MetLife has agreed to change its recoupment policy after the American Dental Association sent a letter in April seeking clarification of its practices.
The ADA had received reports of the insurance company reducing, or “offsetting,” payments owed to dentists to recoup overpayments allegedly made to other, unaffiliated dentists. This has occurred when the dentists separately provided care to the same patient or different family members covered under the same dental benefit policy.
In its letter, the ADA said it was not aware of any provision in MetLife provider agreements that explicitly states this practice is allowed. In fact, there are laws in some states that prohibit it, according to the letter.
Source: MetLife agrees to change recoupment policy following ADA letter / ADA News