Dentist charging a "behavioral fee" for ASD child?

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:It sounds like your kid's issues created a longer appointment than the time normally allotted. Maybe that's why the fee.

Time and stress.
Why do the parents of neurodivergent kids go to great lengths for all accommodations but don’t want to pay extra or be singled out? Part of being neurodivergent is you are different. It’s ok! But pay the fee and accept your kid was a headache and you know they were! You know it!

Should this apply to NT people as well. I have never had a cavity in my life. I have perfect gums (thanks genetics) and my cleanings go very quickly. If patients are going to be charged more for being Autistic and needing accommodations then I hope patients with cavities and who don’t floss get charged more than me for their appointments which surely take longer.

/s

You know that’s not the point! You know it. This is gross and offensive again from
The ND community. Your kids are what they are. We all make allowances and adaptations for you in public schools and all over!! Quit trying to justify this.

Different PP here and I think it’s exactly the point. This isn’t a by the minute charge. Some cleanings are faster than others and they all cost the same. Do you expect your physician to charge extra at your well visit because you have a cough in addition to the high blood pressure you were planning to talk about? If there’s a dentist who wants to set up a totally different model of charging they should be up front about it. That’s all.

I think you should go take a good look in the mirror and figure out what is wrong with your life that you have decided to come on a board intended for SN families and bash some one who had a really bad day. This isn’t the place for you to take out whatever aggressions you have on an anonymous stranger.

NP. Um, yes. What a bad example. This very well may get coded as a sick visit on top of the wellness visit. Most primary care offices will hide in tiny print somewhere that they may bill your insurance like this because they can claim separate codes. I know mine does.

DP but the fact it’s coded and sent to insurance means it was a pre-negotiated cost. Not just an after the fact made up fee.

And in this case OP’d kid got the dental cleaning, which was the exact procedure scheduled. Some patients will be easier, some harder. Some cleanings will go quickly, some will take longer. The options should be switch to time billing, accept that it will take a bit of accommodation, or decide the child is not a good fit and ideally refer them elsewhere. Not use the experience as an excuse to extract money from someone.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I think what makes me really mad on your behalf OP is that this dentist treated your kid like a burden. ALL kids deserve dental care not just the perfect ones. We SN parents get so used to our kids getting excluded due to their disability that it starts to seem like they aren’t entitled to anything. But all kids deserve health care - it should be the one place where “behaviors” don’t get your kid kicked out. That’s not to say that it may not reach a point where the medical professional has to call in more support or refer to a specialist. But you don’t just … fire your harder to treat patients!! And then try to charge them for it. SO unprofessional. She should have come up with a plan to either get more behavioral support for her office or figure out a referral.

Oh course health care providers do. How strange to think they shouldn't.

They shouldn’t. It’s unethical and unprofessional, and possibly illegal if done in violation of the ADA.

To make sure I understand, you think it is ok to force a person to treat a someone they don't have the capacity for. Hold them hostage and have no choice in the matter, like your own little slave.

Healthcare providers do have a choice and they are permitted to have free will, even if you think they are your personal property.

DP. Yes and same if they refused to treat someone on the basis of race or any other protected class or characteristic

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:OP--Just to note, I asked why we were being charged a "behavioral fee," and where we had agreed to do so. After asking several questions about this extra charge, and after other parents in the office also began to take notice, I was told that we no longer had to pay the fee. But please be forewarned about this practice.

NP. The whole thing sounded very tense and stressful for everyone involved, for your DC, you, and the dentists and techs. Maybe you have become accustomed to the stress (tbh, I have not, after so many years, I'm a bit of a wreck now) but the dentists and techs aren't.

You didn't say how old your DC is or how previous other dentist appointments have gone. What is tolerated in young children is less tolerated in older, larger children. Good luck at your next dentist.

Healthcare providers need to be able to work with people with disabilities. Full stop.

I know this is not the point of this post. But you are wrong. Special needs are a spectrum and to say that every single provider should be able to handle every single person with special needs is a crazy idea. Depending on the type and level of severity, special training and skills that don’t exist in the general population might be necessary.

They cannot just dump a patient on the basis of a disability with no attempt to accommodate. Based on what OP said, it sounds like the child could be accomodated (completed the checkup successfully) but the dentist just didn’t want to.

The dentist did accommodate them but it took additional time and OP wasn't willing to pay for that additional time. She is wrong.

IT DID NOT TAKE EXTRA TIME. That has been pointed out multiple times. Why did you insist otherwise?

I have never seen any doctor give a start and end time. I just don't believe it. The fact that the kid got out of the chair several times means by definition it took longer than it needed to. And how long did it take to pick out the toothpaste. Practitioners have a right to ask about medical history - I agree that the way they asked was not optimal.

If the child got up to take a break for sensitivity or anxiety within their appointment time then that’s what the patient needed.
But the bar is hell for some of you people. If the appointment was already taking long then why did Dr. Shin present 50 options for toothpaste? 🙄

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:That’s an ADA violation discriminating against a disability. The American Dental Assoc also acknowledges it’s improper to discriminate on the basis of disability.

It’s not an ADA violation to decline to treat someone you don’t believe you’re qualified to treat.

This is accurate.

The cleaning was completed within the normal appointment window, so it clearly was not the case here that she wasn’t qualified. the dentist just didn’t WANT to give the accomodations, which is illegal.

+1

This.

[Anonymous]

I'm sorry, OP. It hurts every time your child is rejected. My own long time primary care doctor refused to treat my DD when she became an adult because he "didn't want to do that" even though he had never met her, yet gladly added her NT twin brother to his practice. I hope you find someone great to take over your child's dental care.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:It sounds like your kid's issues created a longer appointment than the time normally allotted. Maybe that's why the fee.

Time and stress.
Why do the parents of neurodivergent kids go to great lengths for all accommodations but don’t want to pay extra or be singled out? Part of being neurodivergent is you are different. It’s ok! But pay the fee and accept your kid was a headache and you know they were! You know it!

Should this apply to NT people as well. I have never had a cavity in my life. I have perfect gums (thanks genetics) and my cleanings go very quickly. If patients are going to be charged more for being Autistic and needing accommodations then I hope patients with cavities and who don’t floss get charged more than me for their appointments which surely take longer.

/s

You know that’s not the point! You know it. This is gross and offensive again from
The ND community. Your kids are what they are. We all make allowances and adaptations for you in public schools and all over!! Quit trying to justify this.

Different PP here and I think it’s exactly the point. This isn’t a by the minute charge. Some cleanings are faster than others and they all cost the same. Do you expect your physician to charge extra at your well visit because you have a cough in addition to the high blood pressure you were planning to talk about? If there’s a dentist who wants to set up a totally different model of charging they should be up front about it. That’s all.

I think you should go take a good look in the mirror and figure out what is wrong with your life that you have decided to come on a board intended for SN families and bash some one who had a really bad day. This isn’t the place for you to take out whatever aggressions you have on an anonymous stranger.

NP. Um, yes. What a bad example. This very well may get coded as a sick visit on top of the wellness visit. Most primary care offices will hide in tiny print somewhere that they may bill your insurance like this because they can claim separate codes. I know mine does.

DP but the fact it’s coded and sent to insurance means it was a pre-negotiated cost. Not just an after the fact made up fee.

And in this case OP’d kid got the dental cleaning, which was the exact procedure scheduled. Some patients will be easier, some harder. Some cleanings will go quickly, some will take longer. The options should be switch to time billing, accept that it will take a bit of accommodation, or decide the child is not a good fit and ideally refer them elsewhere. Not use the experience as an excuse to extract money from someone.

They are asking for additional money for the additional time it took. That's fair.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:OP--Just to note, I asked why we were being charged a "behavioral fee," and where we had agreed to do so. After asking several questions about this extra charge, and after other parents in the office also began to take notice, I was told that we no longer had to pay the fee. But please be forewarned about this practice.

NP. The whole thing sounded very tense and stressful for everyone involved, for your DC, you, and the dentists and techs. Maybe you have become accustomed to the stress (tbh, I have not, after so many years, I'm a bit of a wreck now) but the dentists and techs aren't.

You didn't say how old your DC is or how previous other dentist appointments have gone. What is tolerated in young children is less tolerated in older, larger children. Good luck at your next dentist.

Healthcare providers need to be able to work with people with disabilities. Full stop.

I know this is not the point of this post. But you are wrong. Special needs are a spectrum and to say that every single provider should be able to handle every single person with special needs is a crazy idea. Depending on the type and level of severity, special training and skills that don’t exist in the general population might be necessary.

They cannot just dump a patient on the basis of a disability with no attempt to accommodate. Based on what OP said, it sounds like the child could be accomodated (completed the checkup successfully) but the dentist just didn’t want to.

The dentist did accommodate them but it took additional time and OP wasn't willing to pay for that additional time. She is wrong.

IT DID NOT TAKE EXTRA TIME. That has been pointed out multiple times. Why did you insist otherwise?

I have never seen any doctor give a start and end time. I just don't believe it. The fact that the kid got out of the chair several times means by definition it took longer than it needed to. And how long did it take to pick out the toothpaste. Practitioners have a right to ask about medical history - I agree that the way they asked was not optimal.

If the child got up to take a break for sensitivity or anxiety within their appointment time then that’s what the patient needed.
But the bar is hell for some of you people. If the appointment was already taking long then why did Dr. Shin present 50 options for toothpaste? 🙄

Re the toothpaste choices, I just tell the hygienist what flavors of toothpaste and flouride to give my kid at the beginning of the appointment since I know what they like and it takes away some of the anxiety from decision-making.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:It sounds like your kid's issues created a longer appointment than the time normally allotted. Maybe that's why the fee.

Time and stress.
Why do the parents of neurodivergent kids go to great lengths for all accommodations but don’t want to pay extra or be singled out? Part of being neurodivergent is you are different. It’s ok! But pay the fee and accept your kid was a headache and you know they were! You know it!

Should this apply to NT people as well. I have never had a cavity in my life. I have perfect gums (thanks genetics) and my cleanings go very quickly. If patients are going to be charged more for being Autistic and needing accommodations then I hope patients with cavities and who don’t floss get charged more than me for their appointments which surely take longer.

/s

We do. If there is a lot if plaques, you can be charged for scaling. And we pay to have cavities filled. But it's a separate appointment, so as to not mess up the dentist's schedule.

[Anonymous]

I found this example from four years ago: https://m.youtube.com/watch?v=TZ_NRMsseOU

And I found this from a California website. It's a real thing:


ARC 071B: Behavior Modification (D9920) is only payable when the patient is a special needs patient that requires additional time for a dental visit.

[Anonymous]

Anonymous wrote:I'm sorry, OP. It hurts every time your child is rejected. My own long time primary care doctor refused to treat my DD when she became an adult because he "didn't want to do that" even though he had never met her, yet gladly added her NT twin brother to his practice. I hope you find someone great to take over your child's dental care.

I know it’s sad but some people do not want to be around ND people. We preach kindness and compassion but it’s also very hard. Please acknowledge both sides. I’m sorry this is happening to you!!