The reimbursement level determined by the administrator of a dental benefit plan for a specific dental procedure. This may vary widely by geographic region or by benefit plans within a region.
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.