Dr Barbara Neilson - Dental Insurance Review

I chose a new dentist, Dr. Barbara Neilson, from the list of available dentists on my company dental plan site. I pay extra for really good coverage. I chose Dr. Barbara Neilson. It took a half hour wait to get to a room that first appointment. Then I just sat in a chair a long time. Someone took a lot of X-rays. Then someone looked in my mouth and said I'd have to come back for a consult for "severe gum disease". Why do I have to come back? Isn't a consult why I'm here? No clear answer on that. I just have to come back for a consult and X-rays. Didn't we just do at least 6 X-rays? Why do I have to come back for X-rays? No clear answer. They also tell me I have an infection. I ask shouldn't we do something about the infection? No one can answer that and I'm again told to come back. So I come back a few days later and they do 5 more X-rays and then a woman comes in and talks to me for 1/2 hour about gum disease. I already know all this, and it's beginning to feel like a time share sales tactic. They tell me I'm done now and I have to come back. What about all the decay and infection. No one answers me. At the desk they hand me a form to sign stating that I agree to pay them over $500 for a deep cleaning, "irrigation" and fluoride. What about the infection? We can't do anything about the infection until you get this treatment. What the *** is an "irrigation"? Why is it costing me 100's? Also, my insurance covers 80%. And cleanings are covered 100%. How do you get a bill of over $500? And what about the infection? They won't even talk about the infection until I sign an agreement to this creatively billed "cleaning". I called my insurance company and got the story on Dr. Barbara Neilson and other dentists like her in Pennsylvania. They're fleecing those of us who carry "commercial" dental insurance through our employers. Here's how it works: your dental insurance pays (if it's like mine) about 80% of the cost of a cleaning, and the dentist cannot charge you more than a rate agreed to when they signed a contract with your insurance company. A dentist like Dr. Neilson will decide that your gum disease is so advanced that you need the more expensive "deep cleaning", also covered by insurance. And here's where it gets interesting and even more profitable for Dr. Neilson and her ilk: there's a code that dentists in Pennsylvsnis are allowed by the State to use. The code is for "irrigation", which is spraying water around your teeth to clear away debris after scraping. Because most insurance plans won't cover this "spraying away debris", dentists can charge whatever they please for it. Dr. Nelson charges you in excess of $200 to spray water around your teeth after scraping. They'll also tell you you need two fluoride treatments (not covered for adults) also at vastly inflated prices (since the insurance company can't cap the fees). The dentist office will hide all this in a bundled bill. The desk staff will also be glad to tell you how evil your insurance company is and that they don't cover the things you really need. This is a SCAM of the highest order. What I really need is an infection treated but Dr. Neilson will force me to wait until I'm able to save several 100 dollars for her assistant to spray water in my mouth. Think I'm exaggerating? 100% true. And Dr. Neilson isn't alone. If you bother with dental insurance, and still can't get basic dental care, it's scammers like Dr. Barbara Neilspn who are to blame. Be really careful what you agree to with a PA dentist. Review their charges with your insurance company before you sign anything or accept any care.
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I want to clarify this because I understand the scam better now. Spraying water in your mouth is something dentist have to do anyway when they clean your teeth.

Pennsylvania and some other states allow dentists a billing code for the water spraying. Insurance companies won't allow themselves to be billed for water spraying because it's a ridiculous charge, like doctors billing for washing their hands before they treat you would be. This plays right into the scamming hands of certain dentists quite beautifully. Since insurance companies won't cover it as a procedure, dentists are allowed to charge you whatever they want for it (since the monetary charges can't be controlled by insurance companies, but pennsylvania says dentists can charge you using this code.

So these dentists bundle it up in your bill so hopefully you won't ask questions, and, if you do they'll claim it's a necessary procedure to "treat your infection" that your evil insurance company won't cover.

They may even tell you to blame Obama care while rolling their eyes.


I called Dr. Neilson and said I don't have $500 and cant we just do the cleaning that's covered by my insurance (if we MUST do a cleaning before she'll treat the infection).

I said they don't have to spray water in my mouth- I'll be glad to rinse as needed as they clean. I also said I'll buy my own fluoride rinse ($6.00 at Rite Aide) to do my own fluoride treatment. When I said all this, boy did they really stop making any sense. They said I had to have the irrigation in all four corners of my mouth to treat the infection- at $50 per corner.

I asked what was in the irrigation that treats infection and they had no answer. And, I asked if I only have infection in one tooth, why do they have to irrigate four corners of my mouth, if it's to treat infection? They had no answer for this either. They said if I don't agree to this hugely expensive irrigation any real treatment they do to my infection won't last, and they refuse to treat the infection unless I pay $500 for the cleaning.

But the cleaning is covered by insurance. So I really shouldn't have to pay so much. This is really all about this code that Pennsylvania let's dentists use to charge you $100's for spraying water in your mouth.

and the dentist can refuse to treat the massive infection in your mouth until you agree to these insane fees. Pennsylvania allows this.

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#543147 Review #543147 is a subjective opinion of poster.

Dental Plan Review

Dentists and creative billing practices in Pennsylvania. Got a good dental plan? This is how you're getting scammed.
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#543090 Review #543090 is a subjective opinion of poster.

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