Despite having dental insurance, you just left your dentist’s office after making a large payment for the visit. You’re probably thinking, “is delta dental going to reimburse me for what I just paid?”
Well, the answer is that it depends. You may or may not be receiving a reimbursement check from delta dental and it depends on the network status of your dentist.
If you are entitled to a check from them, we’ll explain what to expect for the process.
When you’re entitled to a reimbursement check
The main determining factor in whether or not you can expect a delta dental reimbursement check is based on the network status of your dentist.
Key points:
- You can expect a check if they are out of network with delta.
- You shouldn’t expect a check if they are in network with delta.
You may be thinking that it is better to receive reimbursement from but the truth is actually the opposite of what you think.
When you’d get one
You should be getting directly reimbursed by delta dental via a paper check in the mail if your dentist is out of network with delta. In other words, your provider does NOT participate with your insurance but they merely “accept” it as a form of payment.
The reason why you’d be getting a reimbursement check is because delta has a policy where they do NOT reimburse out of network providers directly. Although they can reimburse you.
How that affects you
Since delta won’t pay your dentist directly, it means you are responsible for paying the full cost of treatment at the time of your visit. However, you can expect to get reimbursed from delta once the claim has been filed and processed.
The dental insurance claim process may take about 2-3 weeks for it to complete.
When you wouldn’t get one
You should not be getting a reimbursement check from delta dental if you’re seeing an in network dentist. In other words, your provider is participating with delta and is contracted with them through their network.
The reason why you wouldn’t get a check is because delta does directly reimburse in network providers.
How that affects you
Having delta dental reimburse your dentist directly instead of reimbursing you is actually better for you. It reduces a lot of redundant payments like in the out of network scenario.
You don’t have to pay your dentist and then wait to get reimbursed from delta.
As an example, you can see what happens in a check up and cleaning visit.
- Delta typically covers preventative visits at 100% and that includes: exams, x-rays, and teeth cleanings.
- Since they cover the entire visit, you most likely won’t have to pay a single cent for the visit.
- You come in, get your treatment done and you can just leave.
You can contrast that to the out of network scenario where you do get reimbursed.
- You have to swipe your card and pay for the entire visit up front.
- Then you have to wait a few weeks for delta to reimburse you.
I don’t know about you but isn’t it annoying having to front the money and wait to get reimbursed? Not only do you have to wait for the money but then you have to go deposit the check which is just more work for you to do!
Exception to the rule
Despite everything that we’ve said, there is an exception to the rule. Sometimes you can get sent a check accidentally from delta.
If your dentist is in network with delta dental but you received a check in the mail, it does not belong to you. You should contact your dentist and turn it over to them because delta most likely sent it to you in error.
If you choose to deposit the check, you will get chased down by the dentist’s billing department. They can go as far as to turn your debt over to a debt collection agency and even ding your credit score. That means if you were planning on getting a mortgage soon, medical debt will show up on the credit history and drag your score down by quite a few points!
How long to receive delta dental reimbursement check
On average, you can expect to receive your reimbursement check from delta dental within 2-3 weeks of the claim being filed.
Why it takes that long:
- Your dentist needs to file and submit the claim.
- Delta needs to receive the claim and then it goes through their billing dept.
- Delta then issues you a check but they mail it via snail mail.
Overall, it should take about 2-3 weeks for you to get reimbursed by delta. That is if there are no hiccups in the claim processing and assuming the paper mail does not get lost from USPS. Of course, those are all things that could go wrong.
How do I check the status of my claim?
If you want to check the status of your claim, you can simply give delta dental a call.
What to watch out for:
- However you should be aware that there is a delta dental for every state and each of them have a different phone number.
- The state you live in may not be the same delta dental state. For example, you may live in Arkansas but your delta dental insurance may be through delta of California.
The best way to figure out which number to call is to look at the back of your insurance card. If you still can’t figure it out, contact your HR department and they should be able to direct you.
Takeaway
You should be getting a delta dental reimbursement check if your dentist is out of network with them. On the flip side, if your dentist is in network with them, you wouldn’t be getting any direct reimbursement from delta at all.
Despite all of that, there are exceptions because sometimes delta can erroneously send you a check. If that happens, you should give your dentist a call.