Wednesday, April 7, 2010


Hey all,

I hope everyone had a great Easter. It was an awesome day at our house.
(Easter picture of the kids)

We usually do an Easter egg hunt at our house. I write clues for all the eggs and the kids have to follow the clues to the next egg, and then the last egg sends them to the room that their Easter presents are in.
(the first eggs with the first clues)

I have to say that this year was really tough because the Final Four was on 'til about midnight the night before and all my creative juices were dried up thanks to my attention being elsewhere.
It turned out great, in spite of me.
Easter dinner/lunch was great. We had some friends and family over and people from church that were going to be by themselves.
I don't want to tell you all this, but we went swimming.
Yeah, I said it...swimming. I knew you wouldn't believe me so I took a picture.
(Don't say anything about my grass. The winter beat my lawn down bad and it is just starting come back)
Not to rub salt in the wound or anything, but this week is the kids Easter break and on Monday we went to the beach.

More swimming and playing. Loads of fun.

You know we haven't talked about TV in awhile.
I have two words for you TWENTY-FOUR.
I love this show. It is so good. I think it is known that this is the last season. I heard that it is just getting too expensive to produce.
It is a shame because my wife has just gotten into it, and I have only seen three seasons.
We always DVR it. When we watch it and a commercial comes on it is like a race to see how fast we can get the next scene started. My record is 4 seconds.
We only watch a couple of shows.
My wife loves Chuck and I love my wife so we watch Chuck together.
I still watch and love How I Met Your Mother.
We watch both NCIS's and that is about it.
I have a couple of the BOSS undercover shows that I haven't watched yet.
My wife refuses to watch American Idol this year. She says that Ellen has no musical talent so why would she be a judge. She thinks the network has totally sold out and she refuses to watch.

I did some work on a woman that lives in another country.
She is the sister of one of my patients.
She was having some trouble getting her dentist to change her amalgam fillings out. She sent me some photos of the tooth, and I thought it was a giant amalgam (socialized dentistry) and it needed a crown.
I told her what she needed, and she made an appointment.
Everything went great. The crowns turned out stunning. I was happy and she was thrilled, promising to come back on her next vacation to replace all the other amalgams.

About a month after she left I got this email.

Quick email to say that all is well with the 2 new crowns you fitted.

I have submitted a claims form along with the invoice for the dental treatment to my travel Insurance company and now awaiting their response. I have explained to the insurance company that the dental work was for a broken tooth / filling and a dislodged crown (old gold one) caused by eating a toffee on the first day of my arrival.

Hopefully they may not require to contact you as I have provided proof of the work done along with the credit card payment details, but who knows.
Keep up the good work and look forward to seeing you again soon.....ish!


btw...when I got home, I received my 'yearly' dental checkup reminder from my dentist - should be interesting to see how the dentist reacts to some "top quality workmanship" from overseas

I get this kind of letter or call about two times a year.
Now, this is not something that is terrible. This is not something that even was a blip on my radar. I got it and didn't think twice about it.
I don't mess around with stuff like this.
It isn't a blip on my radar screen because I am not going to do it.
I am not going to lie....PERIOD.

I don't lie for anyone's benefit.
I don't stretch the truth.
The teeth were not broken when I saw them. And if the insurance company ever called me, I would have called her first and explained to her that "Homey don't play that." (In Living Color reference).
I wouldn't have got my blood pressure up or anything. I would just ask them what they wanted me to do because I won't say that.

I don't care what the situation is.
I won't say that I did something in January when I did it December.
I won't charge out a crown if I don't take an impression.
I have told you in the past that I am so by the book.
I find it is so much easier to set a precedent and stick to it, instead of saying things like, "that isn't that bad, so I will do that one."
No, this isn't easy sometimes.
Sometimes I will have to look at a patient in the face and tell them, NO.
They look at me like, "I can't believe you won't do this."
What am I going to do? Put my license and future on the line to save you $75.

How about getting cash for coming in over the weekend?
Man this one has always been tough for me. I have to admit I always put it in the drawer.
I battle with this one every time, but so far I haven't been able to take it home.

How about this one? Patient is going to lose their insurance, they need a new veneer, but they are going to need a gingival graft also. I put a temp on the tooth and send it to the periodontist.
Can I charge out the veneer if I didn't take an impression? I don't think I can.
So even though I don't have any plans of going to completion until after the perio surg, I will go ahead and take the impression. Even though I know I will probably take another one in 10 weeks.

Do you battle this?
Do you take home the cash?
I would like to hear your stories. Remember it is anonymous.
And let's get something straight before you write me anything. I will not judge you. I am not thinking I am holier than thou. I will not think you are a lesser man or woman because you tell me you do something. Period.

Hope you are having a good week?


Anonymous said...

I'm a black and white type of person. There's a right way and wrong way. No gray. I'm with you on setting up specific protocol and sticking to it. I do the same thing you do. With the patient who's obviously involving herself with insurance fraud, stick to the truth. You're right. It's not worth the $75. You're better off without those types of patients. Our practices can get saturated with those types (especially these days)if you let it get to that. Right now, I'm doing a lot of "clean up" in my practice. But the truth is they weed themselves out.

To be honest, I never heard anything about an impression being the measure of whether you can bill a crown or not. I thought it was a matter of beginning the work. If you touch the tooth, then you're legally obligated to finish it. So why not get paid for the time you already invested? If you're on the hook legally, shouldn't you at least see the pay? Things happen and sometimes you can't take an impression (excessive bleeding, staff didn't order your materials, etc). Yet the crown prep is completely done and the tooth is temped. Is there a specific rule to follow when billing out crowns? I don't think so. My opinion is that you should be billing any tooth you begin treatment on.

Try this one...I will charge a patient for cosmetic temps in a cosmetic case even though I don't charge for them in a single ceramic crown situation. I have more problems with anterior veneer temps because they leak and get black smudge or they simple break (not always, but it happens). Should I charge a separate "cosmetic case fee" to cover these cases or a separate fee for these miscellaneous things?

Have a blessed Easter Season, everyone.

Anonymous said...

Just do the right thing the right way the best you can and you never have to look over your shoulder. I don't bend the rules for anyone because those are the ones that come back and bite you. Plus they are the first to complain and people have a short memory.


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