> ## Documentation Index
> Fetch the complete documentation index at: https://dso.getlemma.com/llms.txt
> Use this file to discover all available pages before exploring further.
# Respond to (fight) a chargeback
> The representment recipe: read the reason code, call the patient first, assemble PHI-minimized evidence, meet the deadline, and know when to concede.
**Representment** is contesting a chargeback with evidence. The money has already left your account; you are arguing to get it back, on a short deadline, and **silence loses automatically**.
## Prerequisites
* The chargeback notification, with its reason code and deadline
* Access to the transaction, the chart, and the signed consents
* A pre-approved evidence packet template, see below
## Step 0: call the patient first
Call the patient before assembling the response when doing so is appropriate. Some disputes arise because the cardholder did not recognize the descriptor, expected the dental plan to pay, or received a later charge they did not understand. A clear explanation may resolve the issue.
A **withdrawn dispute is better than a won one**: you keep the money, avoid the representment labor, and keep the patient. Ask the patient to contact their bank to withdraw, and document the conversation.
If you genuinely owe them the money, refund it and stop. Cheaper than winning, far cheaper than losing.
## Steps
It determines what evidence matters. The families:
| Family | Visa examples | What it means | What wins |
| --------------------- | ------------- | ---------------------------------------------------- | ---------------------------------------------- |
| **Fraud** | 10.x | Cardholder says they didn't authorize | Proof of authorization and cardholder presence |
| **Authorization** | 11.x | Authorization problem at the transaction | Processor records |
| **Processing errors** | 12.x | Duplicate, wrong amount, currency | Transaction records |
| **Consumer disputes** | 13.x | Not received, not as described, credit not processed | Proof of service and of your refund policy |
Mastercard uses a different scheme (4837, 4853, and others). See [Card dispute reason codes](/reference/banking/chargeback-reason-codes).
Before defending the charge, confirm the amount, patient, duplicate status, and post-adjudication balance. For a downgrade, frequency limit, or exhausted annual maximum, review the payer contract and the estimate and financial consent provided to the patient. See [Denials vs downgrades](/concepts/payments/denials-vs-downgrades).
**If the charge was wrong, concede and refund.** Defending an incorrect charge wastes labor and produces a complaint.
If a credit balance exists or a refund is in process for the same encounter, resolve that first. Otherwise you risk refunding the same money twice, through the chargeback and through your refund process.
Your processor and the issuing bank are **not** covered entities or your business associates. Apply **minimum necessary**.
| Generally appropriate | Generally not |
| -------------------------------------------------- | --------------------------------------- |
| Signed financial policy and consent | Clinical notes |
| Signed treatment plan and cost estimate | Diagnoses |
| Card-on-file or payment-plan authorization | Radiographs and charting |
| Appointment confirmation | Procedure descriptions beyond necessity |
| Receipt and transaction record | Anything about the clinical content |
| Itemized statement | |
| Evidence the patient was present (check-in record) | |
| Your refund and cancellation policy | |
| Correspondence with the patient about the charge | |
| AVS and CVV match results | |
| Delivery or service confirmation | |
**Have your privacy officer pre-approve a standard evidence packet.** Otherwise staff are making disclosure judgments under a five-day deadline, which is how over-disclosure happens. See [HIPAA fundamentals](/concepts/compliance/hipaa-fundamentals).
One page. Structure:
1. **What the transaction was**, date, amount, service type in non-clinical terms
2. **Why it was authorized**, signed consent, card-on-file authorization, or in-person presentation
3. **Why the reason code doesn't apply**, address the specific claim
4. **The evidence index**, what you've attached and what each item shows
Write for a bank reviewer who may have little dental knowledge and limited review time. Use plain language such as "restorative dental treatment" rather than relying on tooth numbers or CDT codes.
Deadlines are short, commonly measured in days, and set by the network and processor. Record the processor's submission cutoff when the notice arrives; a late response will generally forfeit the representment opportunity.
Reason code, amount, outcome, and, most usefully, **the root cause**. Descriptor confusion? Late statement? Unexpected card-on-file charge? Genuine dissatisfaction?
## When to concede
Conceding is often correct:
* The charge was genuinely wrong
* You owe a refund anyway
* The amount is small relative to the labor
* The evidence is weak, no signed consent, no receipt
* It's a deceased patient's estate
* Winning would cost you the patient relationship over a small sum
**A conceded dispute still counts toward the merchant's dispute ratio.** Compare that effect with the staff time, evidence, and fees required to pursue a weak response.
## Escalation beyond representment
If the initial response fails, **pre-arbitration** and **arbitration** may be available. Compare the fees, disputed amount, evidence, and uncertain outcome before proceeding. A large implant or full-arch deposit may justify the additional step when the record is strong.
## The double jeopardy problem
**Losing a chargeback does not necessarily end your exposure on that encounter.**
If the dental plan later reprocesses the claim and recoups an overpayment, the practice may lose both the patient payment and payer payment. Reconcile the full encounter, including the patient payment, payer payment, chargeback, and recoupment. See [Handle recoupments](/guides/compliance/handle-recoupments).
## Verify it worked
* [ ] Patient called before any representment work
* [ ] Charge verified as correct before defending it
* [ ] Credit balance and pending refunds checked
* [ ] Evidence packet PHI-minimized and pre-approved by the privacy officer
* [ ] Rebuttal written for a non-clinical reviewer
* [ ] Submitted before the deadline, with confirmation
* [ ] Outcome and root cause logged
* [ ] Root cause fed into prevention
## Common failure modes
| Failure | Consequence |
| ----------------------------------- | ----------------------------------------------------------------- |
| Not responding | The dispute is generally resolved without the practice's evidence |
| Missing the deadline | The representment opportunity is generally forfeited |
| Sending clinical records | Over-disclosure of PHI |
| Defending a charge that was wrong | Wasted labor; a complaint |
| Not checking for a pending refund | Double refund |
| Clinical language in the rebuttal | Reviewer can't evaluate it |
| No root-cause logging | The same disputes recur |
| Not reconciling the whole encounter | Double jeopardy on recoupment |