Insurance company with Delta Airline refused to pay for work he did on his mother. They went to court and Delta and the insurance company paid up.
Guy W. Moorman, Jr., D.D.S.
The Swamp
Douglas, GA 31533
912-384-7400
This email message and any attached files are confidential and are intended solely for the use of the addressee(s) named above. This communication may contain material protected by patient rights, work product, or other privileges. If you are not an intended recepient, you have received this communication in error and any review, use, dissemination, forwarding, printing, copying, or other distribution of this email message and any attached files is strictly prohibited. If you have received the confidential message in error, please notify the sender immediately by reply email message and permanently delete the original message.
From: acesthetics@googlegroups.com [mailto:acesthetics@googlegroups.com] On Behalf Of Ken siegel
Sent: Tuesday, January 29, 2013 12:55 PM
To: spikedds@gmail.com; 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"
I thought that I had read someplace that it was actually illegal to bill insurance for something you do on your spouse. I could be wrong but I thought I remembered it.
Kenneth Siegel, D.M.D.
Dental Excellence of Blue Bell
706 Dekalb Pike
Blue Bell, Pa 19422
610-272-0828
610-272-4319 fax
215-498-5991 mobile
From: "David R. Boag DDS" <spikedds@gmail.com>
Reply-To: "spikedds@gmail.com" <spikedds@gmail.com>
Date: Tuesday, January 29, 2013 12:43 PM
To: "smilestylers@gmail.com" <smilestylers@gmail.com>
Cc: "drrodgers@drrodgers.com" <drrodgers@drrodgers.com>, "tonganoxiedental@aol.com" <tonganoxiedental@aol.com>, "drjackpweiss@gmail.com" <drjackpweiss@gmail.com>, "hameldds@gmail.com" <hameldds@gmail.com>, "bigdrtim@hotmail.com" <bigdrtim@hotmail.com>, gnr <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?
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
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?
--
You received this message because you are subscribed to the Google Groups "ACEsthetics" group.
To unsubscribe from this group and stop receiving emails from it, send an email to acesthetics+unsubscribe@googlegroups.com.
To post to this group, send email to acesthetics@googlegroups.com.
Visit this group at http://groups.google.com/group/acesthetics?hl=en.
For more options, visit https://groups.google.com/groups/opt_out.
--
You received this message because you are subscribed to the Google Groups "ACEsthetics" group.
To unsubscribe from this group and stop receiving emails from it, send an email to acesthetics+unsubscribe@googlegroups.com.
To post to this group, send email to acesthetics@googlegroups.com.
Visit this group at http://groups.google.com/group/acesthetics?hl=en.
For more options, visit https://groups.google.com/groups/opt_out.
--
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
--
You received this message because you are subscribed to the Google Groups "ACEsthetics" group.
To unsubscribe from this group and stop receiving emails from it, send an email to acesthetics+unsubscribe@googlegroups.com.
To post to this group, send email to acesthetics@googlegroups.com.
Visit this group at http://groups.google.com/group/acesthetics?hl=en.
For more options, visit https://groups.google.com/groups/opt_out.
--
You received this message because you are subscribed to the Google Groups "ACEsthetics" group.
To unsubscribe from this group and stop receiving emails from it, send an email to acesthetics+unsubscribe@googlegroups.com.
To post to this group, send email to acesthetics@googlegroups.com.
Visit this group at http://groups.google.com/group/acesthetics?hl=en.
For more options, visit https://groups.google.com/groups/opt_out.
--
You received this message because you are subscribed to the Google Groups "ACEsthetics" group.
To unsubscribe from this group and stop receiving emails from it, send an email to acesthetics+unsubscribe@googlegroups.com.
To post to this group, send email to acesthetics@googlegroups.com.
Visit this group at http://groups.google.com/group/acesthetics?hl=en.
For more options, visit https://groups.google.com/groups/opt_out.
0 comments:
Post a Comment