Delta Dental considers the following (among others) to be unacceptable billing practices in the dental office:

• Submitting for services not actually performed

• Misrepresenting actual treatment rendered or the actual treatment date

• Failing to disclose discounts and/or waiver of co-payment

• Submitting claims which overstate the fee that is intended to be accepted as payment in full

• Failing to disclose other coverage for the dental services

• Billing services on preparation date rather than the completion date

• Charging a Delta Dental-covered patient in excess of your fee or Delta Dental's approved fee level

• Misrepresenting the rendering provider

• Submitting for services previously paid

Note to Delta Dental Participating Dentists

Participating dentists shall not submit any claims to Delta Dental for services performed by dentists who are not participating dentists with Delta Dental on the date(s) when the services were performed. In order to be properly reimbursed, every dentist in a dental practice must sign a participating dentist agreement and credential with Delta Dental.

Patient Discounts

Patient discounts are considered acceptable as long as Delta Dental covered patients receive the same discount. If you are giving a discount, it should be applied to the fee for the service rendered so that the net fee submitted to Delta Dental and the net fee charged to the patient are both reduced. The discounted fees must be specified on claims submitted for payment.

A downloadable sign/statement for your dental office regarding insurance fraud. Click here to download.

For questions concerning billing and claim submission practices, please contact our Professional Relations Department at 973-285-4163 or Customer Service at 800-452-9310.