View Full Version : Have you ever bargained with a Dr. when paying out of pocket?
01-15-2007, 03:05 PM
We went to the Dentist last week for Madeline's first official teeth cleaning. We have been going since she was two but this is the first actual cleaning. It was $120, that included 2 x-rays, fluoride, cleaning, and the exam. My husbands company does not have dental insurance so it was out of pocket. Have you ever say, offered them, oh say 2/3's. They are still making money and there is no paper work to fill out. My husband says that I am crazy and that it isn't a Pawn Shop. I am not going to insult them by offering $20, I really like this dentist but even I am not tied to him and can go somewhere else if they tell me to get out. But I know if they are filing on Medicaid or anyone's insurance they are not getting $120 a kid. I feel like if the Government and insurance companies can bargain, why can't I?
So has anyone else done this, and if so how did it turn out???
01-15-2007, 03:14 PM
Yes, I have. However when I was doing it, it was more of a "you're the eighth doctor I've seen this week and I can't afford to pay you anything more than this" type situation. I've never done it just to get a better deal. However you are right that insurance companies would be paying far less.
Ask him what his contracted rate is with a big insurance company (name a specific company, like Blue Cross or Aetna) and then offer him that plus 20% or so. The worst they can do is say no, right?
01-15-2007, 03:19 PM
Just to give you an idea of costs, the last time I had a cleaning and exam (no x-rays) the insurance paid $102. The last x-rays (over a year ago) were $18. I'm not sure what they pay for kids as we haven't had them on insurance until this year. The ped dentist charges $50 for fluoride and exam (no real cleaning yet).
Dental doesn't have nearly the discounting that medical does, partly because most people don't have dental insurance (Medicare doesn't cover dental and Medicaid only for children).
01-15-2007, 03:57 PM
I've sort of bargained with my ob-gyn in the past re the outpatient surgery. After complaining about the cost of procedure and my insurance company refusing to pay for it for reasons that I did not quite understand she gave me the so called "cash price".
I pay for all my dental work cash and when I had to have a bunch (over 5 for sure) of root canals re-filled I half-jokingly asked for a volume discount and got 10% off. I can't imagine asking for a discount on a routine cleaning though.
01-15-2007, 04:24 PM
My clinic always offered a "discount for cash" price. Basically, we offered a hugely discount price to people who paid in full at the time of the visit -- partly because we thought it was the right thing to do and partly because it's quicker cash (insurance payments can take months to come in). I would definitely try to negotiate something this time and I would ask next time at the time of the visit if they can offer a discount for paying that same day.
It is in the office's best interest to keep their clients happy.
01-15-2007, 04:32 PM
I've gone to the same dentist for 23 years. (He's gorgeous and does not age!!) Anyway, I make sure to let him know that I do not have insurance, and when I mention it, he tells me that I won't have to pay for the x-rays. So for a routine exam/cleaning I pay $50 or so. I think it may be because I've gone to him forever(I even live in another state now, but plan my cleanings around when I go back home to visit.) I would just casually bring it up that you do not have any insurance and ask if there is some sort of pay-slide or slide scale or whatever its called-someone help me out here! Even if they don't offer that, they may just be kind enough to give a discount, since you asked. It's worth a try. I just wouldn't offer them a set amount. They may not take you seriously, and that would just be akward. Good luck!
01-15-2007, 04:48 PM
I guess I would agrere with your husband. For years I paid for all of my dental expenses out of pocket. It never occured to me to ask for a discount. One of the reasons MDs take a lower contract rate when participating with an insurance company is because they are then provided with many, many potential patients to fill their appointment slots.
To my knowledge there are not alot of states that provide medicaid coverage for dental (if any) so it still isn't the same as medical rates.
Barbara-mom to Jack 3/27/03, a Red Sox fan
and Anna 5/12/05, my little Yankee fan!
01-15-2007, 06:37 PM
I wouldn't ask the dentist himself, but I would ask the front desk if there is a cash discount. Everyone I have dealt with (doctors/dentists/opthalmologists/physical therapists/chiros, etc.) have had cash discounts. It isn't so much bargaining because they are usually a fixed amount, as just asking to pay the correct rate.
01-15-2007, 08:34 PM
At my dentist's office (he happens to be my dad), you'd get politely refused for an offer to only pay 2/3 of your bill. If you paid cash at the time of the appointment, I could see asking for a small (say, 10%) discount but that's about it. Sure, you could go somewhere else, but you'd be hard pressed to find anyone willing to do all that for $80.
01-15-2007, 09:58 PM
I would absolutely ask for a cash price or ask if there's a cost sheet/discount for those who aren't billing through insurance. It never hurts to ask, especially if it's available. The worst they can say is no.
01-15-2007, 10:13 PM
Thanks everyone, I paid after the appt. so I guess I will ask when we go back in July. I will probably ask the office manager when I check out.
Thanks Lori - The 2/3's was a guess, I really didn't know what to ask for but 10% is better than nothing.
01-16-2007, 08:56 AM
Suggestions about the etiquette of the situation: talk to the office manager, not the dentist/doctor when negotiating price. Discuss the cost of services before you come in for your appointment - not after services are rendered. And if you're asking for a discount, be prepared to pay the full amount in cash the day you are seen. Also point out how they will benefit from negotiating with you - you will pay immediately so no need for them to file with insurance or pay the costs of processing a credit card or billing (each bill sent out to a patient costs $5-10 in staff time & resources), and you/your family will be loyal patients guaranteeing repeat business for years to come.
It never hurts to ask, but rather than naming a specific figure, I would ask whether they offer a sliding fee scale or would give you the discount offered to insurance companies.
01-16-2007, 09:17 AM
Just wanted to point out that even when they get a fraction of the total charges from insurance - my dentist bills me for the difference. So it does work a little differently than my health insurance (where I pay an office co-pay but the difference between the charged amount and the reimbursed amount isn't charged back to me).
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