Dentist Mystery Charge on Bill (141 Oral Hygiene Instruction)

Went to my normal dentist yesterday for a regular check-up and clean. Everything went smoothly, I have no tooth issues, and the dentist didn't find any either.
After I paid my bill and walked out, I read my receipt and saw a line item on the bill: 141 - Dental Hygiene Instruction - $35, no benefit paid by my health insurance. I have never seen this on my bill before (though its possible I didn't check 100%). (for reference, other items on the bill were Remove Calculus $136, Topical Agent $37, Examination $67)

I called the reception on my way home and queried item 141, they were defensive and said it was just a standard change for Dental Hygiene Instruction. I explained that I didn't ask for or receive any dental hygiene advice, and therefore why was I charged it? She reiterated it was "just a standard charge and that they always charge that on every bill". I asked if I don't want hygiene advice did I need to specify up front? She said they could put a note on the system for next time, but normally health funds cover it and it was out of their hands if my health fund didn't (again very defensive). I said yes put a note, as I didn't ask for it and I didn't receive it - that was the end of the conversation.

I later googled it and asked a dental hygienist I knew - both sources indicated it was probably not legitimate in those circumstances. I stewed on this obviously - so I went back today to ask that the charge be refunded. The receptionist refused and again reiterated it was "just a standard charge they charge everybody, it's an allowed item number and they are entitled to charge it". I asked her to confirm that they charge this to everybody regardless of is the service was performed or not, and she confirmed yes. She said they've never had any complaints before. The only resolution I got was that she said she would raise it with the dentist.

I later got a text from the clinic containing the following: "the fee of $35 is a standard fee that we charge with item 141 inclusive for the professional services of a hygienist visit and time allocated. The total fee would be the same, even if we did not use this item. We use this item now as some funds pay back a little bit on it, but that depends on your fund and your level of cover. If you are not happy with our fees and service we provide, we are more than happy to send your records to another dentist that you will be satisfied with."

Question: should I just accept that this is a legitimate cost recovery strategy of the dentist, and stop being petty, If I don't like it move to a new dentist. OR should I reject the proposition that this is standard charge listed under a service item that was not provided or authorised, and do a credit card charge back under "goods not as described"?

Thanks all.

Poll Options expired

  • 36
    Accept the charge and stop being petty
  • 282
    Do a credit card charge back

Comments

  • +62

    Well you got it in writing that they ripped you off. Contact relevant ombudsman/etc if you have time too.

    Send them written request for refund. Then use this for chargeback.

    And no, that's not a standard item, just like your dentist friends said. Their own text even admits it.

  • +52

    I'd just go to another dentist and leave them a scathing review on multiple review sites.

      • +21

        Only if what you say isn't true

          • @Naigrabzo: So many downvotes. People think you can go to court with a lawyer to defend yourself for the price of bus fair and a Happy Meal.

      • +3

        Be weary.

        Yes, a legal action is likely to wear you out, and leave you tired.

      • Review anonymously

      • This is both true and in the public interest.

        That's sufficient defense in all states.

    • +2

      I wouldn't recommend posting bad reviews unless you are being objective and can prove it. The OP has a text message from the clinic though, so they can base their review around that.

  • +12

    I would fight it.

    An examination, you'd expect to get feedback and comments. It's ridiculous that they add on $35 for some advice which is probably to brush in a certain location more or whatnot.

    Same with the cleaning fee. Part of the cost is labour time which would include comments.

      • +17

        Obviously the item number exists and is a legitimate service/ charge IF the dentist actually provides it.

        The OP has stated it wasn’t provided then the practices excuse that “it’s a standard charge” is garbage and basically fraud.

        Further there is a thing called financial consent (as you should well know) and a practitioner can’t just charge a patient without advising them of the cost upfront

        Given that service was not provided and the OP wasn’t advised of the charge and thus did not agree to it it should be refunded.

        The dentist/ practice attempting to justify this unethical practice is just salt in the wound.

        OP should complain to AHPRA.

        Also OP do NOT complain to the ADA. That’s just the dentists union and they’ll defend the dentist. AHPRA is the government dental board and they are supposed to protect patients

        • -6

          I'm not sure if you read the comment I was replying to?

          They were saying that "It's ridiculous that they add on $35 for some advice which is probably to brush in a certain location more or whatnot."

          I am responding to that, in regards to what situations would be acceptable. I am trying to put some general information out there in regards to this

          I suggest before getting angry, you try to actually read and comprehend what is going on. If you want my opinion on the OP's situation, read down for my other comment to his actual post

          • -4

            @Tech5: It seems an educated view is not well received around here. Surprising absolutely noone.

        • AHPRA avenue is not a bad idea actually. don't post any reviews though. What's your hourly wage? Hope it's more than $35 per hour. You'd be working hard on this one.

          But I think the charge is absolute bull though. Especially how the practice explained it.

      • $500 an hour? Do they make a million a year? The number is a bit farfetched to use as an example to demonstrate your point.

        • +3

          No but the cost to keep the clinic open is over 250 an hour.

          A single drill costs $1000. We need 10+ Per dentist. Bearings wear out every few years. This is legit 1% of the costs.Costs add up in Australia

          Whether or not you believe me, an actual dentist, is up to you

  • +3

    I think it's their way of reserving a separate line item for the labour of the dental hygienist.

    Although i agree with you, they're double dipping to an extent in that they're already charging for the removal of calculus (which would be carried out by the dental hygienist) and that it's dodgy af.

    It's pretty cheap for the examination portion, mine would start at $100.

  • +10

    Find another dentist and move on.

  • +12

    Dental hygiene instruction =make sure you brush your teeth and floss.

    • +41

      Stop giving away industry secrets!

      • +31

        it's not a secret, they'll tell anyone for $35

      • +2

        Rob didn’t show his face 😀

      • OzBargainer saves $35 with this one easy trick. Dentists Hate Him!

    • +5

      Floss before you brush; Brah.

      • +16

        Do I owe you $35 for reading that?

        • +6

          I am going to add that to the next bill. Just charge you extra $35 for filling in the gaps (of ya knowledge). BOOM TISH!

      • *After

        • Technically before.

          You floss to get rid of gunk and bacteria. Then you brush your teeth and that kills everything everywhere.

          If you floss after brushing, then the gunk will still be there.

          But honestly, flossing is important, so as long as people do it, doesn't matter in the overall scheme of things

          • @mbck: Most don't flloss.

            • @Naigrabzo: Hence why I said it doesn't matter before or after, as long as people do it

              • +1

                @mbck: Agreed. if you are doing it, why not just do it before. Otherwise let em rot right boys let em rot.

                I have a dentist friend and I am eagerly waiting for him to buy a boat so I can also enjoy for free. Less flossing the better.

    • +2

      9 out of 10 dentist agree!

  • +7

    I'd move on to another dentist, they have doubled down on the charges so find another one.

    Leave them a review on Google Maps etc.

  • +7

    Good on you to fight with them. I couldn’t be bothered and would normally just make a mental note and find another dentist.
    They obviously know what they are doing. Name and shame?

    • +2

      I wanna know the place too, so I can blacklist them.

  • +9

    Which health fund are you with?

    Do they have any approved no gap check up dentists?

    141 Oral hygiene instruction -
    Instruction in techniques for the removal of bacterial plaque. Advice of appropriate toothpaste and medicaments may be included.

    Source

    What an absolute pi55 take. Tell them to get nicked.

    Lucky you're not a smoker or they might have added item 142

    142 Tobacco counselling
    The analysis and assessment of a patient’s tobacco use and advice on the prevention and cessation of the use of tobacco aimed at reducing the patient’s risks of developing tobacco-related oral diseases and conditions.

    • +11

      I'm gonna add item 141 to my bills. "141 Computer operation instruction - Instruction in techniques for the resolution of computer faults. Advice of appropriate switch to turn off and on again may be included."

      • I'm gonna add item 141 to my bills.

        Imagine some of the codes for the OzBargain Forums……

        • ID10T, PEBKAC, EEOC. All industry terms in IT

  • +12

    Depends what you're trying to achieve.

    If you want your $35 back, it's probably not worth your time and hassle. That said, given the way you've described the circumstances, I'd probably be looking for a new dentist.

    If you want to kick up and stink and cause so problems. You can consider Fair Trading, relevant dental associations/colleges, and your private health insurer. Effectively lodge a detailed complaint with each of them and see what they have to say. You probably won't find out what happened, or see any personal benefit from it, but you'll probably create grief and hassle for them, that may lead to a change of practice.

    My bet is they've not only just found an item code they can just tack on that no one says anything about, but it's probably one that usually has a high PHI rebate so for the punter it's "free" … but just serves to jack up the overall cost of PHI.

    • +5

      I think you're on the money there.

      I'd say that they've come up with a suitable set of item codes they can bill that most health insurances will accept. However OPs one didn't cover this

  • +3

    You're stuffed now anyway, you'll have to go to another dentist and don't tell them where you used to go. (They'll probably find out anyway)

    • How can they find out?

      • I don't really know, but like all medical professionals, seem to be able to login somewhere and check out your history.

  • +4

    Like others have said, after what has now happened, I would definitely bee looking for another dentist.

    Because next time you go back there, they might make it up to you in the form of a "free tooth extraction"! 🤣

    • +4

      Looks like this dental clinic does nothing for free though.

      OPs dentist probably even charges for you to see his face.

      • +8

        Item 69 Facial :)

        • No Emoticons!!!
          (that's a $4.20 charge)

    • they might make it up to you in the form of a "free tooth extraction"!

      By the sound of it, they are probably doing this to customers already. Not for free though…

  • +16

    Could you give a suburb/postcode etc, so locals can check if they are getting ripped by the same dentist

    • OP’s asking question for own gain, not others.

    • +3

      And risk losing their job/being pulled up to a tribunal for it?

      Yeahnah

      • +1

        Because someone leaves the competition…

    • +3

      Dentists talk.

      About how to scam their customers??

    • These are dentists, not mechanics…

  • +13

    Thank you for all the comments and votes - its no surprise other Ozbargainers think the same way.

    I'll definitely change to a new dentist (I think I've burned that bridge now), as for the chargeback - Im going to sleep on it so to speak over easter, and hopefully I'll calm down and be more reasonable then.

    Interestingly - I do agree this is a fraud on Private Health Insurance, maybe I'll settle for dobbing them in to Private Healthcare Australia - my fund (Frank) doesn't cover it so probably not interested.

    I'd rather not name and shame here, they know exactly who I am and with liable laws and wot-not, I'd hate to get myself in trouble. They're in Adelaide though.

    Thanks again All!

    • +11

      I just googled Adelaide+Dentist and found them. Cheers for the heads up.

    • +1

      Definitely fraud on PHI and I believe it's rampant. I wonder if you'd get this charge if you did not have PHI.

      • +1

        Ever wonder why PHI premiums keep going up?

    • You are a wise man.

    • +7

      You could make a complaint to the Dental Board of Australia www.dentalboard.gov.au - they have a mandatory code of conduct. A quick skim makes it look like they didn't follow it (ie billing for stuff they didn't do and then admitting they just stick it on the bill as insurance will just pay for it).

    • +2

      My take is your dentist is gaming the health fund system… something that I expect that they take very seriously.

      Have your records transferred to another local practice and then report them.

      From here

      Fraud by health providers or practice staff, these concerns should be directed to the Provider Benefits Integrity Hotline within the Department of Health

    • Chargeback is easier than you think, that would be the first thing I would do in your situation before making formal complaints/reports to regulatory bodies.

    • +1

      In Adelaide eh? Any chance they're on Port Road?

      • My sister in Adelaide ran into the same problem as OP did with a dentist she now formerly went to on Port Rd. They were previously located on Woodville Rd only a year or two back. She noticed what looked like excessive billing lines being charged to the govt via the children's dental allowance and after reviewing her own previous bills picked up the same charges for work never done to her private insurance provider. The staff she dealt with when tracking down what the charges were for, were pretty rude and unhelpful to say the least, apparently.

    • I work at a dental clinic, and every clinic charges differently. If you find a clinic that does "packaged deals"…it doesn't matter if you get xrays done or not…or oral health instructions…they will charge you the quoted amount. This is why it is very important for you to make sure they give you a quote prior to attending the appointment. Also…it's legal for them to charge you "oral health instructions" even if it's just basic brushing techniques or flossing techniques. It's very hard for you to argue the charge since it's only you and the dentist in the room. I'm sorry you've had a bad experience there, but as a consumer make sure you've joined a health fund that is in your favor. If you're a healthy person who doesn't need anything else that two dental check-ups and cleans in your fund. It would work better for you if you set up a bank account with a good interest rate and deposit around $100/monthly…Usually, a check up+clean won't cost you more than $320 and you'll only need it twice a year. Also always ask for item codes prior to your appointment so you can find out what your insurance will cover. Insurance isn't worth it if you're only seeing a dentist once or twice a year. Hope this helps you in the future.

  • Dodgy charges on top of overpriced items. I recently had a check up, examination $49, topical agent $28, remove calculus $89- Adelaide too.

    • thats standard.

  • +6

    It's a polite bad breath surcharge.

  • +1

    You don't want to be difficult do you?

    https://youtu.be/ZJ2msARQsKU

    • +7

      Amazing

    • +13

      Hallelujah! We were so deluded until you pointed this out to us.
      I will make sure I donate $35 to my dentist's "Buy Me a Tesla" fund next time I am due for a check and clean session.

    • +7

      Are you the dentist?

  • Is there no gap dental for check ups? Don’t some dentist advertise this… maybe not with this one.

  • +16

    I can’t believe poll result, hilarious!

    Look, dentists charge time based fees. 1 hour might be $400, so 30 min $200 and so forth.

    In your case, it’s unfortunate they use an item number that your health fund doesn’t pay. But regardless, they would still charge you the $200, and just spread it over the other item numbers differently. They obviously decided this is their standard way as it extracts more rebates for customers in general, but not in your case.

    What I would do in your case, is tell them you want them to reverse this invoice / hicaps claim, and resubmit it loading up those costs to the other item numbers, in the hope your health fund pays more. So you will still get charged same price but hopefully higher rebate.

    • +16

      Why not just honestly bill for the services that were actually provided though.

      Scammers gonna scam.

    • +4

      I think it is too late for them. If they decided to bill for a service not provided, that is a sure-lose in credit card disputes. Other allegations regarding fraud might be more tricky to prove but there is zero doubt in term of credit card dispute.

  • +3

    Personally I think the average doctors and dentists are no different from plumbers and electricians, but doctors and dentists are smarter at extracting money from us.

    • -2

      LOL true. I would love to believe that a doctor wouldn't replace a body part unless absolutely required but apparently mechanics do!! Shock horror.

  • +13

    similar thing happened to me. conversation went like this:-
    " hi. your going to refund it o things or 1} i'll take this up with your regulatory body 2} i'll be going to consumer affairs 3} will phone local minister of health 4 } watch. I then waited til other patients arrived and raised my voice several notches and asked them repeatedly about their dishonest practices. And made a pont of telling all in the waiting room to be careful. Then informed the maggot behind the counter that this was just the beginning.
    refund was issued that afternoon.
    - I know there will be other maggots who cant cope with this and down vote it as they cant stand to see their cowardice challanged…and thats funny.

    • +5

      100% agree with challenging the false charge, but not taking it out on the counter staff. They don't make policy; take it up with the clinic manager, and put everything in writing.

      • +3

        Most of the time the counter staff can either make the refund, or talk to the right person to make the refund.

        Having said that you shouldn't blame it on the counter staff, but blame it on the business and demand the counter staff resolve it.

      • Unfortunately counter staff are the only face of the business you can interact with.. often emails are a black hole, and dentists won't talk business. Clinic managers are the ones who put the counter staff in this position, not the aggrieved patients.

      • +5

        but not taking it out on the counter staff.

        It's not 'taking it out on them' - it's literally their job to deal with the customers.

        If it makes them uncomfortable dealing with customers who don't like being scammed then they can raise it with the owner/manager and maybe things will change.

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