Are there legal problems in giving discounts to family, staff or colleagues ?
Such discounts usually fall under your ability to set your own fees. This may not be true for certain insurance plans, which preclude charging some patients in their plan less than the agreed rate. You might run into problems granting discounts for family members if it is contrary to insurance plan rules. Some insurance companies have included provisions in their contract with policyholders that limit or prohibit reimbursement to providers who treat relatives. Dental plans or insurance policies may specifically exclude treatment of immediate family, such as children or a spouse. The rationale is that professional objectivity might be compromised when the patient is an immediate family member. There are also concerns, generally, about patients’ willingness to be completely open and honest with a health care provider who is a family member and to question or refuse treatment suggestions from a family member. Medicare (which doesn’t pay for dental care but often sets the standard for payment policies for health care in general) does not reimburse for services when the patient is an immediate relative of the provider or a member of the provider’s household. Medicare defines “immediate relative” as a spouse; a natural or adoptive child, parent or sibling; a step-parent, step-child, step-brother or step-sister; a father- or mother-in-law, son- or daughter-in-law, brother- or sister-in-law; grandparent or grandchild; and a spouse of a grandparent or grandchild. Again, lacking any specific law addressing this scenario, the patient’s benefit contract with the plan or insurance company will control.
Discounts to dentists who refer patients to the practice should be avoided, as they may be found to violate California provisions prohibiting payment of benefits for referral of patients.
Dentist Problems In Billing Forms With Patients
Common questions & answers with patients insurance collections and dental benefits plans.