Re: [ACEsthetics] "Insurance Only"

Okay, but what if you treat your dental team and provide your labor at no cost to them, but they WANT you to get their benefits? How many of us do THAT?

--
David R. Boag, DDS




On Jan 29, 2013, at 12:53 PM, "John M. Highsmith, DDS" <schminsk@bellsouth.net> wrote:

I've been told by insurance consultants that the way to be legal about it is to indicate on the claim form that you do not intend to collect the copay. 
They'll usually then pay you the 80% or so of the discounted amount. The discounted amount becomes the fee.
 
 
John Highsmith DDS
Clyde, NC
AACD Accredited Dentist
LVI Clinical Instructor
Diplomate, ICOI
Fellow, Misch Implant Institute
 
From: acesthetics@googlegroups.com [mailto:acesthetics@googlegroups.com] On Behalf Of David R. Boag DDS
Sent: Tuesday, January 29, 2013 12:43 PM
To: smilestylers@gmail.com
Cc: drrodgers@drrodgers.com; tonganoxiedental@aol.com; drjackpweiss@gmail.com; hameldds@gmail.com; bigdrtim@hotmail.com; acesthetics@googlegroups.com
Subject: Re: [ACEsthetics] "Insurance Only"
 
Can I throw a monkey into the wrench: If I do a restoration on my wife, and I only take what the insurance covers (her job offers dental insurance as part of health beneys), am I fraudulent? If she then pays me, does that make it okay, because she's paying me with my money? Is it just semantics? What if she doesn't pay me in dollars? ;-)
 
If a bear poops alone in the woods, does it stink?
--
David R. Boag, DDS
 


 
On Jan 29, 2013, at 12:16 PM, Howard Hoffman <smilestylers@gmail.com> wrote:


If you sign a claim form that attests to your fee, that is your fee. Done deal. If you give the patient a break on the fee, wasn't the reduced fee your real fee? Why did you tell the carrier it was something other than what you actually charge, and not pass on the discounted fee to them? Their obligation is to pay whatever they are responsible for, based on your fee. If you have an arrangement with the carrier to offer a reduced fee all the way around, that's a different story.
I believe that you must keep the balance on the books and make an effort to collect it. How well your collection process goes before you give up on attempting to collect it (or write it off) is another story.

Howard
 
 
 
On Tue, Jan 29, 2013 at 12:05 PM, Jeff Rodgers <drrodgers@drrodgers.com> wrote:
Well…I completely agree with you in principal.  But when you fill out an insurance form it asks for the fee for whatever you did.  If you report one fee, knowing full well that is not the fee, then is that not fraud?  It is a deception of the insurance company in an effort to gain some benefit for you or the patient.
 
Now…if the patient is the one filling out the form then you have no control over that.  :]
 
Jeff
 
Jeff L. Rodgers, DMD, PC

Atlanta, GA

 
On Jan 29, 2013, at 11:37 AM, TonganoxieDental@aol.com wrote:


I appreciate you bringing this up, Jeff, as this is my dilemma.
 
Let's take a hypothetical case for a person who doesn't have insurance.  They come in to replace a chipped composite that was done recently enough that I feel badly charging them the full amount, but long enough ago that I feel I am entitled to something.  So instead of charging $250.00, I charge $125.00 and write off the other $125.00.  I am in no way misrepresenting fees; I'm just denying myself the extra $125.00 "out of the goodness of my heart."  Likewise, if they have insurance, pay the premiums, and are entitled to their benefits, then they should receive them.  When I write off the balance, I am still denying myself the remainder "out of the goodness of my heart."  I am the only one who is "short-changed" in this transaction, as I see it.  My intention is never to defraud an insurance company or misrepresent what I do; my intent is to use my right as a business owner to reduce the amount owed to me.
 
But I see all sides.

Grant
 
In a message dated 1/29/2013 10:30:33 A.M. Central Standard Time, drrodgers@drrodgers.com writes:
 I hate to play devil's advocate here but if you represent to the insurance company that you are charging one thing knowing full well that you are actually charging another and the sole purpose is to get the insurance company to pay enough so the patient doesn't have to is really the definition of insurance fraud isn't it?
 
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--
Howard J. Hoffman, DDS, PA
21110 Biscayne Blvd, Ste 402
Aventura, FL 33180
ph: 305-933-3070 (o)
ph: 305-467-6343 (m)
fax: 305-933-2230
 
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Unknown ● Tuesday, January 29, 2013

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