Why are dentists who waive copays said to be committing fraud?

Dentists who waive copays are considered to be committing fraud primarily because they are engaging in overbilling insurance. When a dentist waives the patient's copay, it can create a misleading representation of the actual cost of treatment. This practice can lead insurance companies to believe that the billed amount reflects the true charge for services when, in fact, it does not. By waiving copays, the dentist may receive higher reimbursements from the insurance company than they would if the copays were collected at the time of service.

This situation not only violates the terms of the insurance agreement but also distorts the financial relationship between the patient, the provider, and the insurer, which is why it is categorized as fraudulent activity. It is important for dentists to adhere to billing practices that accurately reflect the services rendered and to avoid any actions that could mislead insurance providers.