ADA Principles of Ethics & Code of Professional Conduct | Page 14

5 . B . 2 . OVERBILLING . It is unethical for a dentist to increase a fee to a patient solely because the patient is covered under a dental benefits plan .
5 . B . 3 . FEE DIFFERENTIAL . The fee for a patient without dental benefits shall be considered a dentist ’ s full fee . 2 This is the fee that should be represented to all benefit carriers regardless of any negotiated fee discount . Payments accepted by a dentist under a governmentally funded program , a component or constituent dental societysponsored access program , or a participating agreement entered into under a program with a third party shall not be considered or construed as evidence of overbilling in determining whether a charge to a patient , or to another third party 1 in behalf of a patient not covered under any of the aforecited programs constitutes overbilling under this section of the Code .
5 . B . 4 . TREATMENT DATES . A dentist who submits a claim form to a third party 1 reporting incorrect treatment dates for the purpose of assisting a patient in obtaining benefits under a dental plan , which benefits would otherwise be disallowed , is engaged in making an unethical , false or misleading representation to such third party . 1
5 . B . 5 . DENTAL PROCEDURES . A dentist who incorrectly describes on a third party 1 claim form a dental procedure in order to receive a greater payment or reimbursement or incorrectly makes a non-covered procedure appear to be a covered procedure on such a claim form is engaged in making an unethical , false or misleading representation to such third party . 1
5 . B . 6 . UNNECESSARY SERVICES . A dentist who recommends or performs unnecessary dental services or procedures is engaged in unethical conduct . The dentist ’ s ethical obligation in this matter applies regardless of the type of practice arrangement or contractual obligations in which they provide patient care .
5 . C . DISCLOSURE OF CONFLICT OF INTEREST . A dentist who presents educational or scientific information in an article , seminar or other program shall disclose to the readers or participants any monetary or other special interest the dentist may have with a company whose products are promoted or endorsed in the presentation . Disclosure shall be made in any promotional material and in the presentation itself .
5 . D . DEVICES AND THERAPEUTIC METHODS . Except for formal investigative studies , dentists shall be obliged to prescribe , dispense , or promote only those devices , drugs and other agents whose complete formulae are available to the dental profession . Dentists shall have the further obligation of not holding out as exclusive any device , agent , method or technique if that representation would be false or misleading in any material respect .
ADVISORY OPINIONS
5 . D . 1 . REPORTING ADVERSE REACTIONS . A dentist who suspects the occurrence of an adverse reaction to a drug or dental device has an obligation to communicate that information to the broader medical
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