Tag Archives: dentist

The black hole of health insurance

I just got back from the dentist where I had my bi-annual cleaning. Everything’s fine; apparently I do a good job with my “home care.” While I was there, though, I asked about a spot at the top of one of my front teeth that is slightly discolored. I don’t think you’d notice it during normal social interaction, but I do, every time I brush my teeth, or look in the mirror with my lips pulled back, which I do in order to stare at the discolored spot.

I asked the dentist about the spot and he said, “I can fix that.”

He went on to explain that it’s a spot that’s decalcified and isn’t medically problematical, although, if it got worse down the road, it could be. I didn’t need to do anything about it, but if I wanted to, no problem.

I’m not terribly vain, but come on, it’s one of my front teeth. It’s tempting to get it fixed. But wait, I asked, isn’t that cosmetic? Insurance wouldn’t pay for it, would they?

“Oh yes they will,” he said. “It’s all in the insurance code.” Then, with a wink, “It’s a filling.”

And there you have my dilemma. I can have this spot fixed if I knowingly participate in a mini insurance scam. What else can I call it?

I’m astonished and appalled at how little we consumers know about how insurance works. One of our household has been seeing a particular specialist every two weeks for months now. Each time, we write a check for the thirty dollar co-pay. We have never seen a statement from our insurance company about this doctor. When I asked the secretary how much an office visit was, she said it depended on a few factors, but ranged from $195 up. Really? There isn’t a set office visit fee? How much is this costing the insurance company?

In this particular instance, we don’t have a choice. We’ll keep seeing this doctor until they resolve the problem. But invisible charges? I’m much less comfortable with that than I am with the idea that the dentist can code a procedure as a filling so I can have something fixed that I wouldn’t pay for otherwise.

Maybe the insurance industry is rigged to be one big, cosmic, balancing act; my conscience might keep me from taking advantage of my dentist’s offer because I’m angry that the real cost of our health care is hidden from us. If that’s the case, then in the end, I’m the one who loses.

I once called a doctor’s billing office when the paperwork from the insurance company listed several procedures I didn’t recognize. They said, “There aren’t really codes for what you had, so we picked the closest ones.”

Really? So not only does the insurance company not know the truth, but now I have no record of what was done to me because believe me, when they say they picked the “closest” codes, they mean they picked things that look totally unrelated.

I know I can’t change any of the bizarre machinations of the health insurance industry. I do, however, need to make a decision about that little, discolored spot. Would it be wrong to have it done? It is one of my front teeth…

Advertisements

How to create a loyal customer

When I was still a young woman, I had to have a wisdom tooth out. I’d always been a coward and a visit to the dentist ranked high on my list of things to avoid, but it was an emergency; the tooth had to come out. I was terrified and doubted that I would survive without emotional support from my parents who were bicycling in Europe at the time. I needed someone to act in loco parentis so I let my dentist’s office play the part. Aside from making the appointment with the oral surgeon for that very afternoon, I’m not sure exactly what they did to earn my undying gratitude, but that day I swore to return faithfully, twice a year, to have my teeth cleaned. And I have, even though the practice itself was sold long ago and none of the original cast of characters remains. The office had earned my loyalty.

Some months ago, I received an unsolicited catalogue from Soft Surroundings, a vendor whose clothes are a cross between J. Jill and Chico’s; all to my taste, and all too expensive. However, inside the catalogue was a coupon for ten dollars off a purchase from their outlet web site. Right before the coupon expired, I searched the outlet site for the pieces I had liked in the catalogue, and found one. I filled out the online form and included the discount code. When the transaction completed, not only had I been charged ten dollars for shipping, but the discount had not been applied. I was not a satisfied customer.

I had to wait an hour for their web site to synch to their database before customer service could help me. When they were finally able to see my record, the customer service representative, who was, mind you, very pleasant, informed me that the item I had ordered was not on the outlet site and therefore ineligible for the discount, but as a sign of goodwill she would apply the discount anyway. I accepted the offer, but remained peeved by the assertion that I had made a mistake.

When I hung up, I retraced my clicks, found the url for the shirt, and sent an email to their customer service department. The episode ended for me once I reclaimed the moral high ground, but not for them. Within moments they had emailed me back, apologized for the confusion, and informed me that they were removing the ten dollar shipping charge. I was now a fully satisfied customer.

My final note is about IDG List Services and a young woman I’m not sure I should name ─ Kim McDonald ─ who works there. I rented a list from them for a project I was doing for a client. I was not happy with the results and had no expectation that it would matter one iota to IDG, a big company with lots of customers. I was wrong. Kim worked very hard to satisfy me. And she invoked the names of a whole slew of people on her team she said were also working on my behalf. Her emotional support cost IDG nothing, but bought a ton of goodwill. In business, there’s no line item for goodwill on the balance sheet. But there should be.