# Do Dentists diregard the prices set out by prsi



## foxylady (28 May 2007)

I recently had to get a tooth pulled by a dentist  who charged me 63 euro (Their prsi Rate) However the rate for this on welfare.ie is 13 euro???  

Any dentist out there able to explain this to me????????


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## ClubMan (28 May 2007)

Isn't the "_PRSI _rate" just what _SW _pay as a subsidy to the dentist and not a price list per se?


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## foxylady (28 May 2007)

ClubMan said:


> Isn't the "_PRSI _rate" just what _SW _pay as a subsidy to the dentist and not a price list per se?


 

It is in a way but there are set prices that you have to pay on certain treatments shown here:

http://www.welfare.ie/publications/dental_sof.html


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## ClubMan (28 May 2007)

Do you earn more than €55K? If not then have you queried the charges with your dentist?


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## markowitzman (28 May 2007)

could be surgical extraction? if you earn over 55k dentist can balance bill for routine extraction.


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## foxylady (28 May 2007)

I dont earn over 55k and even if it had have been surgical it would have only cost €10 per 15 mins. It took less than five minutes.

I queried it next day as could not talk that night and the receptionist tried to fob me off with loads of excues , sais she would get dentist to contact me but he still hasnt.


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## dawnsurprise (28 May 2007)

on a similar topic - every time i go to get my teeth cleaned, I am charged by the dentist - even though you are entitled to a free clean every 12 or is it 18 months?  when i queried the amount, i was told it was a "special cleaning".... is there any dentists out there that will define "special cleaning" because i could find nothing special about it....


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## markowitzman (28 May 2007)

> even if it had have been surgical it would have only cost €10 per 15 mins.


 Not necessarily. If it is over 45 mins they can charge more. This in essence covers wisdom teeth etc.


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## markowitzman (28 May 2007)

special cleaning is treatment of gum disease.....code 051 which is a balance bill item.


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## dawnsurprise (28 May 2007)

i dont have or never had gum disease - could it be something else?


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## ClubMan (28 May 2007)

Interesting - never knew that there were different levels of cleaning which were charged differently under the _Treatment Benefit _scheme. I'm due to visit my dentist soon so must check which he plans on doing. 

_dawnsurprise _- you should query the extraction charges again and continue to insist on a proper response to your questions. If this proves problematic then put your complaints in writing to the dentist in the first instance and, if necessary, bring the complaint to the attention of the relevant authorities (not sure who but maybe _SW _and/or one of the dentists' representative bodies.


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## michaelm (29 May 2007)

dawnsurprise said:


> on a similar topic - every time i go to get my teeth cleaned, I am charged by the dentist - even though you are entitled to a free clean every 12 or is it 18 months?  when i queried the amount, i was told it was a "special cleaning".... is there any dentists out there that will define "special cleaning" because i could find nothing special about it....


If covered by PRSI you are entitled to a clean/polish every six months and an exam/check-up every 12 months.  To avoid the dentist charging you up front you need to get a D1 form from the dentist in question (D2 if claiming on a spouses PRSI) and send it to the DSW Treatment Benefit Section for pre-approval.  I appreciate that dentists may have administrative difficulties engaging with the State in relation to PRSI claims but IMHO the system, where dentists can charge PRSI qualified customers €80 or €90 upfront for an exam & cleaning and subsequently refund the €60 that the state pays, is against the spirit of the PRSI scheme; also there is no guarantee that  the refund will arrive, I have had to chase the dentist for said refund in the past.


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## liteweight (29 May 2007)

foxylady said:


> I recently had to get a tooth pulled by a dentist  who charged me 63 euro (Their prsi Rate) However the rate for this on welfare.ie is 13 euro???
> 
> Any dentist out there able to explain this to me????????



I'm just amazed that you managed to get a tooth pulled for 63 euro!


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## ClubMan (29 May 2007)

michaelm said:


> If covered by PRSI you are entitled to a clean/polish every six months and an exam/check-up every 12 months.  To avoid the dentist charging you up front you need to get a D1 form from the dentist in question (D2 if claiming on a spouses PRSI) and send it to the DSW Treatment Benefit Section for pre-approval.


The two dentists that I've used in the past couple of decades have always done this for me in advance of a visit.


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## liteweight (29 May 2007)

ClubMan said:


> The two dentists that I've used in the past couple of decades have always done this for me in advance of a visit.



Me too but I've never been refunded the money. I was always told that the price charged was after the deduction had been taken into account.


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## michaelm (29 May 2007)

ClubMan said:


> The two dentists that I've used in the past couple of decades have always done this for me in advance of a visit.


That's the way it used to be across the board but that seem to be changing now.





liteweight said:


> Me too but I've never been refunded the money. I was always told that the price charged was after the deduction had been taken into account.


Might I suggest that you may have been ripped off in that case.  Your PRSI should cover the full cost of the exam & cleaning.


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## foxylady (29 May 2007)

markowitzman said:


> Not necessarily. If it is over 45 mins they can charge more. This in essence covers wisdom teeth etc.


 
Yes but as I said it took approx 5 mins.


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## foxylady (29 May 2007)

michaelm said:


> That's the way it used to be across the board but that seem to be changing now.


 


Seems to be that unless you know the fees charged you are at the mercy of the dentist and most people are not aware of these rates.


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## markowitzman (29 May 2007)

you must have an approved d1 form PRIOR to treatment/exam.
There is NO requirement on dentist to refund money for treatment provided prior to approval.


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## liteweight (29 May 2007)

michaelm said:


> Might I suggest that you may have been ripped off in that case.  Your PRSI should cover the full cost of the exam & cleaning.



Yes indeed! A quick look through the threads on this board and it becomes obvious that dentistry needs to be regulated and policed more efficiently. Does anyone know if a dentist is obliged to display a price list?


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## markowitzman (29 May 2007)

I do display a price list and it was the best thing I ever did as now everyone knows my fees etc and there are no surprises when it comes to pay etc.


> Does anyone know if a dentist is obliged to display a price list?


not to my knowledge but I think it is a wonderful idea.


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## dawnsurprise (29 May 2007)

how long does it take to get back a d1 form?


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## markowitzman (29 May 2007)

they do a fax service that usually yields a response in a couple of days but frequently they respond that the application requires further information from the applicant which delays things significantly.


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## foxylady (30 May 2007)

markowitzman said:


> you must have an approved d1 form PRIOR to treatment/exam.
> There is NO requirement on dentist to refund money for treatment provided prior to approval.


 
If they overcharged surely they would have to refund the difference, as I mentioned earlier price I paid was supposedly the prsi rate.


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## markowitzman (30 May 2007)

you are a private patient until you have approved form and in it's absence there is no requirement to refund.


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## foxylady (30 May 2007)

markowitzman said:


> you are a private patient until you have approved form and in it's absence there is no requirement to refund.


 

1. The form is only available from dentists who insist on sending off themselves.

2. price quoted was rate after being approved instead of 103 as mentioned earlier.


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## HotdogsFolks (30 May 2007)

To people who are unhappy with their dentist (and live in Dublin) -

I use Joseph Kilroy on Henry Street in Dublin 1. He cleans my teeth for free twice a year, handles all the paperwork, is a nice "non-alarmist" dentist, and doesn't do any of that sleazy trying to figure out how much you earn tactic which lots of Dentists seem to do...


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## markowitzman (30 May 2007)

> that sleazy trying to figure out how much you earn tactic which lots of Dentists seem to do...


over 55k is balance bill on all items
not a tactic........it is how the scheme operates.
Please address your concerns to the DSFCA.


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## HotdogsFolks (31 May 2007)

markowitzman said:


> over 55k is balance bill on all items
> not a tactic........it is how the scheme operates.
> Please address your concerns to the DSFCA.


 
No, what I mean is - they are trying to figure out what optional work you can afford. 

You can always tell by someone's tone if they're being innocent or sleazy...


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## markowitzman (31 May 2007)

for crying out loud if you are not comfortable with "sleazy" dentist change.


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## socialfairy (18 Jun 2007)

Hi, just regarding hotdogsfolks post- i actually went to the same dentist and got charged for the "special clean" which took all of five minutes. was very upset at my treatment there


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## ClubMan (19 Jun 2007)

Went to my dentist the other week for a checkup and clean/polish. He also took x rays and thankfully found no problems. All covered by _PRSI_ which his secretary had cleared/processed for me in advance. While there I heard her calling another patient to tell them that they were not covered by _PRSI _and informing them what the private patient charges were.


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## Macer (21 Jun 2007)

Can someone clarify. I visit my dentist every 6 months, thankfully in the past 6 years this has only involved a "good Clean" (his words not mine). Previously there was no charge for this service, but some years ago they began to charge me €30, I am also required to sign a blank department of ...... form. On my visit last week the charge has been put up to €40 again signed the claim form. The "clean" takes no more than 15 minutes, should I be charged for this service ? and is it up to the dentist what they charge and also what they claim from the department (given I'm signing a blank form!!!!).


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## ClubMan (21 Jun 2007)

Macer said:


> Can someone clarify. I visit my dentist every 6 months, thankfully in the past 6 years this has only involved a "good Clean" (his words not mine). Previously there was no charge for this service, but some years ago they began to charge me €30


Have you not asked the dentist what this charge is for? Have you not got receipts in case you can claim _MED1/2 _tax relief? 


> I am also required to sign a blank department of ...... form.


You are not required to do this - many _GPs _will process _PRSI _claims on behalf of the patient in advance of a consultation but you could presumably do this yourself if you wanted to.


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## dawnsurprise (21 Jun 2007)

clubman... 
 where do you get the form to do this yourself and how long does it take... i have been charged the same as Macer for a regular cleaning! i have an appt on 2 july... will i have time to have this cleared before i go?


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## ClubMan (21 Jun 2007)

You get the form from the dentist.


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## Luckycharm (4 Jul 2007)

Ok need to go to the dentist again soon   Went for the first time in 13 years back in Jan to get my first fillings. Was waiting till covered paritally by PRSI it cost around €90 for filling which I thought was expensive. I need a couple of more and my sister went to another dentist who charged €40 per filling no PRSI Cover(sounds too cheap) so what should I be expecting to pay in Dublin been cover paritally by PRSI? 
ANy reason I cannot change Dentist only been to the other one twice one for initial checkup - second time for a couple of fillings. Picked him because he was closest.


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## ClubMan (4 Jul 2007)

Luckycharm said:


> so what should I be expecting to pay in Dublin been cover paritally by PRSI?


Did you check the _SW _link(s?) posted earlier?


> ANy reason I cannot change Dentist


 Of course not.


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## foxylady (5 Jul 2007)

Luckycharm said:


> Ok need to go to the dentist again soon  Went for the first time in 13 years back in Jan to get my first fillings. Was waiting till covered paritally by PRSI it cost around €90 for filling which I thought was expensive. I need a couple of more and my sister went to another dentist who charged €40 per filling no PRSI Cover(sounds too cheap) so what should I be expecting to pay in Dublin been cover paritally by PRSI?
> ANy reason I cannot change Dentist only been to the other one twice one for initial checkup - second time for a couple of fillings. Picked him because he was closest.


 

Dentists can charge pretty much what they like for fillings and they do. There is very little benefit to be obtained through prsi, just cheap extractions, one free chekup a year and one free cleaning anything else is more or less at the dentists discretion


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## Plek Trum (11 Jul 2007)

foxylady said:


> Dentists can charge pretty much what they like for fillings and they do. There is very little benefit to be obtained through prsi, just cheap extractions, one free chekup a year and one free cleaning anything else is more or less at the dentists discretion


 

I suggest you refer to the actural PRSI entitlements for dental benefit, instead of merely "guessing".

PRSI patients qualify for discounted rates on the following:
Single compound / amalgam fillings
Composite anterior fillings
Pin retained fillings
Angle / Inscisal tip fillings
Extractions
Endodontic treatment
Apicetomy
Partial dentures
Denture relines (upper / lower)
Denture repairs.
Hygiene visits (protracted gum / periodontal treament).

The discount you are entitled to on all the above is fixed, nationwide.
The balance you pay to your dentist however, is at their discretion.

You can visit your dentist and request a D1 / D2 form and a free post envelope.  Complete your details, mark the form " for approval" and retirn to Letterkenny.  You will receive details of your qulaification status and so will your nominated dentist, once it has been processed and approved.

If you are unsure of any costings, why not ask your dentist  when you are with them and your propsed treatment plan has been put to you???


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