The vast majority of time if delta dental sends you a check, it was most likely done in error. However there is an exception because there is a situation where you were meant to receive the insurance check.
Let us explain all of the possible reasons as to why you may have gotten a check from your insurance company. Then we'll walk you through when it is appropriate to cash it and when you should be returning it.
Potential reasons you received a check
In our experience with working with delta dental for the past few years, we could think of three reasons as to why they may have sent you a check.
Your dentist may have filed the insurance claim incorrectly.
Delta dental made an error and sent you the check instead of your dentist.
You chose a dentist that was out of network with delta dental.
Claim was filed incorrectly
Your dentist may have been the one who made the error by filling out the insurance claim incorrectly. If they forget to check off section 37 of the ADA dental claim form, delta dental will send you the check instead of to them.
The image above is an unfilled 2019 ADA dental claim form.
Where we want you to pay attention to is section 37 which states: "I hearby authorize and direct payment of the dental benefits otherwise payable to me, directly to the below named dentist or dental entity."
Essentially if your dentist forgets to fill out that part, the insurance check from delta dental will go to you instead of them.
Delta dental made a mistake
Alternatively, delta dental could've sent you the check in error while it was supposed to have gone to your dentist. In other words, unlike the scenario above your dentist did fill out the claim properly.
However, it was the billing department from delta that made an error. Whoever processed the claim simply mailed the check out to the wrong person. If you think that doesn't happen, you should think again. Every year we will get about a handful of these situations. Our office would run our aging report and see some claims that haven't been paid out in over a month.
We would contact delta and they would tell us that the check has already been mailed out but when we ask where, they would say to the patient. When we ask them why since we filled out the claim properly, they usually say "I'm so sorry, it went to the patient instead."
Delta dental sent the patient the check by mistake.
Your dentist was out of network with delta
The third situation where delta dental may have sent you a check is if you see an out of network provider. That means the dentist that you received services from was not a preferred or participating provider with delta dental. They weren't in-network with the insurance.
Out of all of the PPO dental insurances that our dental office works with, delta dental is the only one who will send checks to the patient. For the obscure PPO insurances that we're not in-network with, they'll still send us the check. However for delta dental, they WILL NOT send us the check even if we fill out section 37.
That is simply a quirk about delta dental. They will refuse to send the check to your dentist if they are out of network even if they completed section 37 of the claim form. A lot of dentists are pushing back on delta for this... there is a current ongoing class action lawsuit against them by the ADA.
What you should do with the check
If you weren't meant to receive the check from delta dental, you should return it to its rightful recipient, your dentist. If you don't, you'll probably receive a large bill from your dentist stating that none of the visit was covered and that you'd be responsible anyway. You might as well avoid the back and forth and settle the bill ahead of time.
However if you were meant to be the recipient of the reimbursement check then you can simply cash it. It doesn't get easier than that. Although the big question is how to tell who was meant to get the check from delta.
How to tell who the delta dental check was meant for
We've created a decision tree above to help guide you for figuring out who that check was meant for.
If you made no payments at the dentist, it's meant for your dentist.
If you made a copayment, it's also probably for your dentist.
If you paid for the entire visit upfront, the check is meant to reimburse you.
Hopefully that helps you in figuring out what to do with the check. If you're ever in doubt, please contact your dentist and ask them if you have a balance or not. If there is, that check was probably meant to settle that balance.
If you don't give it back to your dentist, they'll send you a big bill later on anyway.
