Make Sense of Bundling and Downcoding

Two of the most often reported concerns member dentists have with third-party payers are bundling and downcoding.  What are they and what can you do?

Claims bundling is the systematic combining of distinct dental procedures by third-party payers that results in a reduced benefit for the patient/beneficiary.

Downcoding is a practice of third-party payers in which the benefits code has been changed to a less complex and/or lower cost procedure than was reported except where delineated in contract agreements.

In this first video in a series on third-party issues, you will learn the differences between bundling of procedures and downcoding. Examples of each will be provided and you will be given recommendations on what you can do.

Running time is 3 minutes, 21 seconds.