Re: [ACEsthetics] "Insurance Only"

Delta Dental and BC/BS told me to always charge our full fee because that was the way they determined accepted fees.  Never write off before filing.  Guy

On Tue, Jan 29, 2013 at 10:18 AM, David Hamel <hameldds@gmail.com> wrote:

Jack,

I pointed out the dilemma of that reasoning once to a dental benefits committee person.  You charge your full fee but it you only intend to collect part of that fee then you have overcharged and committed fraud, is that what your comment meant about making sense?

So what happens when you send in your full fee but then accept only what the insurance company allows, knowing ahead of time that is what you will do.  Only this time you know it because you have signed a contract to do that?

In both scenarios a higher fee than the intended collection is being sent in.  ; )

Dave

David Hamel DDS

1200 Broadway

Marysville, KS 66508

785-562-5529 O

785-562-8115 C

KDA Past President 2010

On Jan 29, 2013, at 9:06 AM, Jack Weiss wrote:

I've heard the same as Lance. If you routinely don't charge the co-payment, then its fraud, because the higher fee is NOT your regular fee (actually, that makes sense). You can do it occasionally without being illegal. At least, that's how I understand it. If its once in a blue moon, the ins co wouldn't waste their time and expense going after you.

         Jack

From: Lance Timmerman <bigdrtim@hotmail.com>
Reply-To: <bigdrtim@hotmail.com>
Date: Tuesday, January 29, 2013 9:03 AM
To: <tonganoxiedental@aol.com>, <acesthetics@googlegroups.com>
Subject: Re: [ACEsthetics] "Insurance Only"

I BELIEVE that if it is not routine, it is not a big deal.  if it is SOP, then yes, you are at risk of trouble....

 

 

From: TonganoxieDental@aol.com

Sent: Tuesday, January 29, 2013 6:55 AM

To: acesthetics@googlegroups.com

Subject: [ACEsthetics] "Insurance Only"

 

There are times when I do a procedure, but don't want to charge a full fee (like some bonding I did a year ago chips), is it ok to charge the insurance and then write off the balance?  I know that it is illegal to accept insurance as full payment as a general rule, but is there any reason that on rare occasions that can be done? 

Thanks!

Grant

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Guy W. Moorman
The Swamp
Douglas, Georgia

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