Dentists scamming the PRSI system?

hamiltron

Maybe I'm missing something here, but it appears that every dentist in my area is blatently ripping off people using the PRSI dental benefit system.

After finding that my own dentist was not applying the system properly, I asked 4 other dentists how much they charge for fillings, with and without PRSI. In every case it was the same - fillings will cost you only around €20 - €30 less if you are on the PRSI scheme. e.g. they cost from €85 privately - €65 if you are on PRSI.

The system is supposed to be that the dentist is supposed to charge the private fee, less 15%, then the DSFA (Department of Social and Family Affairs) pays €32.35 of the total and you pay the balance. In the above case, you should be charged:

€85 - €12.75 - €32.35 = €39.90

...so you are being ripped off to the tune of €25.

Is this the case everywhere? Can anyone explain why this might be acceptable? I did call the PRSI people to confirm that I had understood the scale of fees correctly:

http://www.welfare.ie/publications/dental_sof.html

I am going to sort out my own situation with letters to my dentist, but was thinking that I should also write to the DFSA to report the situation. The press might be interested also - no?

Colonel Sanders

last time I was at a dentists I had to fill out the form as normal but left the line blank where it said to sign after I hd my check up. The receptionist saw it blank and made me sign it before I went in. They could have claimed that the dentist did far more than a check up. Slightly off topic but a scam in the making nevertheless.

hamiltron

Colonel Sanders wrote:

last time I was at a dentists I had to fill out the form as normal ...

That's another wierd thing - I did not have to sign any form and I don't even remember giving them my PPS number - they just said that they were going to charge me the PRSI price. I know that some dentists organise the registration for the scheme for their patients, but in my particular case, I get the feeling that they did not know what they were doing.

Still, my main point is still that there seems to exist a general abuse of the system by dentists as a whole.

MOH

Just wondering, it's not a case that you pay the money up front and then claim back the 32.35 ?

hamiltron

MOH wrote:

Just wondering, it's not a case that you pay the money up front and then claim back the 32.35 ?

Well, some dentists will tell you that they will charge you the private rate until they get confirmation that you qualify for the scheme, then the dentist will refund you. But once you are qualified, the 32.35 is paid by the DSFA to the dentist. They should knock that off the bill to you (on top of reducing their charge by 15%).

Instead they don't reduce their fee as they should, reduce the amount they charge the customer by €20 odd and pocket the €32.35 they get from the department...

I am quite sure that I will be able to get my reductions by dealing with my own dentist, but I wanted to raise some awareness of the issue as a general consumer rip-off.

hshortt

You are making a complaint and then you are going to let these guys loose in your mouth!!??

I do agree, and as Colonel Sanders said, I've also never signed the form after they've completed it, it's always blank.

Cheers

TheDriver

Defintely some dentists charging lot more but luckily I found one that goes by the book and deserves the business.

Zaph

hamiltron wrote:

The system is supposed to be that the dentist is supposed to charge the private fee, less 15%, then the DSFA (Department of Social and Family Affairs) pays €32.35 of the total and you pay the balance.

I had three fillings two weeks ago and another last week, and I was pretty sure that they were overcharging me for the first lot so I asked the secretary to check and I'd pay when I was back next time. Based on the above calculation the charges of €97 for private and €50 for PRSI are correct. However, where I was being overcharged is that they assumed my salary was above €55k and therefore I had to pay the full amount, although I don't think they were deliberately trying to overcharge me they just made an incorrect assumption. It's something worth watching out for as in my case for each filling I would have been paying almost double, and for the dentist he gets to add on nearly €15 more that he can't claim from the DSFA.

deisemum

I don't know how the dental prsi system works as it doesn't apply to me but I worked as a dental nurse in the UK and I can honestly say that I and my dental nursing friends in other practices who worked for NHS dentists witnessed practically all of them ripping off the NHS especially if it was a patient that was exempt from paying.

When I told a dentist that had a private practice how much NHS dentists were claiming and earning he was shocked. The NHS dentists were often earning a hell of a lot more than the private dentists.

hamiltron

zaph wrote:

Based on the above calculation the charges of €97 for private and €50 for PRSI are correct.

€97 - Funny amount to be charging people for a filling, wouldn't you say? Sounds like a certain dentist wants to earn about €80 for a filling, so set a PRSI price that would end up giving him that... If a person not covered by PRSI got the same work done, would the dentist really charge him/her €97? I doubt it...

I think that the dentists in my area have just not had to be smart like that yet. Unless dentists are required to publish a range of charges for various types of work (like restaurants, bars, etc. have to publish drinks/food prices), they will always be able to claim that the equivalent Private price for any given work was more than they would actually charge a private person. I will suggest that to the DSFA.

Anybody out there ever paid around €100 for a standard amalgam filling outside of the PRSI scheme?

Of course, the question will be asked "Why should a dentist have to accept 15% less for PRSI work than private?" Fair question - it is a bit unfair on all of those self-employed people out there. This, however, should be argued between the dentists and the department ... not simply adjusted for by unscrupulous dentists.

Lex_Diamonds

Paid €130 the other day for a filling. Seems high! Said he had to throw a metal pin in there, probably boosts the cost. Either that or I'm getting ripped.

Wudyaquit

I'd trouble like this with Ronan Cahill's dental surgery in glasnevin - they overcharged me for a filling and told me I was only entitled to Eur 30 back from the PRSI. Before july 07 the entitlements were different, and I should have been entitled to almost Eur 50 based on what they had told me (Eur 120 for the filling all in - I should have gotten Eur 30 plus 15% of the total Eur 120 cost)
When I rang them about it, they said the filling actually had cost 150 eur (despite me having a receipt for 120 Eur). When I said this they told me the extra 30 was for a prescription they had given me - again this wasn't mentioned on the receipt so they changed their story again.
Anyway, the PRSI agreed that they owed me the money, but when it came to it, the surgery claimed that the dentist who'd done the filling didn't work with them anymore and the PRSI stopped persuing them.

Any ideas on how I might get them to pay what they owe?
They've been incredibly arrogant (not to mention greedy) about the whole thing and it's been very clear from dealing with them that it's standard procedure. For most people it would be impossible to argue with them unless they had a receipt as they would just increase the supposed charge by the amount they overcharged....

eth0_

I was lied to/had very shoddy work done/had the hard sale put on me to start work on a dental implant THE NEXT DAY by three dentists a few years ago - 2 in Dublin 1 in Drogheda.

After those experiences i'd never see a dentist in the Republic again unless it was an emergency. My dentist is in Newry and she's brilliant, talks you through what she's doing (if you want to hear it, that is!), lots of pain relief and she knocked some stuff off my bill when I got a crown + bridge done.