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Humana claimed I could get a crown for $60 for core build-up and $370 for the actual crown, but in fact when I went to one of the two providers in the area the dental provider - Great Expressions in Stockbridge, GA, Great Expressions tacked on an additional $400 for #10103 (not an ADA procedure code) for "Specialty Crown/Non-covered benefit". I was told by Great Exp.

that the $400 was for the Outside of the crown and the $370 was for the inside of the crown (excluding the core build-up). In other words, the inside would be metal or high noble metal ($370) and the outside would be porcelain ($400). The total cost of the crown would be $830. If I just wanted the $370, I would end up with a metal tooth - HAHAHAHAHAHAHA.

This is a heads up for anyone wanting to get Humana dental. When calling Humana to complain and get an explanation of the allowed charges, I was basically told that Humana would/could not hold the covered company to the pricing on the Humana sheet.

Buyer beware!!!!!!! Your insurance pricing means NOTHING.

Monetary Loss: $860.

Location: Newnan, Georgia

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Guest

Same thing happened to me but with a different insurance company. After doing work, Great Expressions told me it would be an another $400 (over the estimate).

Kassim Fsp

I went to Great Expressions on Jeff Davis Hwy in Fayetteville, GA last Thurs., 10/1/2020. Molar (#15) has been chipped for years following a new filling.

Dentist said there is decay at root and a crown is in order to avoid the decay going into nerve, then I would also need a root canal in addition to crown. Reviewing estimate: Code 2740, Porcelain crown/ceramic substrate, $370.00, Code 2950, Core buildup including any pins, $60.00, and last but not least, Code 10103, speciality crown alt benefit, $400. Called Humana who called Great Expressions. Was told it is more durable?!

The 3 crowns I already have were done in the late 70's. That's pretty damn durable to me. Only Great Expressions offers the specialiity crown alt benefit.

Think it is an upsale and Great Expressions should not be offered as a provider by Humana. It is fraud and should be reported to State Dental Board.

Guest

Happened to me today at Great Expressions. They said the crown was made of a better material.

I asked them what material sells for $400 for 1/10th of an ounce.

Things went downhill from there. There was no charge for the office visit.

Guest

Ironically, the same thing is currently happening to me with the same dental center Great Expressions. I have PPO dental plan and they're still charging me $800 dollars.

Guest
reply icon Replying to comment of Guest-1714477

Well actually they wouldnโ€™t allow me to stick to the lower bill though I received it twice, once after I already payed the larger amount so now theyโ€™ve stopped sending it!

Sula Tat

Is it humana or the dentist because I have the same charge & at a Great Expressions no less! I found your complaint trying to find out what it is.

But curiously they have knocked about $200 without me saying anything but it's on a bill that looks typed up. Needless to say that's the bill I'm sticking with.

Guest

It might be the issue with the dental office rather than the insurance.

Guest

I had the same experience and more trouble with Great Expectations in Lawrenceville...changing dentists.

Guest

Same thing just happened to me in Boynton Beach, with Solstice Dental Plus Plan One, at Great Expressions Dentist. The crown should be $525, according to the fee schedule provided by Solstice.

Code 10301 is not listed anywhere, so I find fault with Great Expressions and Solstice, as neither could supply a reasonable answer. BUYER BEWARE!

Guest

I am experiencing the same thing with the same company but in Boynton Beach, Fl. What nonsense!!!

Guest

People really need to get an understanding of insurances, then blame yourselves or your insurance for what is and not being covered. With DMO insurances, any "cosmetic" crown/filling etc, will endure an upcharge to cover costs from the lab to make it.

You pay a contracted rate from your insurance. Usually the best coverage from a DMO insurance will be that of the most basic of procedures. In this case, a 2740 is a Porc Fuse to Metal. Meaning there is metal on the inside and porc on the outside.

A DMO insurance will only pay for the metal at a fair rate.

However, the Dentist will need to upcharge an alt benefit charge for the porc "cosmetic" to offset the costs from the lab, or they just don't make any money for it if they don't do it otherwise.

You want to get this type of procedure at a low fee, then get a PPO insurance that will cover it at the 80% mark. Be prepared for a premium pays out of your checks or monthly if you're paying for it.

Guest

anonymous...

I have had Great ( NOT SO GREAT ) Expressions for 15+years and yes you are all right....they will try and charge you for everything and anything they can get away with!! Their own dental hygienist told me under her breath " They do not want to replace your old crown because you are a "DHMO" patient!

and they only get $45. for your co-pay! Is this not Fraud! are they not in Breach of Contract???

I am so tempted to get a metal Bridge just so they have to do it for $45 per unit for the cost of my co-pay!!

and they get nothing else but $135. for a 3 unit bridge....

Guest
reply icon Replying to comment of Guest-1238394

Maybe you shouldn't listen to what a Hygienist has to say in place of the Dr. Hygienist's have nothing to do with those types of procedures.

I don't know what your situation is, but most insurances won't replace a crown until a 5 year sometimes more frequency has been met. If you have had it done within a year, most dentist's will guarantee their work and fix it at no cost, UNLESS you did something silly to break it, then you incur the costs.

Guest

Yep I almost got suckered into that also thanks for heads up. I was told by insurance its a metal not covered.

So dentist thought they were going to get an extra 1600 for my crowns. I think not.

Guest
reply icon Replying to comment of Guest-1139190

So did you go with the all metal that your *** insurance would cover other than the one that looks like the rest of your teeth? What did you do?

Guest

Great Expressions is notorious for using bogus codes to jack up prices on all of their dental work. They also tell every patient they need deep cleanings (most do not).

A crown is one code no matter what dentist you go to, regardless of the material used. There is one code for a metal crown, a different code for a porcelain fused to metal crown and a different code for an all-porcelain crown. // To the person in McDonough... a single crown should not cost $3300 without insurance.

Anywhere. I am a dentist.

In this part of town, crowns average $1000-****, depending on the material.

Guest

If you have a DMO your only two options is to go to the dentist on the insurance or pay 100% out of pocket. Great Expressions is the only choice within 50 miles of my home for my Aetna DMO.

I too was charged $400 for specialty crown alt benefit. I was also charge for code 02740 Crown/Porc/ceramic substrate. The actual cost of this is $1328 with my insurance contracted cost being $420. Insurance is paying $154 and I am paying $265.

Prefabricated post and core is costing me another $78.60. My insurance pays for the resin-anterior surface and final restoration. This makes my out of pocket cost after insurance for one tooth being crowned - $743.60.

The actual usual cost for someone without insurance at Great Expressions is $3300.

Guest

First of all, your dental policy is ***. No dentist can do a crown and buildup for these fees.

You would be lucky to find it for under $1000.

Any policy which requires you to go to a corporate chain clinic is a piece of *** policy.

By the way, I am a dentist. There is nothing wrong with all metal crowns on molar teeth.

Gold crowns are the most long-lasting restorations that money can buy.

Anyone who thinks they can get good dentistry from a corporate chain clinic is just delusional. Next time, select a professional based on honesty and competence, rather than being on some insurance company list..

Guest
reply icon Replying to comment of Guest-779708

You're a dentist? What's the name of your practice, so I'll know where not to go?

I did a quick Google search, because I knew that #10103 was not a procedure code. The treatment coordinator tried to come up with an explanation, yet fell short. I visited the Stockbridge location as well. I also was told that I needed 'localize' treatment that would cost over $500.

According to the Fee Schedule such a procedure is $50.00

Henrius, thinking that good dentistry can be obtained by visiting a chain clinic, doesn't make one delusional. People just may not know. You can't select a dentist based on 'honesty.' How would you know if a dentist or anybody for that matter is honesty during your first encounter? My policy reads $45 for the core buildup and $280 for the D2740.

Also there are some stand alone practices on the list.

He or she just needs to look. Good luck

Guest
reply icon Replying to comment of Guest-862994

All of your comments have been so helpful ! I too go to Great Expressions in South Florida, and came across the $400 1****/fee.

After these crowns, I am done with them - I agree they jack up prices, they are dishonest about needing deep cleanings etc., I believe the more we responsibly post, the better for those behind us.

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