Preventing Fraudulent Billing Charges on Your Account

It's important that patients carefully review their dental bills before paying in an effort to prevent fraudulent insurance billing. Mistakes happen and sometimes an incorrect bill can be issued to the insurance company. In the worst case scenarios, dishonest insurance companies can use certain tactics to take advantage of customers and insert fraudulent charges into their bills.

Below are some ways you can protect your wallet and prevent fraudulent billing charges from appearing on your account.

Avoiding Bills with Fraudulent Charges

Here are three common methods of insurance fraud and what consumers can do to protect themselves

Fraud: Upcoding. Inflated claims, also known as "upcoding," involve a provider charging for a more expensive treatment than the one that was actually done. A simple, routine cleaning might be billed as a deeper, more expensive cleaning procedure.
What you can do: Make sure the procedures listed on the bill match up with what was performed by the dentist. If you are unsure of some of the language used on the bill, don't be afraid to contact your dentist to see if their records match those submitted to the insurance company.

Fraud: Parting out. Providers might try to break down a single procedure into separate parts, and then bill each step as its own procedure. This "parting out" of procedures causes the total visit to cost more.
What you can do: Be proactive. Ask for a receipt or copy of your bill before you leave the dentist office, and make sure the listed charges add up to the bill you receive from the insurance company.

Fraud: Fake insurance. Believe it or not, there are phony insurance companies that actually offer no coverage at all.
What you can do: Before signing up for dental insurance, check with your state's department of insurance to make sure the company is properly licensed.

Preventing fraudulent charges on your dental bill starts with you. Take the proper steps to make sure you pay only for what you get so you can avoid being a victim of insurance fraud.


Need More Information About Dental Insurance?

Kool Smiles provides information about dental insurance and how it can save you money. If you have additional questions about how dental insurance, billing or how to avoid fraud, be sure to find the Kool Smiles near you, and make an appointment for your child today.

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