A written description of the service provided that is prepared when the term “by report” is included in a procedure code nomenclature; may be requested by a third-party payer to provide additional information for claims processing.
The misrepresentation of a fee as higher than actual charges; for example, when a patient is charged one fee and an insurance company is billed a higher fee to benefit the patient’s co-payment, or to increase a fee to a patient solely because the patient is covered under a dental benefits plan.