Beware of Trailwinds Dental

[Kathe]

Bait and switch! My paperwork shows exactly what I would pay out of pocket and what insurance would pay. AFTER the work they said OF COURSE that’s not covered. My paperwork and Seniors Against Crime say their mistake. I won’t pay more than documented on my paperwork. But be careful!

[Bill14564]

Was the work done? Would you have had the work done if the cost breakout was different? When the insurance company disputed the charges and provided an explanation was the explanation something the dental office could have reasonably known about ahead of time?

Personal experience with this office: I needed a crown replaced and was provided an estimate of the cost breakdown. I needed the work done so I had the work done. The insurance company refused some of the charges because the original crown was put in just under five years ago (four years and ten months but still under five years). There was no way the dental office could know that the original crown had been there less than five years. I had to pay more than expected but in this situation I can't blame the dental office for that.

[EdFNJ]

Bait and switch! My paperwork shows exactly what I would pay out of pocket and what insurance would pay. AFTER the work they said OF COURSE that’s not covered. My paperwork and Seniors Against Crime say their mistake. I won’t pay more than documented on my paperwork. But be careful!
Sounds like McDonalds Happy Tooth Meal Dental, I mean How's Your Azzbeen (after you leave) Dental. They cleared my "plan" with my insurance and I ended up getting a bill for almost $300. Took weeks to get it removed. This was about 3 years ago. Was charged for things I didn't want or approve or ask for even telling them it won't be covered. Of course there are 2 sides to every story so YMMV.

[EdFNJ]

Was the work done? Would you have had the work done if the cost breakout was different? When the insurance company disputed the charges and provided an explanation was the explanation something the dental office could have reasonably known about ahead of time?

Personal experience with this office: I needed a crown replaced and was provided an estimate of the cost breakdown. I needed the work done so I had the work done. The insurance company refused some of the charges because the original crown was put in just under five years ago (four years and ten months but still under five years). There was no way the dental office could know that the original crown had been there less than five years. I had to pay more than expected but in this situation I can't blame the dental office for that. Actually you CAN blame them because when they submit to insurance which they should (and can) do while or before you sit there they would have known and told you (not that you wouldn't have had it done but your dentist COULD know before doing the work). They simply didn't get a pre-authorization. Had they done that you would have known.

[keepsake]

I had this 'prior work done' limit, years ago. It was the exact same dentist that did the work less than five years earlier on same tooth. No excuse. These offices should know the insurance rules BETTER than the patient.

[TedfromGA]

Sounds like McDonalds Happy Tooth Meal Dental, I mean How's Your Azzbeen (after you leave) Dental. They cleared my "plan" with my insurance and I ended up getting a bill for almost $300. Took weeks to get it removed. This was about 3 years ago. Was charged for things I didn't want or approve or ask for even telling them it won't be covered. Of course there are 2 sides to every story so YMMV.

Trailwends Dental on 466a was not there 3 years ago! We've had very good experiences there since it opened.

[retiredguy123]

This thread is very confusing. I'm glad I don't have dental insurance. But, I suspect that the OP signed something that said they are responsible for any treatment that was not paid for by the insurance company. It is a pretty standard disclaimer.

[Michael G.]

I never had any luck with ANY dentist here in Florida.
They all want to sell you some $1000 dental work when my teeth are fine and no problem.

I went to one not so long ago and they recommended $2300 worth of dental work, I said no thanks.
As I was leaving through a crowded waiting room, the dentist said: "You better reconsider or you'll need a root canal."
I said: Goody, "I LOVE root canals", as everyone in the waiting room laughed.

[JMintzer]

Actually you CAN blame them because when they submit to insurance which they should (and can) do while or before you sit there they would have known and told you (not that you wouldn't have had it done but your dentist COULD know before doing the work). They simply didn't get a pre-authorization. Had they done that you would have known.

Pre-authorizations mean nothing. The insurance company will tell the provider that the "pre-authorization" is NOT a guarantee of payment...

I have to deal with this all the time...

[Michael G.]

Pre-authorizations mean nothing. The insurance company will tell the provider that the "pre-authorization" is NOT a guarantee of payment...

I have to deal with this all the time...

Same thing with any medical clinic when asking if they take your insurance,
all will say YES which didn't mean a thing useless their in your NETWORK. :cus:

[JMintzer]

Same thing with any medical clinic when asking if they take your insurance,
all will say YES which didn't mean a thing useless their in your NETWORK. :cus:

Absolutely false. We ALWAYS check to make sure we are in the patient's network BEFORE seeing them. I can say the same for all of my colleagues...

[EdFNJ]

Pre-authorizations mean nothing. The insurance company will tell the provider that the "pre-authorization" is NOT a guarantee of payment...

I have to deal with this all the time... Maybe "pre-auth" was the wrong term? I would think when it comes to having work done on a specific tooth the insurance company has specific records of what was done and when that specific tooth was worked on previously as we experienced with Howell Dental. They first contacted Aetna and knew EXACTLY what was covered before anything was done. Tooth #5, yes #7 no because it was done 3 years ago. Obviously I know nothing about Podiatry (or dentistry) but what would be the equivalent to working on a specific tooth treated less than 5 years ago that could be denied? Seems replacing a specific crown or covering a full mouth xray for a general exam under 3 years is more specific and is clearly listed on the policy under exclusions. As an example Policy says General exam every 6 months but full mouth xray every 3 years. Dental insurance seems very specific (if one reads the policy or checks with the insurance co).

[thevillages2013]

Man I hate going to the dentist! I have all my original teeth (minus wisdom teeth) and only one filling and I go twice a year for cleaning. There is a constant fight however about x-rays. Me-“why do you X-ray my teeth?” Dentist- “ to find cavities between your teeth “ Me- “ look at my records and see how many cavities have been found between my teeth “ Dentist -crickets

[Djean1981]

Dentist office can contact the insurance company to get pre-authorization with coverage info - just like for a hospital procedure.

[MrFlorida]

Does anybody have a dentist that is not a salesman ?

[biker1]

Not getting periodic X-rays because they haven't seen decay in the past is essentially the same as telling your PCP not to run blood work periodically because the numbers have looked OK in the past. To each his own, but I personally don't skimp on these sorts of thing. Penny wise but pound foolish.

Man I hate going to the dentist! I have all my original teeth (minus wisdom teeth) and only one filling and I go twice a year for cleaning. There is a constant fight however about x-rays. Me-“why do you X-ray my teeth?” Dentist- “ to find cavities between your teeth “ Me- “ look at my records and see how many cavities have been found between my teeth “ Dentist -crickets

[Michael G.]

Absolutely false. We ALWAYS check to make sure we are in the patient's network BEFORE seeing them. I can say the same for all of my colleagues...

You might check but I find many don't.

[Michael G.]

Does anybody have a dentist that is not a salesman ?


LOL Good one!

I always wondered if I walked in any Dentist office with PERFECT teeth no cavities or fillings,
I bet there still would be something wrong.

[Bill14564]

LOL Good one!

I always wondered if I walked in any Dentist office with PERFECT teeth no cavities or fillings,
I bet there still would be something wrong.

We'll be going for our third 6-month cleaning in August. We've had no extra work recommended. The only additional work we've had done was due to poor work by a previous dentist (a crown fell off). We use TrailWinds.

[JMintzer]

Same thing with any medical clinic when asking if they take your insurance,
all will say YES which didn't mean a thing useless their in your NETWORK. :cus:

You might check but I find many don't.

All ≠ Many...

[biker1]

Not with my dentist. But then again, my wife is retired and doesn't practice anymore so they have always been straight with us.

LOL Good one!

I always wondered if I walked in any Dentist office with PERFECT teeth no cavities or fillings,
I bet there still would be something wrong.

[thevillages2013]

Not getting periodic X-rays because they haven't seen decay in the past is essentially the same as telling your PCP not to run blood work periodically because the numbers have looked OK in the past. To each his own, but I personally don't skimp on these sorts of thing. Penny wise but pound foolish.

I take care of my teeth just need cleaning periodically. If you don’t take care of your teeth as well as I do then you should be worried about it and excited about getting X-rays. There is no risk to the patient when getting blood drawn for lab analysis. That can’t be said about dental X-rays. Several studies show a link to brain tumors and gland tumors such as the saliva gland

[biker1]

I’m not worried about my teeth and don’t get excited about X-rays. I do, however, take the advice of dental professionals, including my wife. They know more than I do. Just as I take the advice of my PCP. Enjoy your tilting at windmills.


I take care of my teeth just need cleaning periodically. If you don’t take care of your teeth as well as I do then you should be worried about it and excited about getting X-rays

[thevillages2013]

I’m not worried about my teeth and don’t get excited about X-rays. I do, however, take the advice of dental professionals, including my wife. They know more than I do. Just as I take the advice of my PCP.

Understood that you can’t be objective because all those X-rays your wife ordered help pay for your retirement :popcorn:

[biker1]

Nope, covered by my excellent dental insurance. And I am totally objective - people who know more than me advise getting periodic X-rays. That is as objective as you can get. As I originally stated, to each his own.


Understood that you can’t be objective because all those X-rays your wife ordered help pay for your retirement :popcorn:

[biker1]

Not exactly. The exposure level is a small percentage of your daily exposure. Exposure on airline flights is greater.

I take care of my teeth just need cleaning periodically. If you don’t take care of your teeth as well as I do then you should be worried about it and excited about getting X-rays. There is no risk to the patient when getting blood drawn for lab analysis. That can’t be said about dental X-rays. Several studies show a link to brain tumors and gland tumors such as the saliva gland

[brianherlihy]

we all have a lot of money/ and the Dentist will take it all

[thevillages2013]

Not exactly. The exposure level is a small percentage of your daily exposure. Exposure on airline flights is greater.

Hopefully you don’t really believe that

[biker1]

Yes, I do. That fact that you apparently don't is shocking. Sounds like you don't believe is science. Whatever, the world is made up of all kinds who don't believe in facts.

https://www.orasurgery.com/comparison-of-medical-dental-and-natural-radiation-levels/

Hopefully you don’t really believe that

[Pairadocs]

Bait and switch! My paperwork shows exactly what I would pay out of pocket and what insurance would pay. AFTER the work they said OF COURSE that’s not covered. My paperwork and Seniors Against Crime say their mistake. I won’t pay more than documented on my paperwork. But be careful!

We've found dental "care" in Florida in this area to be VERY different than what we were used to. More like a retail business than a medical type of professional. Gum surgery, replacement of previous dental work not causing any problem, I could make a whole list of such things we've been told. Totally 100% difference in the dentist we were used to, who was more like a physician, never suggested we do all kinds of things we were not there for. Very unsatisfied with those we have tried over the years and finally decided to just drive to our previous home (we're from Florida). Do others here return to their home states and cities for dental care ? Has anyone found a true professional, not some kind of "dental supermarket" ? If so, share names and experiences ? Do you drive to Orlando ? Gainesville, Tampa t find professional people ?

[EdFNJ]

We've found dental "care" in Florida in this area to be VERY different than what we were used to. More like a retail business than a medical type of professional. Gum surgery, replacement of previous dental work not causing any problem, I could make a whole list of such things we've been told. Totally 100% difference in the dentist we were used to, who was more like a physician, never suggested we do all kinds of things we were not there for. ? Exactly. Up north the dentists often had offices in their homes, were in practice for many years and you'd never see an advertisement (not sure if it is even allowed in some states). The Happy News is filled with discount coupons and special deals in advertisements by dentists. Some sound more like a car dealership than a dentist. We found that very disconcerting when we moved down here.

We did find Howell Dental on 466 probably closest to what we were used to after trying a few.

[EdFNJ]

Does anybody have a dentist that is not a salesman ? LOL/ Check out Howell on 466.