Insurance Management FAQs
Am I required to collect coinsurance from my patients, or can I simply
accept the amount that the insurance carrier pays as payment in full?
According to the ADA Principles of Ethics:
5.B.1. Waiver of Copayment. A dentist who accepts a third party* payment
under a copayment plan as payment in full without disclosing to the third party*
that the patient’s payment portion will not be collected, is engaged in
overbilling. The essence of this ethical impropriety is deception and
misrepresentation; an overbilling dentist makes it appear to the third party
that the charge to the patient for services rendered is higher than it actually
*A third party is any party to a dental prepayment contract that may
collect premiums, assume financial risks, pay claims and/or provide
Answer is informational only and not intended as
legal advice. Answer may contain excerpts from
The ADA Practical Guide to
Frequently Asked Legal Questions.