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I've been seeing the same dentist for the past 15 years. Today I had an appointment and when I arrived, I was told that they couldn't see me because I have Medicare and they didn't accept Medicare. I've had Medicare for the past 7 years and have always paid cash. They said they could be fined if they saw me. Is this true or were they making that up?


Thanks, Ken

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The Balanced Budget Act of 1997 prohibits drs from making private contracts with Medicare recipients. It means that’s drs cannot take cash from Medicare recipients for services covered by Medicare unless the dr has opted out of Medicare. There are similar laws regarding Medicaid, drs cannot accept Medicaid recipients as cash clients. It’s possible some of these laws extend to dentists as well, although in the OPs case traditional Medicare doesn’t cover dental cleanings so under the 1997 act I cited, they should be allowed to pay cash. But their dental office is really who they should be asking about this as someone there should be able to explain the policy change.
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Stacy0122 Feb 2021
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I would say that they are making it up if you are a cash patient.

I would ask the dentist if they know that cash customers are being turned away.

Call and leave a message on the dentist's voicemail or go in and request to see the doc. Be loud if you are brushed off so you can be heard by the person that you want to speak with. The front office workers in medical offices tend to be beyond ignorant towards patients and many times their employer has no clue that they are behaving so out of line.
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rovana Feb 2021
I don't quite understand - if you are paying cash, why not just say you have no applicable insurance coverage and go from there?
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Medicare or MEDICAID? I suspect it is the latter.
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AlvaDeer Feb 2021
Oh, I took it to mean medicare.
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My dentist no longer accepts the work-provided dental insurance plan i am on, so yes they can refuse to accept you. I did pay cash for the visit i was attending and in the meantime had to find a new dentist - after 20 years.

The reimbursement model gets too low - they can't afford the patient.
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Medicare doesn't really pay for dental work that I know of; nor does many supplemental insurance policies. I am not certain why a dentist would even ask about medicare or medicaid as they just don't cover dental; I understand their asking if you have dental insurance. Usually a dentist gives you an estimate of the work you need, and asks for some payment up front, the rest after the work is done.
Also, you are paying cash, so what you are a member of or not a member of should not figure in things?
I would speak with your dentist again, ask what you are missing, and telling them you will take your/their story to the American Dental Assn. or the Dental Board of the State of ____________(your state) to ask for details. Tell them that you suspect there may be some patient abandonment here and you would like a letter of explanation as to why they can no longer treat you.
Have there been any problems between you and this dental group in the past?
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kennyb2 Feb 2021
No problems at all, I did cancel one appointment because of covid.
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Some Medicare Advantage plans cover dental.
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Yes, they can refuse any patient. A few years ago, my tooth abcessed and my entire face was swollen and I had my dentist for years. They started the root canal procedure, like drilled it to drain it. The new office manager came in and said my dental was cancelled, I told her yeah, I have cash no problem. She said they could get me a dental credit plan (they get referral fees), I said no, I have cash. They stopped the procedure, put an anticeptic ball in the tooth and some putty on top and said they couldn't finish it. I was so pi$$ed.
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notgoodenough Feb 2021
Wow, I don't blame you, I'd be pi$$ed off, too!
I would seriously have reported this to the AMA, or whatever watchdog agency oversees dentists! Stopping in the middle of a procedure! If that wasn't a classic "bait and switch" tactic, I don't know what is! Shame on them!
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I don't get the fined part. We don't use our Medicare dental plan. He just wouldn't file with Medicare. They are either confused or making it up.
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I have no idea how it works, so I am not claiming to be an expert in this matter.

This is only a thought that I am throwing out for the OP!

I have not used their services so I can’t recommend or not recommend them.

In my state there is a dental school run by a large university (LSU) that the public can use at discount rates.

I have no idea what the policies are at dental schools but I do know that the prices are greatly reduced.

Best of luck to you in finding dental care.
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There must be something to not accepting cash, because it is happening more and more.

As Geaton says, they view it as complicated.

Seems crazy to me but I am no expert on this topic!

Once I took my brother to get insurance for his motorcycle. He had cash on him. The agency refused his cash.

It seems like cash is not always welcomed these days.
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Geaton777 Feb 2021
They are not a retail outlet. They don't like to have cash because it "disappears"; it sets them up for robbery; but mostly because their bookkeeping and accounting apps can't track it like a check or cc payment. They don't have a way to "make change". My business doesn't take cash either. Most corporations and non-retail businesses don't take it. In medical facilities and clinics everything regarding billing is based around codes. It is more complicated than you can know.
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