Protect yourself from fraud

Delta Dental takes a strong position to prevent fraud from affecting your benefits. Sometimes fraud comes in predictable forms, and other times it is less obvious, but fraud always leaves traces. Here are some examples of fraudulent practices:

The signs of fraud

• Dental offices that routinely fail to charge or collect your full coinsurance or copayment amount or deductible. This amounts to overbilling the insurance company for the services rendered.
• Dentists that perform unnecessary treatment (for example, x-rays, fillings and crowns that aren’t needed)
• Patients or dental offices that conceal other insurance coverage
• Incorrect information on your Explanation of Benefits (EOB)
• Individuals who use someone else's identification number
• Patients who persuade the dental office to falsify the date of treatment
• Dental offices that submit a claim for a covered service when a non-covered service was performed
  
  

After you receive treatment, you will receive an EOB from Delta Dental, which lists the services that were provided, the dates of services and the amount your dentist is charging. Please review the EOB for accuracy. Incorrect information on an EOB can be a sign of fraud and should be reported to Delta Dental.

How to report fraud

To report a problem or suspicion of fraud, please complete our online Fraud Report Form or call our toll-free hotline: 800-526-1852. You may remain anonymous.