Dentist charging a "behavioral fee" for ASD child?

[Anonymous]

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.

[Anonymous]

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.

I mean, to be fair you admitted in your post that your child’s behaviors were a lot. And required extra time and accommodations, which Dr shin provided? (And did YOU give the office advanced notice that this type of extra time and accommodation would be necessary for your child?—and did they “agree” to it?) Just trying to apply your rationale for NOT paying to their rationale for charging to begin with.

The fact that it took extra time and accommodation to successfully complete this appointment was not in dispute by you. But how can they warn you in advance about a special behavioral fee (which probably took extra staff, and time they weren’t prepared for given the regular appointment time allotted) if they don’t have any clue until you get there that there are any special circumstances??

Sounds to me like they were trying to go forward with the appointment as best as possible while also being compensated fairly …and yet when you pitched a fit about it, they removed the fee just to avoid the hassle of you.
And likely wanted to just have you leave in peace.
But you were so ungrateful and resentful that you decided to come on here and trash them online anyway. Wow.

Nothing she said or did seems out of line to me. I’m sorry that you are faced with some challenges in this department, but no one owes you services.

Wow--if this is the dentist, this seems unhinged. OP already said that the appointment didn't take extra time, and that the practice was aware of the child's disability. And medical/dental professionals need to understand how to provide services to people with disabilities.

OP didn’t say that until her 2nd and third entry, so was only going on her first entry here.

Well whose problem is that? Don’t opine unless you read the thread. Otherwise seems like you just have an ax to grind.

[Anonymous]

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.

[Anonymous]

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.

[Anonymous]

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.

They can actually drop a patient. They have to provide referrals if requested. But they are not required to treat especially f they do not feel qualified.

[Anonymous]

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.

[Anonymous]

Anonymous wrote:I’m sorry OP. I think it’s ok for a provider to admit they aren’t the right fit to handle a patient. Ideally there would be compassion and referral to somewhere that may be equipped to provide the service you need.

But trying to milk a fee out of you after the fact is horrible if you had not agreed to pay any such fee ahead of time. Even more so since you gave them notice of your child’s health issues ahead of time. And what was the point of asking where your child is on the spectrum if she doesn’t even intend to keep treating your kid?

100% I find the fee appalling. If they had planned ahead of time for a longer appointment or extra hands and then advised that those things require an extra fee, that is one thing. But this post appointment penalty for behavior that you told them about ahead of time is unethical IMO. I have been at this game for a long time and we have had some utterly disastrous medical and dental appointments and no one has ever tried to charge anything extra. Good for you for arguing it, OP. I probably would have paid it out of pure shock and to get out of there faster.

[Anonymous]

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.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Honestly, that sounds reasonable as you are paying for their time and if you needed frequent breaks and other things, understand its a business and they have to pay staff and that means they cannot schedule another patient. If an regular appointment takes 30 minutes and yours took an hour, they need to account for the extra time.

OP--just to note, the appointment did not go over the allocated time. While DC got out of the chair several times, it was only for a very short period of time. And we were the only patients in the office until another patient showed up for the appointment after ours.

OP, did the dentist office allocate any extra time for your child (as opposed to a standard appointment)?

I think people here are assuming something which might not be true. There's a semantic (and practical) difference between "not going over the allotted time" and "not taking any more time than a typical patient would," and I'm wondering if the latter is actually true -- especially given the stops and starts.

[Anonymous]

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.

I mean, to be fair you admitted in your post that your child’s behaviors were a lot. And required extra time and accommodations, which Dr shin provided? (And did YOU give the office advanced notice that this type of extra time and accommodation would be necessary for your child?—and did they “agree” to it?) Just trying to apply your rationale for NOT paying to their rationale for charging to begin with.

The fact that it took extra time and accommodation to successfully complete this appointment was not in dispute by you. But how can they warn you in advance about a special behavioral fee (which probably took extra staff, and time they weren’t prepared for given the regular appointment time allotted) if they don’t have any clue until you get there that there are any special circumstances??

Sounds to me like they were trying to go forward with the appointment as best as possible while also being compensated fairly …and yet when you pitched a fit about it, they removed the fee just to avoid the hassle of you.
And likely wanted to just have you leave in peace.
But you were so ungrateful and resentful that you decided to come on here and trash them online anyway. Wow.

Nothing she said or did seems out of line to me. I’m sorry that you are faced with some challenges in this department, but no one owes you services.

Wow--if this is the dentist, this seems unhinged. OP already said that the appointment didn't take extra time, and that the practice was aware of the child's disability. And medical/dental professionals need to understand how to provide services to people with disabilities.

OP didn’t say that until her 2nd and third entry, so was only going on her first entry here.

DP. I also don't think that is exactly what she said, either. The words seem carefully chosen.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Honestly, that sounds reasonable as you are paying for their time and if you needed frequent breaks and other things, understand its a business and they have to pay staff and that means they cannot schedule another patient. If an regular appointment takes 30 minutes and yours took an hour, they need to account for the extra time.

OP--just to note, the appointment did not go over the allocated time. While DC got out of the chair several times, it was only for a very short period of time. And we were the only patients in the office until another patient showed up for the appointment after ours.

OP, did the dentist office allocate any extra time for your child (as opposed to a standard appointment)?

I think people here are assuming something which might not be true. There's a semantic (and practical) difference between "not going over the allotted time" and "not taking any more time than a typical patient would," and I'm wondering if the latter is actually true -- especially given the stops and starts.

Then that would be an “extended time” fee. The fact that they called it a “behavioral fee” leads me to believe this is not the case. Also they would have known about an extended time fee in advance.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Honestly, that sounds reasonable as you are paying for their time and if you needed frequent breaks and other things, understand its a business and they have to pay staff and that means they cannot schedule another patient. If an regular appointment takes 30 minutes and yours took an hour, they need to account for the extra time.

OP--just to note, the appointment did not go over the allocated time. While DC got out of the chair several times, it was only for a very short period of time. And we were the only patients in the office until another patient showed up for the appointment after ours.

OP, did the dentist office allocate any extra time for your child (as opposed to a standard appointment)?

I think people here are assuming something which might not be true. There's a semantic (and practical) difference between "not going over the allotted time" and "not taking any more time than a typical patient would," and I'm wondering if the latter is actually true -- especially given the stops and starts.

They should have told her about the fee ahead of time in that case.

[Anonymous]

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.

I mean, to be fair you admitted in your post that your child’s behaviors were a lot. And required extra time and accommodations, which Dr shin provided? (And did YOU give the office advanced notice that this type of extra time and accommodation would be necessary for your child?—and did they “agree” to it?) Just trying to apply your rationale for NOT paying to their rationale for charging to begin with.

The fact that it took extra time and accommodation to successfully complete this appointment was not in dispute by you. But how can they warn you in advance about a special behavioral fee (which probably took extra staff, and time they weren’t prepared for given the regular appointment time allotted) if they don’t have any clue until you get there that there are any special circumstances??

Sounds to me like they were trying to go forward with the appointment as best as possible while also being compensated fairly …and yet when you pitched a fit about it, they removed the fee just to avoid the hassle of you.
And likely wanted to just have you leave in peace.
But you were so ungrateful and resentful that you decided to come on here and trash them online anyway. Wow.

Nothing she said or did seems out of line to me. I’m sorry that you are faced with some challenges in this department, but no one owes you services.

Wow--if this is the dentist, this seems unhinged. OP already said that the appointment didn't take extra time, and that the practice was aware of the child's disability. And medical/dental professionals need to understand how to provide services to people with disabilities.

OP didn’t say that until her 2nd and third entry, so was only going on her first entry here.

DP. I also don't think that is exactly what she said, either. The words seem carefully chosen.

Oh please stop it with the absurd sleuthing. OP wrote “Yes. I provided all the information about DC's diagnosis, as well as specific accommodations that might be helpful (i.e. turn off television, solo room, nothing tied around neck) in advance. They didn't seem to have read any of the notes when we came in.”

[Anonymous]

I find it pretty normal to be charged a fee for extra time at the dentist, whatever your issue is. I have white coat anxiety and only go every few years. I always tell them I need a double appointment because I haven’t been in X years and I won’t come back for several years. They do charge extra but will accommodate me.

[Anonymous]

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.