deep cleaning" One doesn't usually have Periodontal Maintenance without having had the SRP first. I thought it was pretty standard to have Perio maintenance after having an SRP. Are you only getting cleaned once per year?!? If you actually do need Perio Maintenance, Huaman covers it as preventative 4x per year. https://your.humana.com/feds/dental.html It seems weird that they would have billed a perio without explaining to you that you have gum disease and why SRP would be needed?
Then I guess you'll never know. None of us know your dentist or the front desk ladies. So we can't ask them on your behalf.
As for the three deep cleaning, it really depends on the situation. If you have extensive buildup under the gums of all flour quads, they might want to split up the cleaning into multiple visits. Do one quad one time, another quad another visit, and then the rest of it in the third.
You shouldn't need it every year though. But again, these are things you should be asking your dentist, not strangers on the internet.
D4910 is not the SRP, it's Perio Maintenance that happens after SRP.
D4910 is not the SRP, it's Perio Maintenance that happens after SRP.
Good catch.
OP: Perio maintenance is not the same as "deep cleaning." They are two different procedures. Perio maintenance is also not the same as "routine" cleaning. If you are diagnosed with periodontal disease, it's likely you will never be able to have a "routine cleaning" again. It'll always be a perio maintenance cleaning instead.
That cleaning goes deeper than a surface clean you get with a routine cleaning, but doesn't require that they dig under the gums like they do with the scaling and root planing. Scaling and root planing (SRP) is not a routine cleaning, or a perio maintenance. It is a procedure done, possibly a few times in your entire life, when you have periodontal disease and inflammation caused by buildup under the gumline at the depth of the root of the tooth, where a toothbrush can't reach.
Scaling and root planing is typically done with local anesthesia and with some patients with phobias, conscious sedation.
Perio maintenance -can- be done with local anesthesia but doesn't usually need any anesthesia at all.
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