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A database of fees charged by out-of-network dentists could help lower your bill. (iStockphoto.com)

Smart Shopping Can Relieve Pain From Dentists' Charges

by Michelle Andrews
Apr 17, 2012 (Kaiser Health News)

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Michelle Andrews

If you need dental work, chances are you'll pay a big chunk of the bill out of your own pocket, even if you have dental insurance.

Dental coverage often maxes out at a just few thousand dollars a year or less and typically covers only half of the cost of major procedures like crowns and root canals.

Getting a reliable estimate of prices in your area can be critical if you want to keep a lid on costs. A free consumer website may provide the information you need.

It's the work of Fair Health, a nonprofit corporation that was created as part of a 2009 settlement between then-New York Attorney General Andrew Cuomo and insurers.

An investigation revealed that an insurer-owned claims database used to determine out-of-network reimbursements presented a conflict of interest. In addition to the consumer website, Fair Health provides independent-claims data that insurers can use to determine out-of-network rates.

The Fair Health database is regularly updated and contains medical and dental claims from insurers and third-party administrators covering 126 million people. With the database, people can look up out-of-network reimbursement amounts for procedures in their area.

According to Robin Gelburd, president of Fair Health, 40 percent of dental care is provided out-of-network compared with just 10 percent of medical care. That makes the dental cost calculator a potentially useful tool for many consumers.

During a recent search on a zip code in Manhattan, for example, I learned that the estimated cost for a porcelain crown is $2,100 here, making the $1,750 that my dentist charges seem if not exactly a bargain at least not highway robbery.

Copyright 2014 Kaiser Health News. To see more, visit http://www.kaiserhealthnews.org/.

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