# Cost of Extraction via Dental Benefit Scheme



## InfoSeeker (28 Jun 2007)

I am getting a tooth extraction next week
My dentist does not want to do it and has referred me to an Oral Surgeon who is on the DSFA Panel.
So I called to confirm my appointment and also asked what the cost would be, receptionist said just bring your VHI Policy # and there would be no charge.
Now I have no dental care with my VHI, it is a medical health policy option only.
So there is no way I could be covered with this.
I went to the Oasis website and found at http://www.welfare.ie/publications/dental_sof.html
that the cost (I earn <55k p.a) would be 10 euros 15 cent per 15min up to a max of 45 min which is 30 euro 45 cents.

Has any other poster had a tooth extracted who earns less than 55K and has enough stamps for coverage?

If so is what I documented above accurate?


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## InfoSeeker (28 Jun 2007)

Actually having read what I posted I am pretty sure I have got one thing completely wrong.

Dentists can obviously charge what they want so if he charges 50 euro per 15 mins then 16 euro 10 cent is charged to me plus another 10 euro 15 cent per 15 mins


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## foxylady (28 Jun 2007)

InfoSeeker said:


> I am getting a tooth extraction next week
> My dentist does not want to do it and has referred me to an Oral Surgeon who is on the DSFA Panel.
> So I called to confirm my appointment and also asked what the cost would be, receptionist said just bring your VHI Policy # and there would be no charge.
> Now I have no dental care with my VHI, it is a medical health policy option only.
> ...


 
I recently went to a dentist to get a tooth pulled and they wanted to send me to an oral surgeon at an outrageous cost , i then went to a different dentist for a second opinion who pulled the tooth out there and then ata cost of 13 euro


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## InfoSeeker (28 Jun 2007)

I am totally confused but I have researched this.
I called the Oral Surgeon again and the receptionist again stated that all you needed was a VHI Policy #
I told her I had no dental cover under VHI, it was for medical health, and asked if she wanted to know my pps # to clarify that I qualify for dental benefit.
She said no, all she needed from me next week was my VHI Policy # and that there would be no charge.
Surely this is wrong but I got her name and to be honest I do not know what to do.
I will say it to the Oral Surgeon himself before the extraction to confirm....hope I do not annoy him though as he would have the last laugh


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## Megan (28 Jun 2007)

InfoSeeker said:


> I am totally confused but I have researched this.
> I called the Oral Surgeon again and the receptionist again stated that all you needed was a VHI Policy #
> I told her I had no dental cover under VHI, it was for medical health, and asked if she wanted to know my pps # to clarify that I qualify for dental benefit.
> She said no, all she needed from me next week was my VHI Policy # and that there would be no charge.
> ...


My daughter has an appointment with an Oral Surgeon in mid July as her dentist thinks she needs to have her wisdom teeth extracted. The appointment letter says there will be a charge of €100 on the day of appointment and a further €80 if she needs an xray. Her VHI will cover the extraction of her teeth but not the appointment. My daughter doesn't have pps cover.


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## InfoSeeker (28 Jun 2007)

Thanks for the reply Megan.
I am assuming that you have DeCare Dental Cover with VHI, it is documented at [broken link removed]

I do not have this, I just have Plan B cover


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## Megan (28 Jun 2007)

InfoSeeker said:


> Thanks for the reply Megan.
> I am assuming that you have DeCare Dental Cover with VHI, it is documented at [broken link removed]
> 
> I do not have this, I just have Plan B cover


No she doesn't have DeCare Dental Cover. She also has Plan B cover. As far as I know Plan B will cover the extraction of wisdom teeth. Her plan doesn't cover the €100 fee for her first appointment with the Oral Surgeon. She will be able to include this is her Annual Claim to VHI if she has to make one. 
I would doubt the info given to you by the receptionist.


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## InfoSeeker (29 Jun 2007)

I agree re the advice the receptionist gave but I did call twice and both times I spoke to the same woman.

Each time she was adamant that there would be no fee even though I told her my VHI did not have dental care.

Not sure who is paying for my tooth extraction but sure what else can I do?

All will be revealed on Mondau afternoon.


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## Megan (29 Jun 2007)

Good luck on Monday. Do let us know how you get on.


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## InfoSeeker (2 Jul 2007)

Megan -> Went to the dentist this afternoon and had the extraction.
There was no charge.
All I had to do was fill out a VHI Surgical Procedure form and sign it.
Perhaps this form of dental treatment is categorised as a surgical procedure and is then covered by medical health insurance
Regardless it went well, took 10 minutes, got a few stitches and was not charged.


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## ClubMan (2 Jul 2007)

Did the dentist confirm that you were not liable for charges or could they still invoice you for the amount or any balance that might not be reimbursed by _SW _or _VHI_?


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## InfoSeeker (2 Jul 2007)

I talked to the receptionist twice prior to appointment on the phone and she confirmed that there would be no cost.

Today I confirmed this with the receptionist and oral surgeon also and received the same answer, ie no cost once the form is completed.

I cannot work it out as I cannot see how I am covered but so far I am happy with the outcome


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## ClubMan (2 Jul 2007)

Did you ask _VHI _how you might be covered? 

If it was me then I'd be curious as to how I wasn't liable for some charge if I believed that I was not covered by _PRSI _or _VHI_. Otherwise I'd be wondering if I would receive an invoice at some point in the future.


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## Megan (2 Jul 2007)

Good to know all went well. As ClubMan says - maybe when the form goes into VHI there might be a shortfall that you might have to pay. As you check a number of times with the oral surgeon and staff and they say there is no charge I wouldn't worry about it as it is their problem if they are given out the wrong info.


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## InfoSeeker (3 Jul 2007)

Clubman -> I am very curious as this seems incorrect but I am happy so far that there is no charge.

I would agree that there could well be a charge but I have asked all the relevant people.

(1)I called the receptionist to confirm appointment and told her I have the stamps for PRSi, etc. 
She said all I need was a VHI Policy #. 
I told her I only had Medical Health Insurance with VHI (Plan B) and no dental cover.
She said it did not matter and that there was no charge......I agree that I cannot see the logic here

(2) Called VHI and gave policy # and confirmed my coverage.
They confirmed that I did not have dental coverage and would not be covered.

(3) Called same receptionist again and she said I was covered and there would be no charge.
Asked her by whom and she said VHI, I explained that I called VHI and she said that their info was incorrect.

(4) Yesterday I had the tooth extracted, waited strategically till the surgeon came out to reception and asked if there was any cost...he asked if I filled out the VHI Surgical Procedure Form, I said yes and he said there would be no charge.

That is a synopsis of what has happened so far.

I will let you know if I get invoiced.

I agree that I cannot see the logic in it and will look in more detail at VHI's website later.


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## foxylady (3 Jul 2007)

Seems that its is covered under surgical extraction as opposed to dental.


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## InfoSeeker (3 Jul 2007)

Based on the actions I completed in the dental surgery I would agree.
However I called VHI and they did not think I was covered.
I checked their site and cannot easily find a reference which would support your statement.


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## Megan (4 Jul 2007)

Would all of us who have VHI/BUPA that need a tooth extracted be better going to an oral surgeon instead of a dentist? It seems that we would be cover by our medical insurance but wouldnt be if the dentist extracted the tooth. Usefull to know.


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## markowitzman (4 Jul 2007)

not true megan. vhi covers towards cost of surgical extraction at dentist also whereas bupa only covers oral surgeon.


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## Madra (6 Jul 2007)

So did you need to be referred by a dentist in the first place or could you have decided on going directly ? If one could go direct is there a DBS panel one can check and just make an appointment ?


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## markowitzman (7 Jul 2007)

generally you would need to be referred. as a courtesy for patients frequently dentists will have the list of surgeons that are on bupa/vhi list


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## Megan (7 Jul 2007)

markowitzman said:


> generally you would need to be referred. as a courtesy for patients frequently dentists will have the list of surgeons that are on bupa/vhi list



Will the dentist charged their patient to refer them to a surgeon or do they do that as a courtesy to their patient?


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## markowitzman (7 Jul 2007)

Megan please re read what I said. The dentists would have the list of who is on bupa list for example. In answer to your query, obviously yes as they need to examine, frequently xray, write a referral letter, sometimes prescribe as an interim measure, use the receptionists time, use the nurses time, encur the cost of setting up the surgery from a cross-infection perspective specifically for this one patient and of course general fixed overhead also.
Short answer as a courtesy to you.............yes!


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## InfoSeeker (9 Jul 2007)

I was referred to the oral surgeon by my dentist.
I will be covered for the extraction as it is deemed a surgical procedure according to my dentist.
I am going back to my dentist next week for a filling and will settle with him for the work he has done.
This will include a temp filling on the tooth that was extracted as well as the admin work.
He is very good though as after what you are entitled to via PRSI then the outstanding fee is not a lot and also his work is good....I am happy with the cost and the care I received so that is all that matters IMHO


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## Megan (9 Jul 2007)

Thank you Markowitzman for your reply to my question. I do wonder why the dentist do a xray and then when you go to the oral surgeon they do another xray at a further cost to the patient. This isn't covered by VHI.


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## markowitzman (10 Jul 2007)

initial dentist cannot refer what he/she cannot see.


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## Megan (10 Jul 2007)

markowitzman said:


> initial dentist cannot refer what he/she cannot see.



My point is why doesn't the dentist forward the xray to the oral surgeon.  One xray less for the patient and a saving of €80. (That is the price my daughter's oral surgeon charges for an xray).


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## markowitzman (10 Jul 2007)

good point Megan but it depends what xray you are talking about.
large xray called an opg is frequently only available with oral surgeon whereas smaller periapical xray is frequently taken at general dentist. both xrays are frequently needed. hope this helps.


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## Plek Trum (11 Jul 2007)

All dentists should be in a position to provide their patients with OPG's (Panoramic x-rays) and PA's.  More modern practices now are able to do this digitally.  We do not charge patients for referrals and forward all x-rays required to relevant surgeons.   In this digital age, a quick email suffices and aids the surgeons own computerised records.

Referrals for extractions are due to complications, be they forseen (e.g root structures) or not (previous medical history / oral history). Wisdom teeth are the most common reasons one would be referred to a surgeon (but not solely).

VHI Plan B (+) covers the extraction of wisdom teeth with an oral surgeon,  whether under local anaesthetic (XLA) or under general anaesthetic (XGA).  Neither procedure is covered under the VHI DeCare Dental Plan.

Note to all readers:  If you are being referred for extraction of wisdom teeth and do NOT have private medical insurance (VHI / QUINN / BUPA) please be careful when enquiring as to which policy to undertake.  I have experience of patients enquiring with providers regarding specific procedures, taking out that policy and later having their cover questioned / withheld due to "pre-exisiting condition".


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## markowitzman (11 Jul 2007)

> All dentists should be in a position to provide their patients with OPG's (Panoramic x-rays) and PA's. More modern practices now are able to do this digitally.


we do also plek trum but you would be amazed how few have the opg facility. you raise a very valid point re pre-existing condition. Personally have had greater difficulty with bupa in this regard.


> We do not charge patients for referrals and forward all x-rays required to relevant surgeons.


used not to but now do as costs have escalated out of all proportion. Charge is to cover costs/hourly overhead.


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