Iowa Admin. Code r. 650-27.7
Current through Register Vol. 47, No. 13, December 25, 2024
Rule 650-27.7 - Representation of care and fees(1) Dentists shall not represent the care being rendered to their patients or the fees being charged for providing the care in a false or misleading manner.(2) A dentist who accepts a third-party payment under a copayment plan as payment in full without disclosing to the third-party payer that the patient's payment portion will not be collected is engaging in deception and misrepresentation by this overbilling practice.(3) A dentist shall not increase a fee to a patient solely because the patient has insurance.(4) Payments accepted by a dentist under a governmentally funded program, a component or constituent dental society sponsored access program, or a participating agreement entered into under a program of a third party shall not be considered as evidence of overbilling in determining whether a charge to a patient or to another third party on behalf of a patient not covered under any of these programs, constitutes overbilling under this rule.(5) A dentist who submits a claim form to a third party reporting incorrect treatment dates is engaged in making unethical, false or misleading representations.(6) A dentist who incorrectly describes a dental procedure on a third party claim form in order to receive a greater payment or incorrectly makes a noncovered procedure appear to be a covered procedure is engaged in making an unethical, false or misleading representation to the third party.(7) A dentist who recommends or performs unnecessary dental services or procedures is engaged in unprofessional conduct.(8) A dentist shall not bill for services not rendered. A dentist shall not be prohibited from billing for those services which have been rendered, for actual costs incurred in the treatment of the patient, or for charges for missed appointments.(9) A dentist shall not bill or draw on a patient's line of credit prior to services being rendered. A dentist may bill or draw on a patient's line of credit for those services which have been rendered or for actual costs incurred in the treatment of the patient.(10) A dentist shall not be prohibited from permitting patients to prepay for services, in whole or in part, on a voluntary basis.Iowa Admin. Code r. 650-27.7
ARC 9218B, IAB 11/3/10, effective 12/8/10