Dental insurer MetLife has agreed to modify its recoupment policy for dental providers following a letter from the American Dental Association, according to a July 11 news release from the group.
Here are four things to know:
- The ADA sent a letter to MetLife in April asking the insurer to clarify its practices after receiving reports that MetLife was reducing payments owed to dentists to recoup overpayments supposedly made to unaffiliated dentists.
- According to reports, the recoupments occurred when dentists separately provided dental services to the same patient or different family members who are covered under the same policy.
- The ADA’s letter questioned the policy found in MetLife’s provider agreement that allows for the recoupment practice, and noted that the practice is prohibited by some state laws.
- In June, MetLife notified the ADA that it is changing its policy “to only offset claim overpayments from the provider [it] overpaid,” and MetLife expects the change to be completed by the end of the year.
