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My dentist charges me $30 for each visit for their PPE cloth
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amother




Honeydew
 

Post Tue, Jan 05 2021, 7:57 am
FranticFrummie wrote:
Because of Covid, dentists need to make upgrades to their practice and procedures. I get that.

What I don't understand, is why don't they deduct that as operating expenses when it comes tax time? It's a necessary improvement, not an interior design choice, and shouldn't be dumped on the clients.

If they are using the expenses as a tax deduction, AND charging the clients, that's double-dipping. I don't know if that's illegal, but it's certainly questionable.


If you report income and expenses - its not double dipping.

What you are suggesting is that the dentists are charging cash and not reporting it.
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Amarante




 
 
 
 

Post Tue, Jan 05 2021, 7:59 am
FranticFrummie wrote:
Because of Covid, dentists need to make upgrades to their practice and procedures. I get that.

What I don't understand, is why don't they deduct that as operating expenses when it comes tax time? It's a necessary improvement, not an interior design choice, and shouldn't be dumped on the clients.

If they are using the expenses as a tax deduction, AND charging the clients, that's double-dipping. I don't know if that's illegal, but it's certainly questionable.


That's not how taxes work - they aren't a credit. No one is giving them free PPE or paying for the upgrades or compensating them for the inability to see as many patients - therefore each patient seen costs more since there are fewer patients but costs are higher.

And all businesses - including dentists - calculate how much it costs to provide services as well as provide a profit or salary to the owner.

If costs rise for a business they are generally always theoretically a deduction since all business expense are deductible.

ETA - Interior design choices are a valid tax deduction for any business including a dentist.


Last edited by Amarante on Tue, Jan 05 2021, 8:15 am; edited 1 time in total
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FranticFrummie




 
 
 
 

Post Tue, Jan 05 2021, 8:01 am
Amarante wrote:
That's not how taxes work - they aren't a credit. No one is giving them free PPE or paying for the upgrades or compensating them for the inability to see as many patients - therefore each patient seen costs more since there are fewer patients but costs are higher.

And all businesses - including dentists - calculate how much it costs to provide services as well as provide a profit or salary to the owner.

If costs rise for a business they are generally always theoretically a deduction since all business expense are deductible.


OK, I misunderstood. Thanks for clearing that up. embarrassed
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amother




Honeydew
 

Post Tue, Jan 05 2021, 8:01 am
Amarante wrote:
I don't think any of these cover dentists who don't accept insurance since the cost for services is always the responsibility of the insured. The dentist doesn't have anything to do with insurance beyond providing evidence that service was rendered.

This is different than services by a doctor who is in a network and agrees that insurance is full compensation for services. It's the same as a Medicare doctor who does not have the right to charge anything in addition to what Medicare reimburses. Or if you go to a doctor out of network, they can charge whatever they generally do and reimbursement by insurance is between you and the insurance company since the provider doesn't have a contract to provide services for a specific insurance reimbursement - that is exactly what being in the network means.


Right. We're talking about insured patients - and while maybe there are new reimbursement rates for 2021 that take the extra costs of service into account - those weren't negotiated for 2020.
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FranticFrummie




 
 
 
 

Post Tue, Jan 05 2021, 8:03 am
amother [ Honeydew ] wrote:
Right. We're talking about insured patients - and while maybe there are new reimbursement rates for 2021 that take the extra costs of service into account - those weren't negotiated for 2020.


That makes sense. When budgets were drawn up, I don't think anyone saw 2020 coming.
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amother




Honeydew
 

Post Tue, Jan 05 2021, 8:06 am
FranticFrummie wrote:
That makes sense. When budgets were drawn up, I don't think anyone saw 2020 coming.


That comment was about the reimbursement rate from insurance providers....

But as I said upthread - Dentists can't see as many patients in a day as they once did, and they were forced closed in many jurisdictions.

Like many other businesses - they are suffering. Its very expensive to run a dental office, and when there are new restrictions that impact how many patients can be seen a day - its hard.
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Amarante




 
 
 
 

Post Tue, Jan 05 2021, 8:08 am
amother [ Honeydew ] wrote:
Right. We're talking about insured patients - and while maybe there are new reimbursement rates for 2021 that take the extra costs of service into account - those weren't negotiated for 2020.


Correct - if someone is going to a dentist where insurance covers the cost of procedures, then they can't tack on a separate fee. But that is very specific to dentists who are in a network and agree to take whatever insurance pays as full compensation.

At least in my experience, almost no dentists take insurance so it's moot. They charge whatever they want. Typically one is covered 50% of "customary charges" for major work like root canals and crowns which means that if your dentist charges more, you are reimbursed 50% only for a lower amount that the insurance company determines is the "customary".

But I think we both agree that contracts are going to be negotiated (or were) for 2021 to factor in greater costs for providing dental services in 2021. Ironically insurance companies actually did well because people were getting fewer medical and dental procedures done.

The additional charge in 2020 was for dentists who were attempting to make back some of the increased costs they hadn't anticipated when they entered into contracts for 2021. Since the procedure was covered by insurance, the only way to attempt to get money would be to call it a PPE charge which isn't permitted as a way around network charges.

But for most people who don't have insurance for network dentists, it's moot. My dentist charged $165 for a cleaning. He could present a bill for $195 or $165 plus $30 and it would make no difference as I will still owe him $195.
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amother




Chocolate
 

Post Tue, Jan 05 2021, 8:14 am
It’s just a way for them to recoup losses from the strain that covid compliance is putting on business.

Alternatively they can just increase their rates, which would probably not go back down after this all passes (if it does). But then everyone would be up in arms about the higher rates...

Every industry is hurting and figuring out how to make it work for them.

Unless you sell PPE then your raking it in 😂
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amother




Honeydew
 

Post Tue, Jan 05 2021, 8:17 am
Amarante wrote:
Correct - if someone is going to a dentist where insurance covers the cost of procedures, then they can't tack on a separate fee. But that is very specific to dentists who are in a network and agree to take whatever insurance pays as full compensation.

At least in my experience, almost no dentists take insurance so it's moot. They charge whatever they want. Typically one is covered 50% of "customary charges" for major work like root canals and crowns which means that if your dentist charges more, you are reimbursed 50% only for a lower amount that the insurance company determines is the "customary".

But I think we both agree that contracts are going to be negotiated (or were) for 2021 to factor in greater costs for providing dental services in 2021. Ironically insurance companies actually did well because people were getting fewer medical and dental procedures done.


Right - this conversation is limited to dentists who take insurance - perhaps not your experience - but this does happen.

I suspect Receivables insurance companies are feeling the burden of it..
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Amarante




 
 
 
 

Post Tue, Jan 05 2021, 8:22 am
amother [ Honeydew ] wrote:
Right - this conversation is limited to dentists who take insurance - perhaps not your experience - but this does happen.

I suspect Receivables insurance companies are feeling the burden of it..


I think it's very specific to location. The same appears to be true for Medicaid as where I live almost no doctors take Medicaid whereas it appears that in certain parts of the Tri-State area, there are many doctors who take Medicaid.

That is different from Medicare as almost all doctors take Medicare because they would have a difficult time if they excluded everyone over 65. It is hard to find a OB/GYN who takes Medicare though because many of them do fine without senior ladies. Very Happy There are doctors who cater to the extremely wealthy who don't take Medicare though. I have a friend who pays out of pocket for her doctor and there is a very famous hip replacement doctor who doesn't take Medicare because he doesn't have to. However if you use his services, everything else is covered by Medicare so you are only out of pocket for his fee.
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Frumme




 
 
 
 

Post Tue, Jan 05 2021, 8:38 am
amother [ Bronze ] wrote:
No, because it's not an actual free market with competition, and because they are not up front about costs.


I'm confused, don't you ask how much your bill will be beforehand? What isn't upfront about it? If they weren't upfront after the original quote, then when you pay you would have seen it on the receipt and (hopefully) ask them to take off the extra charge or at least reduce it. You can say you were expressed that the total amount was going to be X and not have the hidden charge of Y.
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amother




Honeydew
 

Post Tue, Jan 05 2021, 8:41 am
Amarante wrote:
I think it's very specific to location. The same appears to be true for Medicaid as where I live almost no doctors take Medicaid whereas it appears that in certain parts of the Tri-State area, there are many doctors who take Medicaid.

That is different from Medicare as almost all doctors take Medicare because they would have a difficult time if they excluded everyone over 65. It is hard to find a OB/GYN who takes Medicare though because many of them do fine without senior ladies. Very Happy There are doctors who cater to the extremely wealthy who don't take Medicare though. I have a friend who pays out of pocket for her doctor and there is a very famous hip replacement doctor who doesn't take Medicare because he doesn't have to. However if you use his services, everything else is covered by Medicare so you are only out of pocket for his fee.


Oh - well if you're not in NY then not sure if your experience is relevant.
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Amarante




 
 
 
 

Post Tue, Jan 05 2021, 10:12 am
amother [ Honeydew ] wrote:
Oh - well if you're not in NY then not sure if your experience is relevant.


I wasn't writing about my experience per se although when I lived in New York, my dentists didn't accept insurance either but that's irrelevant.

Unless one goes to a dentist in New York State who is within your dental network, there doesn't appear to be any problem in terms of how a dentist calculates a bill.

The OP didn't indicate she was dealing with a dentist in New York State who was within a network which covered procedures. You can have dental insurance and choose to go out of network and the dentist can charge whatever they want because they have no contract with any insurance company.

I parenthetically added what appears to be a difference in dentists who are in network because in my experience (both Los Angeles and New York City) dentists I went to were never in a network - much like psychologists who generally aren't in network either.
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amother




Goldenrod
 

Post Tue, Jan 05 2021, 10:23 am
amother [ Honeydew ] wrote:
Oh - well if you're not in NY then not sure if your experience is relevant.
whi is this an exclusive NY conversation. Nj dentists are also charging COVID supplies and cleaning fees. Including those with insurance. The patient pays it.
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amother




Honeydew
 

Post Tue, Jan 05 2021, 10:25 am
Amarante wrote:
I wasn't writing about my experience per se although when I lived in New York, my dentists didn't accept insurance either but that's irrelevant.

Unless one goes to a dentist in New York State who is within your dental network, there doesn't appear to be any problem in terms of how a dentist calculates a bill.

The OP didn't indicate she was dealing with a dentist in New York State who was within a network which covered procedures. You can have dental insurance and choose to go out of network and the dentist can charge whatever they want because they have no contract with any insurance company.

I parenthetically added what appears to be a difference in dentists who are in network because in my experience (both Los Angeles and New York City) dentists I went to were never in a network - much like psychologists who generally aren't in network either.


Quote:
Most dentists don't take insurance - at least in my experience.


sorry - took you overly literally, my bad.

I just don't want to dismiss this NY guidance/reminder as 'moot' suggesting that it doesn't actually impact anyone in NY... because it does.

If I were a dentist - I'd argue that the extra PPE charge isn't a direct cost of the procedure... wonder if that's happening.
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jd1212




 
 
 
 

Post Tue, Jan 05 2021, 10:31 am
Tax deductions save on taxes, it doesn’t make the expenses disappear... my relative is a dentist and it was crushing to be closed for 3 months, and then also spend a ton to clean so much and space out patients which reduces revenue, staff that quits. I hate all this silliness here. It’s not being greedy, it’s trying to stay barely afloat.
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amother




Honeydew
 

Post Tue, Jan 05 2021, 10:47 am
amother [ Goldenrod ] wrote:
whi is this an exclusive NY conversation. Nj dentists are also charging COVID supplies and cleaning fees. Including those with insurance. The patient pays it.


I was responding to a poster who brought up NY guidance.
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