A patient has insurance coverage from July 1 of the last year until June 30 of the current year, after which the patient no longer receives this benefit. The patient had a maximum benefit coverage of $1200. For the year-end to date, the patient used only $450 of the benefit. Toward the end of June, it is determined that the patient needs to have a bridge, but the work cannot be completed before July 1. The patient is informed of the fee for the bridge. The patient insists that since she has over $700 of unused balance from her insurance, the dentist should change the date of service to ensure insurance coverage. What would the dentist be committing if he does this?

Question

Quizplus · Accepted Answer

Fraud is a deliberate deception to secure unfair or unlawful gain. The dentist would be deceiving the insurance company to receive payment for the work.

A Patient Has Insurance Coverage from July 1 of the Last