"Dentists and Dragons - Chapter 2" by Troy H. Cheek on Mar 12, 2005

(If you missed Part 1, go back and read it first!)

Story of the film so far: After discovering that I had broken a tooth, I contacted CrapDent, my insurance company, to arrange to have it fixed. They sent me to Dentist #1, who explained that he doesn't take CrapDent anymore. Dentist #2 agreed to see me, but said he didn't extract teeth and, besides, I needed a root canal. He sent me to Dentist #3, who didn't do root canals, and wanted to send me to Dentist #4, who didn't do crown work and would have to send me back to Dentist #2 for that. Dentist #3 did eventually agree to just pull the tooth for me, along with a couple of hyperextended wisdom teeth that he seemed to be more worried about than the broken one. During this time, more and more tooth had broken off, I'd developed an infection, the pain in my head had been building, I wasn't sleeping well, and I'd given up even trying to chew anything on that side.

I called my insurance company, CrapDent, to make sure that dentist #2 hadn't billed them for anything like a cleaning or exam, seeing as I didn't get either one like I had expected to. I discovered that Dentist #2 wouldn't actually file a claim for routine services like that. Apparently, he gets paid for routine stuff like that based on the number of CrapDent patients he signs up during a given year, regardless of how many actually go to him or how many services he actually performs. This would explain why Dentist #1 never seemed concerned that I'd never come to see him back when he was listed as my primary care dentist.

During this conversation, the subject of my three pending extractions came up, and there was some question as to whether CrapDent would pay for them as they couldn't find Dentist #3 on their lists, which wouldn't be a problem as I'd gotten a referal from Dentist #2, who was. Except that the referal said root canal (which #3 doesn't do) and I was talking extraction. And, besides, a simple extraction, which Dentist #3 said this would be, should be $0.00 out of pocket expense for me, not the $45 per tooth they'd quoted.

They wouldn't even sniff at Dentist #4. I'd need a referal from my primary care dentist to go to a specialist, and not a referal from another specialist that my primary care dentist had referred me to in the past.

I reminded them that if they'd sent me to a dentist that actually did any dental work himself, we wouldn't be having this conversation. They didn't take that too well.

The subject of 2nd opinions came up, and it turns out that my CrapDent actually has some kind of provision for this. In fact, since Dentist #1 was still officially my primary care dentist at the time I saw Dentist #2, that visit was considered a secondary consult (or something like that), which was why I had paid $25 to hear him tell me that he couldn't help me. Armed with this knowledged, I called some more numbers they gave me and discovered that most dentists in Chattanooga don't keep their offices open on Friday.

Finally, I contacted Dentist #5.

I explained to the staff about the second opinion thing, and how I needed one quick because Dentist #3 was telling my that if I wasn't going to get a root canal RIGHT NOW, I needed to have it pulled. Oh, they'd be happy to see me, once I choose them as my primary care dentist and they see my name on the updated patient roster, which would next month or maybe the one after. Until I was on the patient roster, they really shouldn't even be talking to me.

I whined enough that they gave me to the office manager, and she apologized for the staff and the patient roster thing, but that's the way she'd trained them because, in most cases, CrapDent wouldn't pay for non-roster patients. I bounced between calling CrapDent and Dentist #5 a few times, finally got them talking to each other on the same wavelength, and Dentist #5 agreed to see me for a problem specific consult as provided by their agreement with CrapDent. In fact, they could squeeze me in that very afternoon. Otherwise, it would be the middle of next month.

I went in and filled out all the new patient paperwork, which I think I could fill out in my sleep now. Just a half hour after the allotted appointment time, I was getting an X-ray and speaking to a real live dentist. A general dentist who could pull teeth, do root canals, do crowns, do removable or permanent dentures, and pretty much anything else I'd ever want to have done. And he took the time to break out some visual aids and explain exactly what a root canal was, showed me my X-ray, asked lots of insightful questions, and generally carried on like a dentist instead of a used car salesman.

The kicker was the price. Extractions were the same $45 per tooth as quoted before, but Dentist #5 explained the ways molars were more difficult to remove than other teeth and that's why they couldn't be billed as 'simple' extractions, but rather as 'surgical' extractions, even though the actual procedure was fairly simple. As for the root canal and crown, well, the 'raw' price with no insurance was less than any other quote I'd seen for the 'adjusted' price after insurance. After applying the proper CrapDent payment schedule, prices were down in the area that I could actually afford to pay.

The last thing Dentist #5 did to win my heart was to ask if I needed anything for pain. Nobody had done this before, even when I explained that it was a dull ache most of the time and that I had to take more than the recommended dosage of over the counter pain medications just to sleep through the night. He said if I ever needed anything stronger, just to call him and let him know.

Another person came in, had me tilt my head back, and spooned wood putty into the cavity, or at least that's what it tasted like. (And, yes, I know what wood putty tastes like.) It was actually some kind of quick-setting dental epoxy. This temporary filling, I was told, was supposed to harden and keep food from getting packed down in there until I could decide what to do with the tooth.

I decided, and made an appointment for a root canal two Tuesdays hence. This would be the first of two or possibly three appointments, as the root canal might take two visits just by itself, ad once the root canal was finished I'd need to have a permanent crown put on to protect what was left of the tooth later.

Next Monday, I contacted CrapDent to have Dentist #5 listed as my primary care dentist. "Sure thing! Right away! The patient roster for the upcoming month has already been closed, so your name will show up on their roster for the month after. And remember, we won't pay for any work they do until your name appears on their roster."

I called Dentist #5 to reschedule for the first available appointment in the month after next. Sure, it's inconvenient, but my tooth has been doing so much better since the temporary filling that I figured I could do a month standing on my head.

At 2AM that very night, I woke up feeling like I'd been hit in the side of the head with a 2x4. (And, yes, I do know from personal experience what that feels like.) Aspirin and every other painkiller in the house didn't help, nor did gargling with Ambusol. Never did get back to sleep. After I staggered into work in the morning, I called Dentist #5 to take him up on that offer of something stronger for pain. "Oh, he's in a case right now, but we'll put your file on his desk so he'll see it. If you don't hear back from him in a few hours, call us back."

I checked with Pharmacy #2 (as Pharmacy #1 had closed up shop since I had last used them) several times during the day, until it got to the point that I could just walk in, they'd shake their heads, and I'd walk back out. I broke down and called Dentist #5 again. "We're sorry, but he's in the middle of a root canal and we really hate to disturb him." Well, I know I wouldn't want anybody disturbing him when he gets around to doing my root canal, so I figured it wouldn't kill me to wait a little while longer.

And I did, until about 4:50 PM, when I called and explained that while I understood he was up to his elbows in someone's mouth, Pharmacy #2 closed in about 10 minutes and I really didn't think I could take another sleepless night. "Oh, you should have let us know that you were in pain. We'll call it in right now."

10 minutes later, I had more penicillin for the presumed infection which was causing all the pain, and hydrocodone (aka Lortab aka Percocet aka a couple of other drugs that I've had to hold people down while they had their stomachs pumped because they took too many). Hydrocodone says not to drive or operate heavy machinery. "Honey, I *am* heavy machinery." Regardless, I figured it might be a bad idea to take a couple and then drive for an hour to get home.

Halfway home, halfway up a mountain, I yawned to try to relieve the pressure. My right jaw grated and popped, almost as if coming out of the socket (and, yes, I know what that feels like, too), and there was a sound in my right ear almost exactly like a toilet flushing. Next thing I knew, most of the pain above my jawline was gone, though the tooth was still throbbing. Until then, I didn't realize that most of the pain was actually an earache and not a toothache.

I took my new pain pills and slept really good that night, but I was afraid to take them while driving around the parking lots at work. Back to over the counter stuff and baby's teething gel, which in addition to numbing my gums, also had a really nice strawberry flavor. But the penicillin was doing its trick, and I needed less and less painkillers during the day, though for the nights I still needed something to stop the throbbing so I could get some sleep.

All week long, at least a couple of times a day, I called CrapDent and argued with someone different every time. Tooth hurting so bad that you can't sleep at night without heavy drugs is not considered an emergency, and all they'd agree to pay for a root canal not done by my primary care dentist (still #1 or #2, according to their records, depending on who I asked) was 25.0%. I began to dispair.

Finally, after asking some convoluted trick question involving getting Dentist #2 to write a referal to another general dentist #5 who could conceivably be considered a specialist because #5 did procedures that #2 doesn't, the CrapDent person I was speaking said something to the effect that it didn't matter what they did, Dentist #5 wouldn't see me until my name appeared on their patient roster.

"Wait a minute," I snapped back. "Dentist #5 has already seen me! He's willing to do the procedure whenever I want. The holdup has been y'all telling me that you won't pay."

Oh, no, I'd been given bad information. They'd be happy to pay just as soon as Dentist #5 accepted me as a patient, as they could always backdate him as my primary care dentist...

In minutes I was on the phone with Dentist #5, and again I slammed against the brick wall of not being on their patient roster, so again I had to speak to the office manager. She couldn't understand why CrapDent couldn't put me on the patient roster immediately instead of two months from now, as they had already accepted me as a patient. "Well, they've already closed the list for next month."

"Closed the list? That just means they've printed it out and mailed it to us. They can update the list in their computer whenever they want. We'd just need them to FAX over your eligibility information and we can consider you on the roster right now."

I was back with CrapDent in a flash, recounting the story so far to the customer service representative that answered, a different one as always. However, I did notice that the voice sounded familiar. I also noticed that every time I called, there would be a slight pause before they told me their names. "Thank you for calling CrapDent. This is, uh, John. How can I help you today?" I was beginning to think that I was talking to the same two or three people over and over again, giving me different names so I couldn't keep track of who was telling me all that contradictory information.

CrapDent agreed to FAX said information. Calling the office manager back, I told her that CrapDent might be calling to make sure I was telling the truth about them being willing to take me as a patient, as they didn't seem to believe what I described was possible, and after they they would be FAXing the information. She said something to the effect that there's always a way around the apparent stupidity of the insurance company, if you know what to do. Also something vaguely condenscending about men and forms and dentists, but I let that part slide. She went ahead and scheduled me for my root canal a week from next Saturday.

Tomorrow or the next day I'll call and double check that CrapDent did indeed FAX or otherwise send the required information, and that I am indeed officially on the patient roster of Dentist #5.

Continue on to Part 3.

Copyright 2005 by Troy H. Cheek. Reprint with prior written permission only. Comments and questions to