Waterdown Village Dentistry cannot write off or adjust the amount charged for services provided for two reasons. We have determined our fee structure by considering the professional guidelines currently set out by the ODA. These are the same for all patients, regardless of insurance consideration.
If we could adjust fees and still remain economically viable, we would do so for all patients, not just insurance subscribers. Many insurance companies use a co-payment plan where part of the dental fee is covered by the insurance company and part is covered by the patients.
Through these plans, the patient is legally liable for his/her portion of the fee. Writing off or adjusting the fee means the insurance company assumes responsibility for a higher percentage of the total – this constitutes insurance fraud.
Dental fee is $100. The insurance pays 80% and therefore covers $80, leaving the patient to pay the remaining $20. If we reduce the total amount owed by $20 by writing the patient portion off, your insurance provider has ended up paying the full $80 fee, or 100%. The insurance provider is now responsible for 80% of the $80 or $64. Writing off the original patient portion of $20 defrauds the insurance company of $16.