pricing with dentist

mickman

hi there

my g/friend is getting braces. the braces guy told her she needs one filling and gave her the xray etc. she then went to a dentist to get the job done. she is just gone 25. the dentist charged her 25 euro for another xray and 40 euro for a consultation fee and told her come back next week for the filling and will charge for that also. the receptionist said that once you turn 25 you might not be covered by PRSI etc and in the interim while she is finding out my gf has to pay the charges etc. this dosent sound right to me

1. shouldnt the dentist only bill her after finding out the PRSI answer
2. do they charge "consultation fees"
3. should he have done another xray when she already had one

thanks for any help

DaveTwenty7

1. Most dentists will check a patient’s PRSI eligibility as a courtesy but ultimately it lies with the patient to find out.
2. A consultation fee/ examination fee would be common practice if the patient is not covered by PRSI or Med card, (these schemes will cover one annual examination if your eligible)
3.Depends on the type of x-ray taken and what information was needed. A repeat of the same radiograph would possibly be difficult to justify but it would depend on if enough information was present in the original.

davo10

Mickman, the orthodontist most likely took an OPG xray, this is a wide xray of the jaws which is excellent for showing positions of teeth and bone levels, it is not accurate enough for showing caries in teeth unless the cavity is extensive. A periapical xray is smaller, more accurate and shows more detail of an individual tooth, hense the reason why the dentist took it prior to filling tooth. The decay showing on the OPG may have been a shadow/artifact and your girlfriend may have had an un-necessary filling had the dentist not confirmed it with the smaller xray.

Regarding PRSI, your gfriend had the consultation so of course it is right that a fee is charged. In a lot of cases the dept of social welfare does not approve PRSI treatment so dentist would then have to chase patient's for fees if they were not paid on the day of consultation. It is ultimately the patient's responcibility to find out if they are qualified for treatment. Approvals by Social welfare office can take anything from 2 weeks to 6 months so why should dentist have to wait this long to be paid for a service they have already provided.

mickman

but she is a teacher and has been covered by PRSI before for everything. why shouldnt she be covered now

also i have found out on welfare.ie that a dentist cannot charge more than 33 euro for a consultation. this fee will be covered by PRSI. they cannot charge more than 18 euro for an xray, this will also be covered by PRSI. if they charge more than that and look for top up money then you report them to welfare. i have seen many articles that dentists are being investigated for over charging

two yrs ago i got my teeth cleaned and was covered by PRSI. the dentist also decided to charge me 25 euro on top of it. if i had known then what i know now i would tell him go whistle for it

davo10

I'm afraid you are wrong on both counts. Until it is shown that your girlfriend is covered by PRSI, she is a private patient and the dentist can charge a private fee, however much that may be. If the x ray is taken as part of a prsi once yearly examination, then you do not have to pay. On the other hand if you attend with a problem and an xray must be taken as part of investigation and diagnosis, you also may be charged a private fee. There is no restriction by Dept of social welfare nor any other state body on what can be charged for a private visit and until your girlfriend is approved for PRSI treatment, that is exactly what she will recieve. It is not the dentist who decides whether your gfriend is qualified for PRSI treatment, it is the Dept of Social welfare so it makes no difference what her profession is nor her past eligibility, again I would advise you to ring the treatment benefit section in Letterkenny and check her status.
Incidently, she could have waited until approval was recieved for treatment from Dept of social welfare, this may have taken 6 months and ortho would have had to be put on hold, you can't have it both ways.

The 33euro figure you saw on welfare.ie is what the dentist is paid once yearly by dept of SW for your check up, it has nothing to do with what is charged for private treatment nor what you would be charged if you are a PRSI patient and want a second checkup within a twelve month period.