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  1. #11
    Join Date
    Jun 2006
    Location
    Massachusetts
    Posts
    24,076

    Default Re: Misleading Treatment

    The point I am trying to get at is that the dentist's disagreement does not necessarily make the doctor wrong. It is possible for two professionals to disagree. The doctor thinks the guard needs replacement - that is his opinion. The dentist thinks it doesn't - that is his opinion. It's not an all or nothing, black and white situation where only one person can be right and everyone who disagrees is wrong.

  2. #12

    Default Re: Misleading Treatment

    I hear you. The combination of the two things made it feel like an upsell. I'm not known for being paranoid lol but maybe that's the case here.

  3. #13
    Join Date
    Jan 2010
    Location
    New Jersey
    Posts
    3,627

    Default Re: Misleading Treatment

    The only way to tell if the doctor is right is to pay for the guard and use it. If your headaches go away in a short enough time, it worked, if not then it didn't. Than you can tell your doctor thanks for putting you $900 in a hole and that you will never use their service again.
    I'm not a lawyer, but I did stay at a Holiday Inn Express last night.......

  4. #14
    Join Date
    Nov 2013
    Posts
    6,427

    Default Re: Doctor Recommended an Oral Appliance That Was Not Needed

    Quote Quoting MIVGTI
    View Post
    I have since received a bill for the new one for $900 after insurance.
    What did your insurance cover for the new guard? Did you get an EOB from your insurance company? Did you ever ask the Dr. what the cost would be before signing?

    Have you tried to submit the remainder of the claim to a secondary insurer. Health insurance to pay for a bite guard is a stretch I think. What was the code for coverage that the Dr. used to submit the claim? Do you also have dental coverage perhaps through your employment?

    While I don't disagree with the contract issues (you signed and are responsible), I do think that this was a shady deal and I would be upset with the outcome. If the Dr. treats for headaches and asks you about a bite guard, this is not the first time he/she has given the same story to other patients that it will be covered by insurance. I would seriously wonder how many times patients have had to pay out-of-pocket. And thus, the Dr. would know that health insurance is not going to cover the cost. At $900 out-of-pocket, that guard had better be plated in gold. I think you were indeed ripped off and this is a cash cow for the Dr.

    I also think that the DDS would know more about whether or not the guard needed replacement than would the Dr. The Dr. might know that tensing your jaw muscles or grinding your teeth while sleeping may contribute to your headaches, the DDS would know if your bite changed since the guard was made and if it needed replacement. Did the Dr. ever inspect the guard or how it fit? I doubt it.

  5. #15
    Join Date
    Jun 2006
    Location
    Massachusetts
    Posts
    24,076

    Default Re: Misleading Treatment

    Quote Quoting Who'sThatGuy
    View Post
    The only way to tell if the doctor is right is to pay for the guard and use it. If your headaches go away in a short enough time, it worked, if not then it didn't. Than you can tell your doctor thanks for putting you $900 in a hole and that you will never use their service again.
    And that doesn't tell 100% either because, as indicated, medicine is not an exact science and and what works on one person doesn't necessarily work on another. All any medical professional, be they a doctor, dentist, nurse, PA, or other, can do is use their best judgement on the available facts.

  6. #16
    Join Date
    Nov 2013
    Posts
    6,427

    Default Re: Misleading Treatment

    Quote Quoting cbg
    View Post
    And that doesn't tell 100% either because, as indicated, medicine is not an exact science and and what works on one person doesn't necessarily work on another. All any medical professional, be they a doctor, dentist, nurse, PA, or other, can do is use their best judgement on the available facts.
    Or they can lie to patients to generate revenue where the patient's health is not impacted.

  7. #17
    Join Date
    Jun 2006
    Location
    Massachusetts
    Posts
    24,076

    Default Re: Misleading Treatment

    Sure, it could happen. But there's no way to prove it 100% either way.

  8. #18
    Join Date
    Aug 2013
    Posts
    284

    Default Re: Misleading Treatment

    When you have a hammer, the world looks like a nail. "Professionals" are pre-disposed to give answers related to their specialty. And (NOT an expert) I have heard that headaches are notoriously hard to diagnosis for cause. Many doctors use increasing doses of powerful pain medication like OxiCotin. Works great. For a while. You could have several broken arms and feel no pain. For a while.

    Past that, what every one else said. Call your insurance companies PRIOR to signing for what at best was a Hail Mary procedure. It is worth giving them a call still, just not as useful. I have never used one but I am told that there are Omnibus persons for plans like Medicare that can give good advice and sometimes help negotiate the maze.

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