Two things to note. 1) >>>>>>>> and every time that we have then talked to them they say that we don't have to pay the remainder. This is actually in default

Two things to note. 1) >>>>>>>> and every time that we have then talked to them they say that we don't have to pay the remainder. This is actually in default of the contract between doctor and insurer. However, lots of physicians do it anyway. The minimum legal requirement is that physician must attempt to bill difference 3 times. If insurance audits and finds a pattern of these "writeoffs" it will claw back insurance claims. IN short, insurance doesn't want to pay more than the patient. Of course, the doctor will side with the patient, and then lose a bunch of money during an audit. 2) >>>>>This is just a negotiation tactic between our dentist and the insurance company. They are just trying to make sure that they capture every dollar that the insurance company will possibly pay. You get half right. Its not a negotiation tactic. Its straight up capturing 100% of the potential reimbursement. Doctors have an extremely hard time maintaining different pricing for every contract, by CPT code. If doctors could easily maintain different pricing for different services, they would, because it would "true up" their AR Aging. Therefore they instead have 1 price, the highest possible, and just work to writeoff any underpayments. This is why healthcare costs keep going up. Doctors have no market incentive, they only have a maximizing incentive. That's why an increasing number of doctors do not take medicare or medicaid. Something as simple as making doctor visits ("fee for service") payable via pre-tax dollars would probably make a big dent in the insurance game. HSAs were a step in the right direction, but its incredibly expensive from the employer perspective. You can have an stellar insurance plan and an avg one that offers HSA, and the premiums for the latter will be more expensive! Source: Working in a healthcare startup that lets doctors not play these games. Former exec for brick and mortar healthcare companies.