Is this common practice?

Miss Lee

Miss Lee

Cathlete
My husband's employer just switched dental plans on us and my dentist does not accept this particular insurance. I've been going to this dentist for 15 years and I love him. I have oral lichen planus so I'm obsessive compulsive about oral hygiene and never miss an appointment.

Through tears and sorrow, I called my dentist and explained my situation. I asked if they would please recommend a general dentist and they would not! What's up with that!? I even waited a couple of days and called back hoping to get someone else. I did, but she wouldn't refer me either. She just said that they "really can't do that". I think that's bizarre. Is that a common practice among dentists--that they refuse to refer to other dentists? WTH!

Michele
 
Are you able to pay out of pocket to the dentist and then submit it to the insurance company? I know it's a hassel but you can at least see the same person you have been. That stinks that they wouldn't refer someone else.

Jeanette
 
No, Jeanette. Unfortunately this insurance plan will not pay out of plan providers. The last insurance we had would cover you up to a certain amount. It really does suck, doesn't it :-(

Michele
 
:7 :7 :7 :7 :7 :7 :7 :7 :7 :7 :7 :7 :7

That IS funny--or that the ones I have don't fall out!

Michele
 
Maybe your plan can suggest a new doctor. I know that they do this on the medical side, so I'm just thinking they would do this for dental as well.
 
Yeah, that is pretty common. If your dental plan does not cover out of network, the only thing you can do is

1. Continue going to your dentist and pay 100% out of pocket.
2. Find a new dentist......he must be PPO under your dental plan. You need to look that up online or in a PPO provider booklet (preferably online since the booklets are oftentimes outdated).

I can't believe the insurance doesn't cover out of network at a lesser percentage. That is usually how it works. Your dentist doesn't want to recommend another dentist because he wants to make $$$ of you. That is pretty crappy of him if you have been going to him forever, but oh well. Besides, even if he recommends someone that he really likes that doesn't mean that that dentist will be in network for you either. You need to venture out on your own or get a list and just ask you dentist if he knows any of them.

Maybe you can just pay out of pocket. How many times per year do you go to the dentist anyway??? I need like a kazillion crowns so I get it, but if you are not having major work done....

Good Luck, insurance is a bi%$#!
 
Unfortunately it is common. My husband's company changes both medical and dental insurance every January 1. I'm always having to change doctors and dentists. I'm concerned this year since I'm pregnant and due in a few months.
Susan C.M.
 
I feel for you Susan. It's the same with us but this is thefirst time I've had to change dentists. Our insurance in the past, both medical and dental, would cover some portion if you went out of the network. That's whats so aggravating.

Susan, I hope you find another doctor that you love. I'd hate it if I had to switch mid-pregnancy.

Michele
 
Michele,

I'm a dental hygienist in Illinois and I've never heard of this. I assume it is something that is just office policy. The DDS I work for will go out of his way to find a reputable dentist for transferring patients to see. It could be that your current DDS is just not that familiar with the dentists in your PPO plan and doesn't want to make a blind referral.

Good luck with everything,
 
Since your dentist is probably not used to making referrals to other practitioners who do the same work he does, it is understandable that he wouldn't have a name for you. But they should have told you that they just don't know anyone.

I know, I have the same issue with the plan changing every year for both medical and dental. It's very frustrating. Fortunately, my PPO stayed the same this year.
 
It sounds to me that your question refers to if it is common practice among dentists to refuse referrals, not the practice of changing plans, and thus, dentists. And the answer is "no", most dentists should understand your situation and be able to refer you. However, since yours will not, do as another post recommended and ask your new health provider for a list. Also check with friends and co-workers.
 
Thanks everyone for your replies and suggestions. My new plan does provide a list of dentists to choose from but it's kind of overwhelming. Now I just need to get on the phone and start calling around. Sur wish my old dentist would give a shout out about who he likes!

Michele
 
I know this is not exactly what you wanted, but this place might help.

http://www.1800dentist.com/

They do referrals in all areas. The dentist do have to pay to be on this "list", but they do have to go through a screening and have good customer feedback. It may be better than starting in the phonebook.

Hope this helps!

Valerie
 
Valerie,

Thank you so much. I'm going to call first thing Monday and see what I can come up with. :)

Michele
 
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