Discounts & Credits – Avoid This Mistake!

There is a problem arising regarding a very fundamental concept about dental insurance billing. Many practices are missing this problem, often as a result of innocent oversights. However, the consequences of making this mistake can still be quite damaging to you and your dental practice.

The problem that we’re talking about is in regards to billing an insurance company for the cost of treatment. Sounds simple, right? It is, until your office offers a patient a 5% discount for a time-of-service payment. This is a common discount offered in many offices. However, these same offices are then billing insurance companies for the full amount.

The Insurance Company Should Receive The Same Discount!

If you are offering your patient 5% off, this discount needs to be extended to the insurance company as well.

For example, let’s assume you’re offering a patient a $50 courtesy credit for having a substantial treatment performed. Many dental offices will do this by lowering the patient’s out-of-pocket cost by $50 and then billing the insurance for the full cost of treatment. Instead, you should be billing the insurance company for the cost of treatment, minus the $50 credit.

Any discount or credit offered to your patient will also apply to his or her insurance company.

Again, we know that these mistakes are often made innocently enough. However, you may be violating state laws or the contracts from participating provider contracts. Depending on the case, you could possibly be accused of fraudulent billing practices or overbilling the insurance company. These can both be very serious issues for your dental practice.

Do your research and make sure that any discounts or credits offered at your office are being processed correctly. For more information on keeping your office running smoothly and successfully, please contact CTC National today!