How to show fee discounts on claim forms

Most dental offices will face a "fee discount" question from time to time. There are many reasons for giving discounts, including a patient's participation in a fee discount program. To report discounts on claims for patients who are Delta enrollees, the lower, discounted fee (that is, the fee the dentist intends to collect as payment in full) must be entered as the fee for the procedure on the claim. This insures that the discount is applied to both Delta's portion and the patient's portion.

Entering the dentist's filed fee on the claim for any service that has been discounted would be considered a violation of the Participating Dentist Agreement, since it would be saying one fee is being charged when another actually is.

When a fee is charged to a patient that is lower than the dentist's filed fee, and it is correctly entered on the claim as the actual fee charged, there is no effect on the dentist's filed fees or participation with Delta.

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