Update: A week after I left this review, Sarah left me a voicemail that she spoke with Delta Dental had and that they told me wrong and that if I new the names I should reach out to Delta Dental so that they could use my situation for training. When I called back, I explained that I went to 2 different dental offices that offered the PPO rates (one of which they recommended for our daughter) and that on each of the calls with Delta (at least 3) I was told the same information about our plan. She then said that because of discrimination purposes that they couldn't offer one patient one rate and another patient a different rate. She said that their office decided to charge the Premier rate with all reimbursement plans. When I said, that they could have charged the PPO rates, she retorted with, "we could have charged UCR fees (more for cash patients or out of network fee schedule and more expensive), but we chose to go middle of the road and I know this can all be very confusing." Their choice to choose to charge patients Premier rates does not mean that I am wrong about my plan. I explained that they have they have the right to charge whatever fees they like (within their allowable fee schedules), but telling me that I can see their PPO dentist and get the PPO rate and then trying to charge me Premier rates and telling me I don't understand my plan is condescension at it's finest. To sum up the conversation, we went from you were told wrong, to you don't understand, to it's our office policy and we could have charged more. Know your plan and advocate for yourself.
As an example for our plan, a filling for a rear tooth (2 surfaces) with Premier rate is $228 and with PPO it is $145 and UCR or out of network is $272-306. With our plan, we pay 50% so we want to go to a dentist who will honor the PPO rates. Packer is a PPO/Premier dentist and Owens is a Premier dentist. We saved almost $600 for our daughter's dental work at the pediatric dentist because they honored the PPO rates even though they are a Delta Dental PPO/Premier dental office as well.
The dentists here may be good, but know that if you are a reimbursement plan, they will charge the higher Premier rates. We have a reimbursement plan which is unique, but allows us to have a broader network of dentists. If your family has dental insurance through CSU than likely you have this plan. Dr. Owens is a Premier dentist which charges higher rates. Dr. Packer is a PPO dentist which means the services are the same, but are less expensive because of the negotiated rates with Delta Dental. When I called to make the appointment with Tammy I was very clear that I wanted to switch from Dr. Owens (current patient of his) to Dr. Packer and asked for the PPO rates and she had said that wouldn't be a problem. I asked her to send the information over to me so that I knew what my portion would be. When I got the amount it was the Premier rates. When I asked her why she didn't give the PPO rates she said that both doctors are the same (which is untrue) and said that their Delta Dental rep said that they are allowed to charge the higher rates if they want to because of my plan. Keep in mind, we qualify for PPO rates and said multiple times I wanted the PPO rate when making the appointment. Tammy acted ignorant to my request and said she must have misunderstood why I was switching dentists. When I asked to speak to the office manager or the bookkeeper, she refused to pass me on and told me that they would tell me the same thing. She said if I wanted PPO rates that I would have to go to another office even though they have a PPO dentist on staff. If you are a patient here, I highly recommend you familiarizing yourself with your dental insurance policy because the office will charge the higher rates to line their pockets. Please know your policy before booking an appointment so that you're not taken advantage of and pay more than necessary out of your pocket. Even the nicest dentists have policies that are not to your benefit. read more
