Help Delta Dental fight fraud
How to report fraud
To report a problem or suspicion of a more general nature, please complete our online fraud report form. You may remain anonymous. |
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Health care fraud can directly affect your benefits by increasing the cost of your dental plan and jeopardizing your employer's ability to offer those benefits. The government estimates that 10 to 12 percent of the country's health care costs are a direct result of fraud. Although dentistry's share of these costs is open to question, Delta Dental takes a strong position to prevent fraud from affecting your benefits.
After you have received dental treatment, you will receive a Notice of Payment (NOP) from Delta Dental, which lists the services that were provided, the dates of services and the amount your dentist is charging. Please review the NOP for accuracy. Incorrect information on an NOP can be a sign of fraud and should be reported to Delta Dental.
You can help us in these efforts by learning the signs of fraud and reporting any suspicious activities.
The signs of fraud
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:
- Dental offices that routinely fail to charge or collect your full copayment or deductible
- Patients or dental offices that conceal other insurance coverage
- Incorrect information on a Notice of Payment (NOP)
- 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 actually a non-covered service was performed
- For HMO patients (DeltaCare USA), difficulty obtaining appointment times or followup visits.
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