Did You Know That Claim Forms Must Reflect Date Service Completed

A dental provider must correctly report to Delta Dental of New Jersey the date that accurately reflects when the service or procedure rendered was completed. 

Correctly submitting the date of service for a dental procedure on a claim form may seem fundamental, but it is not always done. Inaccurate dates may be the result of office policy. For example, an office may always submit the start dates for root canal therapy instead of the finish dates, or the preparation dates for crowns instead of the cementation dates. Conversely, the submission of inaccurate dates may be intentional, such as when the date of a standard recall visit is changed in order to maximize benefits. 

The submission of inaccurate or misrepresented dates is one of the unacceptable billing practices reviewed during the claim verification process. The incorrect submission of the date of a service can result in overpayments that are recoverable. If claim forms are intentionally submitted in this fashion, it can be considered a fraudulent attempt to gain benefits. 

For more information, please refer to:

• New Jersey State Board of Dentistry, Administrative Code [NJAC 13:30-8.10]
• The General Statutes of Connecticut [Volume 7, Title 20, Chapter 379, Sec. 20-114]
• The Delta Dental of New Jersey Participation Agreement
• The Delta Dental of New Jersey Dentist Handbook for Participating Dentists, Chapter 4, Form Completion and Chapter 11, Claim Verifications