I went in for a regular annual cleaning (D1110) appointment on 06/05/24. I received a statement where I found I had been up-coded (D4910) for periodontal treatment while I wasn't presented with any treatment plan in-office. In fact I asked about out-of-pocket expenses and the staff told me that my insurance would take care of all of it as this is regular cleaning and covered by most insurers. Guess what, D4910 isn't covered by most insurers.
Please note: the doctor (Dr. Dan Lee) and his assistant were both great to work with. My gripe is with the Simply Dental business and their misleading practices. Especially the person who checked me out was confidently incorrect at best and lying to my face at worst.
I reached out to the business and received a response that seemed to put the onus on me to know what I'm getting treated for. As a patient you need to go equipped with a lawyer by your side to hold providers like these accountable. So I raised a complaint with BBB. I will consider updating my review if they decide to own their mistake and remove the extra charges. I'm prepared to file a complaint with the WA state attorney general in case this isn't resolved quickly.
Edit: The business responded callously calling my 'out of pocket' as "small". $62.40 may not be a lot but it's their duty to inform me of what procedure they are performing on me and present full information. Also up-coding while billing is very misleading. It shows their integrity and how much they care given they haven't bothered addressing the actual issue and tried to shame the expenditure as "small" and trivialize my attempts at raising a valid concern.
Background At a dental office in Ballard I was told I had a cavity and a D2392 composite filling - 2 surfaces was needed. The prices seemed high ($886 for a standard initial visit) so I used to chatgpt to look for places that might provide better value. During my research I found that 3 of the 4 dental places I contacted inflated prices for self insured since as one dental receptionist told me “you don’t have negotiation power”. Chatgpt suggested Simply Dental based on reviews. They quoted D2392 at $220 instead of Ballards $335. My understanding is that Simply Dental self insured prices are based on PPO rates.
My Experience
Why I’m posting a review It seems strange that contrary to other industries dental pricing in the US is not very transparent. For the self insured, negotiation power comes partly from dental pricing transparency. I’m posting this review so maybe chatgpt and search engines can pick up that Simply Dental as of Oct 2024 offers self insured ~parity pricing with those who are insured through 3rd parties.
Even if I switch to getting insurance through an employer, I plan to stay with Simply Dental since I like how they operate.
