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.

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.

No PP - you don’t get to add a surprise autism fee because you felt the child was too difficult. And OP wouldn’t be here if the dentist had acted in a compassionate and ethical manner. Instead the dentist fired OP’s kid then tried to charge extra to boot. If the dentist had said “Hey, we are not really equipped for this - here’s the name of another dentist” that would have been fine albeit annoying.

The issue isn't the diagnosis. The issue is the time. If it took the same time as two or three appointments, then they are losing out on that money and it takes money to run the office and pay the staff.

[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.

ma’am, this is the SN board.

[Anonymous]

Anonymous wrote:

Anonymous wrote:If it takes extra effort for the dentist to perform the procedure, then they can charge you for the extra service.

But this did not take extra time, so why are you posting this? Just to bash a special needs family?

OP is bashing a dentist who is charging extra as her child took significantly more time than what is allotted. It's not fair to expect them to work for free.

[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.

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

[Anonymous]

Anonymous wrote:If it takes extra effort for the dentist to perform the procedure, then they can charge you for the extra service.

that’s just …. not how is works unless its the agreement up front. My cleanings take more time and effort because I always have more calculus due to my specific teeth and I have never been charged extra.

[Anonymous]

Anonymous wrote:Jesus who are these posters intent on giving OP a rough time? This behavior by the dentist office is appalling. I don’t know if it’s illegal or not but I am glad to know so I NEVER go there. Dr. Shin should be happy about that because my kid is way worse than OPs.

OP, I go to Kids Teeth in Rockville. They were recommended to me by a friend with neurotypical children. We didn’t have a diagnosis when we started there and it turned out it’s the worst of all things to trigger my kids anxiety. The first few appointments were absolutely excruciating for me as a parent because I was so embarrassed and shocked because I had never seen behavior like that before from my child, who was counseled out of preschool not long after. It was awful. But both the dentist and the hygienist were amazing and patient and kind and put detailed notes in the file and we figured it out. It’s much better now. I have never once been charged extra or made to feel bad about my child- the dentist has always been extremely generous in describing the variety of anxiety that dentists trigger and working with us on what would help.

It wasn’t until I started bringing my younger, NT child that I realized we were being given a ton of extra time (though I would absolutely have paid extra, it definitely would be nice to be given a heads up if they were going to do that) and the dentist herself was spending extra time and care with us. There are kind people out there.

❤️

[Anonymous]

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?

[Anonymous]

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.

One more time of this nonsense and I’m going to start reporting you to Jeff for trolling the SN board

[Anonymous]

Dr Ensor at Ensor, Lewis and Johnson is amazing and so patient and they see tons of special needs kiddos. Please go to this practice OP. When my kids were young we actually just went and met with her first to get them comfortable. Ironically its my younger son who is NT who has had the most dental issues and he won't see anyone else even though he is now in high school.

[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.

OP here--Nope--the appointment was finished within the allotted time (even though we started late, while we waited for Dr. Shin!).

Well, maybe this is her way of not having to deal with kids she finds annoying. It worked, right? I'd just move on. Not everyone is great with kids who have special needs. Maybe she doesn't have the patience for hopping out of the chair or was offended he didn't want to listen to her song - whatever the case. You don't have to pay the fee and won't be going back. Alls well that ends well.

That’s a super dismissive take on a horrible situation. I’m sorry this happened to you, OP. And you did the right thing informing other people.

[Anonymous]

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.

[Anonymous]

I suspect this violates the ADA. I would report this to the US Department of Justice Civil Rights Division. They have a complaint portal at Ada.gov.

[Anonymous]

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.

No, because the fee was not agreed to in advance. You can't charge someone post-hoc. That is illegal.

The dentist was well within her rights to refuse to see the patient again. But she cannot suddenly invent a fee after realizing that the client is difficult!

Thank you, OP, for the heads-up about this practice. We don't be going there.

[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.

They usually give 20-30 minutes for a cleaning. If the child got out and refused there was a lot of extra time involved. Regardless of the diagnosis, they need to know medical conditions and you pay for extra time. We wanted three cleanings a year, insurance covered two. We paid for the extra.

[Anonymous]

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.