Cost of dental procedure doesn't match pricelist

OSI

A couple of weeks ago my wife went to a well known dental chain suffering with pretty severe pain. When she arrived she was examined and was told she had an infection resulting from a semi-erupted wisdom tooth and that it would have to be removed as a surgical extraction. This was agreed to and the procedure done. After all was said and done she went back to reception fairly disorientated and paid the receptionist.

After reviewing the invoice she received though I noted that the price paid does not match with the prices quoted on the dental chains price list. A price list they state is provided so you know exactly what you are paying. It is provided both online and in clinic. After querying this with them though they first stated that the procedure was different to what was listed and was actually a different price. But this other procedure doesn't match either. i.e. procedure A is quoted as between 170 and 240, and procedure B is listed at 390, but she was charged 350. After returning to them with this to refute their claim, they are now suggesting that it is up to the dentist on the day to set his own price.

Surely if they provide a pricelist that states it is supplied such that "you know exactly what you are going to pay" they must adhere to it? Is there not an element of deception to charge a disorientated patient a different price without taking the time to ensure they knew this would be the case?

OSI

OSI wrote: »

A couple of weeks ago my wife went to a well known dental chain suffering with pretty severe pain. When she arrived she was examined and was told she had an infection resulting from a semi-erupted wisdom tooth and that it would have to be removed as a surgical extraction. This was agreed to and the procedure done. After all was said and done she went back to reception fairly disorientated and paid the receptionist.

After reviewing the invoice she received though I noted that the price paid does not match with the prices quoted on the dental chains price list. A price list they state is provided so you know exactly what you are paying. It is provided both online and in clinic. After querying this with them though they first stated that the procedure was different to what was listed and was actually a different price. But this other procedure doesn't match either. i.e. procedure A is quoted as between 170 and 240, and procedure B is listed at 390, but she was charged 350. After returning to them with this to refute their claim, they are now suggesting that it is up to the dentist on the day to set his own price.

Surely if they provide a pricelist that states it is supplied such that "you know exactly what you are going to pay" they must adhere to it? Is there not an element of deception to charge a disorientated patient a different price without taking the time to ensure they knew this would be the case?

Price lists are often indicative, this was one of the problems pointed out to Mary Harney when she proposed legislation to make lists compulsory, the price may not exactly match the treatment necessary. The most obvious example of this was an exam, X-ray and scale & polish which dentists often had a set price for as a collective, the price of each individual item often added up to a lot more, so technically if you went by the price list, patients would be charged more.

In your wife’s case, this appears to be the difference between a third molar removal, and a surgical third molar removal by an oral surgeon, two different procedures, two different prices. Was your wife informed of the procedure before it was performed? She would most likely have to have consented to it after potential complications were explained. If she was given a verbal quote based on her particular treatment, this over rides the non specific price list on website/wall.

You know exactly what you are paying after the problem has been diagnosed and the treatment necessary discussed.

antix80

It's not just dentists that do this. Indicative prices are usually the minimum you'll be charged.

She's already paid and dont make excuses she was disoriented.. Trademens and professionals the world over pull the same stunt. Unforeseen extras. Things that weren't in the quote. Indicative prices. And you just pay it, then feel ripped off.

If you agree a fixed price, that's all you should pay. My dentist (up north) gives a quote and it's what i end up paying. If he asks me to return in 2 weeks for a followup, it's free. Down here they always add at least 10-15 euros more than i expect. It's not materials, it's not time.. It's just gouging and chancing their arm.

Now, I'm generalising.. There are bad habits in industries and also genuine cases where it's necessary to charge more. The best thing you can do is write a review of the experience on sites like google places and facebook

antix80

I wouldn't be happy, but once you pay you have little comeback.

OSI

OSI wrote: »

If a health professional suggests you don't drive after a procedure, it would suggest to me a certain level of mental impairment is expected, no?



But you arrive at the practice and are greeted by a price list that tells you it is not indicative:

Typically after a surgical extraction a patient has had quite a bit of anaesthetic and has undergone an invasive procedure, that is not to say they were impaired before the procedure when it was discussed.

Few dentists would undertake a surgical extraction, this would typically be done by an oral surgeon.

What was discussed with your wife before the procedure? Usually an OPT X-ray would be taken to assess proximity to the nerve underneath the wisdom tooth, and there would be a conversation about complications to obtain consent, this is when cost is usually discussed as the Clinician is able to assess the difficulty of the treatment and give a quotation. Was this done?

I should say, I do not wish to defend the Clinic, they should outline clearly what your treatment will cost, before it is done, but it is possible that this was discussed at the time, they should clarify this.

Edit: just looking at their price list, surgical extraction in the Oral Surgery section (surgical removal of impacted wisdom teeth is oral surgery), the list price is €390. It also says prices may vary nationwide, that pretty much means that they are not fixed.

antix80

antix80 wrote: »

It's not just dentists that do this. Indicative prices are usually the minimum you'll be charged.

She's already paid and dont make excuses she was disoriented.. Trademens and professionals the world over pull the same stunt. Unforeseen extras. Things that weren't in the quote. Indicative prices. And you just pay it, then feel ripped off.

If you agree a fixed price, that's all you should pay. My dentist (up north) gives a quote and it's what i end up paying. If he asks me to return in 2 weeks for a followup, it's free. Down here they always add at least 10-15 euros more than i expect. It's not materials, it's not time.. It's just gouging and chancing their arm.

Now, I'm generalising.. There are bad habits in industries and also genuine cases where it's necessary to charge more. The best thing you can do is write a review of the experience on sites like google places and facebook

When you asked what the €10-15 was for, what did they say?

You are correct though, unforeseen extras cost more in most services, if they could be foreseen, they would be quoted for.

There is no mystery as to why indicative charges are the minimum you will be charged for a service, that is the minimum price that the provider puts on it. If however it is more complex than the standard (an pertinent example of this is the topic of this thread, a wisdom tooth extraction is far more difficult and complicated than a premolar surgical extraction), would it not be reasonable to charge more?

antix80

Just from experience.. Fillings 70-95. My dentist will always charge 95, i think she even managed it when she had 90 listed as the upper end of the guide price. Now i see she's updated it to 100.
Prsi checkup - and a good opportunity to gain custom and goodwill. During the checkup and scale/polish, she'll start cleaning and say 'I'm just doing a quick clean".. And when I'm on the way out, the receptionist will say "just €15 for the clean" (60 seconds) - up from €7 the previous time.

So.. I started going over the border where I'm happier with the communication and service. As flawed as it is, but under-promise, over-deliver is better than "quote low, bill high". You'll get away with it once but lose credibility and custom if customers feel ripped off.

antix80

antix80 wrote: »

Just from experience.. Fillings 70-95. My dentist will always charge 95, i think she even managed it when she had 90 listed as the upper end of the guide price. Now i see she's updated it to 100.
Prsi checkup - and a good opportunity to gain custom and goodwill. During the checkup and scale/polish, she'll start cleaning and say 'I'm just doing a quick clean".. And when I'm on the way out, the receptionist will say "just €15 for the clean" (60 seconds) - up from €7 the previous time.

So.. I started going over the border where I'm happier with the communication and service. As flawed as it is, but under-promise, over-deliver is better than "quote low, bill high". You'll get away with it once but lose credibility and custom if customers feel ripped off.

Price ranges on fillings tend to vary depending on material (amalgam or composite, you are wrong about that) and surfaces (a filling on the biting surface only, costs less than one which extends into other surfaces because it takes longer and is more difficult when you have to fill proximal boxes, so you are wrong about that as well)

The €15 cost for PRSI is actually set by the Dept of SW, you can check their site if you want. It costs more than €15 if the dentist has to clean plaque from interproximal pockets.

So, from your post, the dentist is charging in the price range quoted for the filling, and what the PRSI states should be charged, but you think you are being overcharged by €10-15?

antix80

It's the max the can charge afaik.. But the charge wasn't clearly communicated prior to treatment. That's a problem.