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    bean213's Avatar
    bean213 Posts: 5, Reputation: 1
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    #1

    Apr 7, 2010, 09:11 AM
    I got a root canal and needed crown lengthening but got billed for a crown?
    I went to a new dentist for a horrible tooth ache. They took a full set of X-rays which is fine but I just needed them to look at the one tooth ASAP. I was told I needed a root canal, crown lengthening, and porcelien crown. I could not afford everything at once so I did the root canal the next day and had a temporary crown put it. I was told to come back for the crown lengthening. I new I couldn't afford it so I was going to wait it out and save up. I also got a 2nd opinion from another dentist who said I didn't need the surgery and they could just do build up and fit me for a crown.
    My problem is that now my insurance won't cover any of the crown from the 2nd dentist because the first dentist billed me for the crown already! Does that make sense? Why would a dentist have a crown made up if they knew they were going to do crown lengthening surgery? It was my understanding that I was going to do the root canal, then the surgery, then once that heals get the final crown. When I call to ask the original dentist the front desk lady talks to me like I'm an idiot.
    One last questions, could anyone explain to me the difference between a "crown porcelain-high noble metal" and "crown full cast noble metal" I saw those on my bill and I know one is the crown but what is the other?
    justcurious55's Avatar
    justcurious55 Posts: 4,360, Reputation: 790
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    #2

    Apr 7, 2010, 09:34 AM

    Aside from talking down to you, what did the lady at the first dentist office actually say? And I just want to make sure I'm understanding this right, the first dentist billed you for a crown you did not actually ever receive? Did you sign any sort of contract for all of the work the dentist told you that you needed?
    flossie's Avatar
    flossie Posts: 1,903, Reputation: 181
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    #3

    Apr 7, 2010, 09:39 AM

    Dental treatment is not to be billed until the treatment is completed. I would call the insurance company and tell them that you have NOT had a crown done and there is no crown in your mouth.

    The dentist who did all the treatment for you should have had you signed an "informed consent" form meaning that everything was explained to you and you agreed to the procedures and costs involved.

    I'm guessing the payment went directly to the dentist. Call the insurance company now. Your dentist sounds like he is committing fraud against the insurance company.
    bean213's Avatar
    bean213 Posts: 5, Reputation: 1
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    #4

    Apr 7, 2010, 09:48 AM

    The lady said the dentist already did most of the work and that is why I was billed. She didn't really explain anything. I asked her, if I still needed crown lengthening surgery then how can you say that most of the work was done? She just repeated herself and said that the crown was already made. She asked me why I would sign something I didn't understand. So I am assuming I did sign some sort of contract. I never received a copy of it. There are signs all over the office stating that they do not do contracts. Honestly, I was in a lot of pain the dentist had given me a percription for vicodin I wasn't really in a good state of mind. Maybe I didn't understand but I thought I did. My main question is, if I needed crown lengthening surgery does it make sense that the dentist would make a mold and have the final crown made before I got the surgery?
    flossie's Avatar
    flossie Posts: 1,903, Reputation: 181
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    #5

    Apr 7, 2010, 09:52 AM

    Crown prep and impressions would normally be done after the crown lengthening procedure.

    Contact your local dental licensing board. Ask them if there is anything they can do for you. It doesn't sound like the dentist is very ethical.
    bean213's Avatar
    bean213 Posts: 5, Reputation: 1
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    #6

    Apr 7, 2010, 09:52 AM
    Quote Originally Posted by flossie View Post
    Dental treatment is not to be billed until the treatment is completed. I would call the insurance company and tell them that you have NOT had a crown done and there is no crown in your mouth.

    The dentist who did all the treatment for you should have had you signed an "informed consent" form meaning that everything was explained to you and you agreed to the procedures and costs involved.

    I'm guessing the payment went directly to the dentist. Call the insurance company now. Your dentist sounds like he is committing fraud against the insurance company.

    Thanks flossie. If I did sign the "informed consent" thing does that mean I am obligated to go back to that dentist even though I had a bad experience? It seems like maybe I didn't understand what was explained to me or what I was signed and now I'm going to have to pay for it.
    Even if I signed that form the dentist never had a crown made and never put it in my mouth so my insurance should not have been billed right?
    bean213's Avatar
    bean213 Posts: 5, Reputation: 1
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    #7

    Apr 7, 2010, 09:53 AM

    Thanks so much for the advice. It's much appreciated. :)
    flossie's Avatar
    flossie Posts: 1,903, Reputation: 181
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    #8

    Apr 7, 2010, 09:55 AM

    I would think the insurance won't pay for a procedure until it is completely finished. Normally they want to see a copy of a lab bill also. Call the insurance company. There should be a toll free number on the back of your dental insurance card.
    bean213's Avatar
    bean213 Posts: 5, Reputation: 1
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    #9

    Apr 7, 2010, 10:55 AM

    You were right flossie. I spoke with my insurance and they said they would only pay once the crown was actually placed in my mouth. The investigationg will still take about a week. It sounds like everything should work out but you never know. *fingers crossed*
    KISS's Avatar
    KISS Posts: 12,510, Reputation: 839
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    #10

    Apr 7, 2010, 11:40 AM

    Something is weird here:

    Quote Originally Posted by OP
    I needed a root canal, crown lengthening, and porcelien crown. I could not afford everything at once so I did the root canal the next day and had a temporary crown put it
    If this is the first dentist, then something is very wrong. The root canal would not have required a temporary crown.

    Generally the root canal is performed and a few weeks later the tooth is shaped for the crown just to make sure there are no problems with the root canal.

    The crown casting is, I believe, the same casting for the temp and final crown.

    Many times the dentist submits a determination of benefits so you know your out of pocket costs.

    I needed a crown done and my dentist was going to do it. The peridontist said that crown lengthening was needed. The dentist didn't catch it right away. He said that he would have found out once he did the crown. I went to school with him in grade school.

    The peridontist is the BEST person to evaluate the need for crown lengthening.

    My opinion based on exerience.

    1. dentist should have done a predetermination of benefits
    2. Dentist should hve done root canal.
    3. A wait period should have started
    4. then crown prep and mold
    5. Temp crown placed
    6. Final crown fit tested and placed if OK.
    flossie's Avatar
    flossie Posts: 1,903, Reputation: 181
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    #11

    Apr 7, 2010, 12:05 PM

    Keep us posted bean. I hope everything turns out in your favour.

    KISS- some general dentists are very aware as to when crown lengthening is necessary and you are right, most want to be sure the root canal is OK and will wait up to 6months before starting the crown.

    It sounds to me like this DDS was a little greedy.

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