Daryl Austin writes for Kaiser Health News about dental fraud. Yes, dentists sometimes identify problems with your teeth in order to be able to perform services that are in fact unnecessary. It’s a way to generate revenue off of trusting patients. How can you protect yourself?
One dentist described how he was fired from his practice back in the 1990s because he told a patient that she did not need a porcelain cap on a tooth that another dentist in his practice had said was needed. Dental care fraud continues to this day.
Because Medicare does not cover dental services and Medicare Advantage plans generally only cover a small piece of the cost, older adults and people with disabilities tend to have to pay for dental services completely or, almost completely, out of pocket. Prices can vary tremendously, so it’s smart to shop around. And, if a dentist recommends a costly service, get a second opinion before getting the service to make sure it is really necessary.
Health care fraud is estimated to be quite common. As much as 10 percent of all health care spending could be for fraudulent claims according to a study by the National Health Care Anti-Fraud Association. Why is health care fraud so prevalent with dental care?
In the dental space, dental practices are being bought by big corporations and private equity firms. They care about maximizing profits. To that end, they might encourage dentists to perform costly procedures that might be unnecessary. Their dentists can follow their directions or fear being fired.
One unnecessary expensive dental treatment to avoid in most cases is quadrant. It could help you if you have severe gum disease. But, it can also wear away your gum tissue, and your gum tissue will not come back. In other cases, dentists recommend crowns when all a patient needs is a filling. Or, dentists might suggest a mini-implant, which has a high failure rate. A regular implant generally is what is needed.
Before going along with your dentist’s recommended treatment, ask about your alternatives. And, find out what your costs will be.
Here’s more from Just Care: