Beware of offers to waive coinsurance/copayment amounts

Your dentist has just offered to give you a discount. She is going to accept your insurance as payment in full and not collect your coinsurance/copayment amount from you. This may sound like a great deal, but it’s not. Here are a few reasons why:

  • Accepting your insurance as payment in full and disregarding your coinsurance, copayment or deductible results in overbilling the insurance company. It's against the law in many states and is viewed by the dental profession as unethical. It’s also a violation of the dentist's contract with Delta Dental.
  • Dentists are not reducing their fee when they do not collect patient payments. Instead, these dentists are charging inflated fees to the insurance carrier to make up for the money they lose from waiving the coinsurance/copayment amounts.
  • Enrollees who knowingly agree to the dentist's scheme are participating in this deception.

No matter how irresistible the offer of "free" dentistry seems, the care you receive really isn't free. As a result, it increases costs and your present dental plan may become too expensive for your employer to offer.

Delta Dental takes overbilling very seriously, and we use a variety of methods to fight it. However, all our anti-fraud methods are not enough without your cooperation. If your dentist is waiving your coinsurance/copayment amounts, or if you have any other suspicions that your dentist might be overbilling, please report it to Delta Dental’s Fraud Hotline at 800-526-1852. Or, complete and submit our online Fraud Report Form. You may remain anonymous.

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