Often Dr Timmerman is asked about insurance coverage. While we strive diligently to help, often the insurance company does little to help. This is a good article to keep in mind, although from a medical insurance perspective.
In dentistry, there is no such thing as a pre-authorization. The paperwork is called a pre-determination, but it is not a guarantee of payment. It is not unusual for something to be determined at full coverage, but when the files are submitted, payment is only partial, instead of full. Be aware of this!
Preauthorization impacts care: Survey
Policies that require physicians to ask permission from a patient’s insurance company before performing a treatment negatively impact patient care, according to results of a survey by the American Medical Association.
The results showed 78% of physicians saying insurers use preauthorization requirements for an unreasonable list of tests, procedures and drugs.
More than one-third (37%) of physicians experience a 1 in 5 rejection rate from insurers on first-time preauthorization requests for tests and procedures, and 57% of physicians experience a 1 in 5 percent rejection rate from insurers on first-time preauthorization requests for drugs.
Nearly half (46%) of physicians experience difficulty obtaining approval from insurers on a quarter or more of preauthorization requests for tests and procedures and 58% of physicians experience difficulty obtaining approval from insurers on a quarter or more of preauthorization requests for drugs.
You get what you pay for. While I sometimes will get patients that say they can get the same product or service elsewhere for less, often out of the country, the reality is that they are NOT getting the same thing.
Recently Dr Oz blogged about dental care, from fighting cavities to whitening teeth. He was close, but NOT correct.
Just like getting stock tips from your waitress, be careful about dental advice from anyone NOT a dentist. WHERE you get your information DOES matter. I feel it is MY obligation to set things straight.
His main point seems to be that anything that stimulates salivary flow is enough to rinse plaque and fight decay. Really? Brush and floss. There is NO substitute. Add professional cleanings 2-4 times per year. There isn’t a magic replacement, nothing in a bottle.
He also suggests raisins will do the trick is wrong too. New studies show that they may affect strep mutans, the bacteria that cause decay. However, raisins are a sticky sugar, so while he says the stimulation of the salivary flow will help, sticky sugars… well… stick! Increased salivary flow won’t help enough. By this reasoning, sticky coconut rice with palm sugar and mango would help too. Plaque with sticky sugars makes holes (cavities). Bacteria in plaque feed on the sugars (fementable carbohydrates) and secrete acid as a byproduct. Brushing and flossing is how to fight them.
If you chewed gummi bears all day long, you wouldn’t be fighting decay. At all. Even WITH the increased salivary flow.
The more disturbing advice is his method to whiten teeth. A slurry of lemon juice and baking soda. Acid mixed with abrasive base. For those that missed high school chemistry, pH concentration ranges from 0-14. Neutral is 7 (water), closer to zero is acidic and closer to 14 is alkaline (or basic). Coca cola has a pH of around 2, as does Gatorade… and lemon juice. Acid from plaque is how we get cavities, so generally speaking, “Acid is bad.”
Baking soda is alkaline, or a base, so it will neutralize acid if enough is used. So while you are trying to use an acid, those very properties may not be what you are hoping for. What is worse is that the soda is abrasive. The abrasives will remove plaque, but also enamel, especially if the enamel has been softened from acid.
Gritty toothpaste in the dental office is abrasive as well. However, this is only used 2 times per year on average, not enough to be a concern. Daily use would be a different story.
Whitening is dependant on 3 factors when using a bleaching agent (usually a peroxide gel): concentration (8%? 22%?), frequency (daily? once?) and duration (one hour? 8 hours while sleeping?). There are no shortcuts.
Dr Oz is clearly an educated man. He is very smart and has received an awful lot of training. But just being smart isn’t enough to validate every piece of advice given. While he is smart, I would not want him designing a commercial jet. He just isn’t trained in that field.
While I AM a doctor, I would never give advice outside of my field of expertise. I will advise people in regards to oral health, but I would never speculate on how you should care for your colon.
Quite often, the costs for dental care are beyond what a person has “saved for a rainy day”. Instead of simply writing a check, payment plans are needed.
Dental offices acting like a bank are less common than in the past. Most well run dental offices operate like any other business, and let the professional lenders lend the money. This allows the dental office the ability to simply focus on the patient’s health and not their pocketbook!
Dr Timmerman works with several lenders, so if one declines, another may accept. Call 206-241-5533 to learn how we can fit ANY dental care into ANY budget!
Tukwila Dentist Dr Lance Timmerman DMD is a general dentist. While he is known worldwide for his skills in cosmetic dentistry, most of his time is spent doing regular general dentistry.
From composite white fillings to extractions, from dental implant placement to dental implant restorations, Dr Timmerman can help.
If you are looking for a dentist for ALL of your needs, Dr Lance Timmerman is worth a call at 206-241-5533 TODAY!
The dental clinic in Tukwila managed by Dr Lance Timmerman DMD is focused on patient comfort. The general dental practice, while skilled in cosmetic dentistry and dental implants, is primarily a family dental office.
Conveniently located in Tukwila behind the Family Fun Center and adjacent to the Starfire Soccer Complex, the office is very easy to get to. Immediately after exiting the Interstate 405 offramp on exit 1, the parking lot for the building is across the street.
If you would like a dental office that is so easy to get to that you can take care of your dental work during a lunch break and not miss work time, call 206-241-5533!
This may become a permanent link on the site, but this article should be well understood. Dr Timmerman often sees people that have sought to save money by leaving the country, only to have work done that had unnecessary risks involved. Poor sterilization, inferior skills and simply poor results are not uncommon.
Why you should be wary of going to a foreign dentist in search of that Bollywood smile
By Tariq Idris
Last updated at 12:39 AM on 6th June 2010
My first patient of the day was a middle- aged woman whose face was totally misshapen. She had been on holiday to India to have dental implants. The procedure had gone wrong but her fears had been dismissed despite the pain.
On her return, she had been admitted to Manchester’s Royal Infirmary where doctors confirmed she was suffering from a blood infection.
Her implants had to be removed, as did some of the jaw bone, and she was warned that should she ever want implants again she would need a bone graft.
The poor woman could not face any more expensive procedures and I had to fit her with false teeth.
Shining example: Actress Davinia Taylor shows off her home-grown smile with Tariq Idris
Her story is a stark warning of the dangers that patients face when they travel abroad for what they believe is a bargain.
Unfortunately she is not the first such case I have seen - nor is she likely to be the last. That is why I want to warn patients about the risks involved. Weigh up everything before undergoing treatment abroad.
I invite anyone planning to go abroad for expensive treatments such as implants, crowns or veneers to get a second opinion from me.
I have worked in the industry for 15 years and my patients have included former Hollyoaks actress Davinia Taylor, singer Charlotte Church and England footballer Steven Gerrard.
I am happy to assess whether patients’ treatment plans are correct and whether they could save money by staying in this country. They can even scan in X-rays and send reports online.
But why the sudden desire to go abroad? Let me explain.
Since the new contract for NHS dentists was introduced in 2006, people are finding it harder to locate an NHS dentist: only 26.9 million people - about half the population - saw a dentist in the two years following the reforms, a drop of 1.2 million from the two previous years.
Dentists are no longer paid different fees for each treatment. They get lump sums instead, meaning they find it less cost-effective to carry out difficult, time-consuming procedures.
Recent statistics have revealed that the number of treatments such as crowns, bridges and dentures has plummeted by 57 per cent since the system was introduced.
Meanwhile, the number of patients having teeth extracted in hospital has risen by a third from 135,000 in 2003/4 to 175,000 between 2007/8.
How awful is that in 21st Century Britain? There is also a rise in the number having implants - artificial titanium tooth roots - inserted into the gums to support crowns, bridges and dentures.
There has been a culture shift away from dentures. People are keen to look and feel younger and more attractive. Even 20 years ago, a pensioner might have accepted that they would end up wearing dentures; nowadays that’s something most try to resist.
However, implants are expensive. We have 28 teeth, excluding wisdoms, and costs can vary from £2,000 to £2,500 a tooth. I have seen treatment plans in this country approaching £100,000.
But that is because about half of all patients wanting implants need bone augmentation. In the most severe cases, bone is removed from the hip and implanted in the jaw.
And that is why many people go abroad. They do not want dentures and fear the costs in this country will be prohibitive. Yet often the service abroad is no cheaper.
Foreign clinics may market an implant in basic terms as costing about £400 to £500. But that is not the whole picture.
Firstly, that price does not include the tooth or any bone graft - just the screw.
Secondly, patients often do not actually need the number of implants or the grafting for which they have been quoted. Thanks to modern science and research, we now know that you do not need 14 implants to replace a top jaw - but a smaller number of pegs with a bridge between them.
You might need only six implants to support a whole jaw and sometimes you can get away with as few as four.
People may be persuaded to have teeth extracted unnecessarily and more implants than they need, both of which push up the cost. They are often told they need bone grafting when they may not necessarily.
A handful of patients I have already given a second opinion to have said: ‘Wow. I don’t need a bone graft? Forget the money. This is saving me from going through a pretty horrendous operation.’
The Hollywood smile is a combination of veneers, crowns and bridges, for which you can pay anywhere between £8,000 and £20,000.
But often the treatments recommended abroad are not appropriate, for example if the patient has a gum problem. Dentists here would not advise veneers or crowns until that was fixed. Otherwise the patient would end up with more problems and could even lose all their teeth.
There is also a potentially serious problem if the veneer is not fitted properly - it will not look good and could trap plaque and cause gum inflammation. And if the tooth is not drilled correctly there is a real risk of damaging the nerve.
Then you have the costs of booking a flight, taking time off work and dealing with any problems on your return.
The key thing to remember is that whether you plump for Eastern Europe or Asia, you are not covered by British regulations.
Here we have a system where you can go back to your dentist, which is regulated by a governing body, or complain to the Parliamentary and Health Service Ombudsman.
And, ironically, about half the patients I have seen who have had procedures abroad would have paid the same, or even less, in the UK.
Recently, a new patient asked about our view on mercury fillings and tooth colored fillings. It seems, even TODAY, that dentists are telling patients that mercury fillings last longer than tooth colored ones, yet most dentists would not place them in their family’s mouths.
The reality is, whether you agree that mercury fillings are poisonous or not, amalgam fillings break teeth. Well placed bonded fillings last longer, as they are more conservative and are sealed into place.
If you feel that your dentist is practicing to a standard of 30 years ago, perhaps you should call Dr Timmerman and see what your options are. 206-241-5533. Mention “Google” and your exam is FREE!
Dr Lance Timmerman of Tukwila, WA has added OraVerse® to his practice. This helps reduce the amount of time that you are numb, so you can get back to your normal life !
If you are like most people, you HATE that numb feeling. With OraVerse® you only have to endure it for half the time.
My daughter had her tonsils removed earlier today. While this is a nerve wracking experience for a parent, it was made worse by the wait. While we were told to be there at 8:30, they didn’t start until after noon. Three and a half hours later…!
My 7 year old had been obedient and did not eat since the prior evening. At this point, she was VERY hungry. Even when they decided to start, they waited. She was given some Versed to make her groggy and to forget when she had the IV started. But by the time the doctor finally came in, the Versed had started to wear off…
All in all, everything went well. She is recovering just fine and seems almost like the normal bubbly child that I love dearly.
But this got me to thinking. I am VERY proud that we see our patients on time. EVERY time. If there is a reservation with us at 9:30, we see you at 9:30! On a bad day, it might be 9:35…
We do this by reserving enough time to allow for the unforseen. This means most appointments are scheduled LONGER than needed, and we DON’T see more than one person at a time.
This DOES create a certain amount of responsiblility on our patients. If we reserved time at 9:30, that doesn’t mean come at 9:45 or 10:00. If you come late, we may need to reschedule and charge a no show fee, or we don’t get as much done as planned. We DON’T go long and affect the person at 10:30, since THEY deserve our time as reserved. We respect YOUR time, so you need to respect OURS.
If you are looking for an office that runs on time and often is done earlier than planned, call 206-241-5533 and see what we can do for YOU…!
