How to Reconcile Delta Dental Payments Step-by-Step

Delta Dental deposited $12,847.52 this morning. Here is exactly how to match it to patient accounts and verify you received what you earned.

Why Delta Dental Reconciliation Matters

Delta Dental is the largest dental insurance carrier in the United States, covering over 80 million people. For most dental practices, Delta Dental payments represent a significant portion of insurance revenue.

Given the volume, even small reconciliation errors add up. A posting mistake on one Delta payment might cost you $50. Multiply that across hundreds of Delta payments per year, and the leakage becomes substantial.

This guide walks through the complete process for reconciling Delta Dental payments, from the moment the deposit hits your bank to the final verification that patient accounts are accurate.

Understanding Delta Dental Payment Flow

Before reconciling, understand how Delta Dental payments move.

Claim Submission

You submit claims to Delta Dental, either through your clearinghouse or directly through Delta's provider portal.

Delta has multiple state-based affiliates (Delta Dental of California, Delta Dental of Michigan, etc.). Your patients may be covered by different affiliates depending on their employer or plan.

Claim Processing

Delta processes claims and makes payment determinations. Processing time varies but typically runs five to fourteen business days for clean claims.

During processing, Delta applies:

• Plan benefit limits and maximums
• Deductibles
• Coinsurance percentages
• Waiting periods
• Frequency limitations

Payment Delivery

Delta sends payment via:

EFT (Electronic Funds Transfer): Direct deposit to your bank account. This is the most common method and what this guide focuses on.

Paper check: Mailed to your office. Less common now but still used for some payments.

Virtual credit card: Some Delta affiliates offer this option. Be aware of processing fees.

ERA Delivery

The Electronic Remittance Advice explains what was paid. ERAs typically arrive:

• Through your clearinghouse
• Through Delta's provider portal (Dentist Connection)
• Via direct connection for larger organizations

The ERA is your key to reconciliation. It tells you exactly what was paid, for whom, and why.

Step 1: Identify the Delta Deposit

Start by finding the Delta payment in your bank account.

What to Look For

Delta EFT deposits typically appear with descriptions like:

• DELTA DENTAL
• DELTA DEN
• DD[State abbreviation]
• The deposit amount and date

Note the exact deposit amount. You will need this to match the ERA.

Check for Multiple Affiliates

If you see patients from different Delta affiliates, you may receive separate deposits from each. Do not assume all Delta deposits are from the same source.

Record the Details

Log:

• Deposit date
• Deposit amount
• Bank description (to identify affiliate)
• Trace number if visible

Step 2: Locate the Matching ERA

Find the ERA that corresponds to your deposit.

Check Your Clearinghouse

Log into your clearinghouse portal. Search for Delta ERAs by:

• Payment date (may be a day or two before deposit date)
• Approximate amount
• Payer name

Most clearinghouses display available ERAs and indicate which have been downloaded or posted.

Check Delta Dentist Connection

If you do not find the ERA in your clearinghouse, log into Delta's Dentist Connection portal directly.

Navigate to claims and payments. Search for recent payments. You can download ERAs directly from this portal.

Match the Totals

The ERA total payment amount should match your bank deposit exactly. If it does not match:

ERA higher than deposit: Look for another ERA that, combined, equals the deposit. Or check for take-backs reducing the payment.

ERA lower than deposit: Multiple ERAs may be combined in one deposit. Find additional ERAs that add up to the total.

No matching ERA found: Contact Delta provider services. Get the trace number for the payment and request ERA reissuance.

Step 3: Review ERA Contents

Before posting, review what the ERA contains.

Verify Patient Information

Check that all patients on the ERA are yours:

• Correct patient names
• Patients you actually treat
• Dates of service match your records

If you see unfamiliar patients, investigate before posting. Payments may have been misdirected.

Review Payment Amounts

For each claim line, verify:

• Procedure code matches what you billed
• Billed amount is correct
• Payment amount seems reasonable for the procedure
• Adjustments are appropriate

Identify Adjustments

Note the adjustment reason codes. Common Delta codes include:

CO-45: Charge exceeds fee schedule. Standard contractual adjustment.

PR-1: Deductible amount. Patient responsibility.

PR-2: Coinsurance. Patient responsibility.

CO-50: Not a covered benefit. May be patient responsibility depending on plan.

CO-96: Non-covered charge. Patient responsibility.

Spot Denials

Claims paid at $0 with denial codes need attention:

• Note the reason for denial
• Determine if appeal is appropriate
• Flag for follow-up

Check for Take-Backs

Look for negative payment amounts. These indicate Delta is recouping a previous payment. Understand why before posting.

Step 4: Post to Patient Accounts

Now apply the payments to your practice management system.

Auto-Posting Option

Most PMS platforms can auto-post ERAs. If using auto-posting:

1. Import the ERA into your PMS
2. Let the system match claims to patient accounts
3. Review the matching before finalizing
4. Address any claims that could not be matched
5. Verify totals match the ERA

Auto-posting saves significant time but requires verification.

Manual Posting Option

If posting manually:

1. Open the first patient account on the ERA
2. Find the correct date of service
3. Post the payment amount to each procedure
4. Post the contractual adjustment amount
5. Update patient responsibility if applicable
6. Move to the next patient
7. Repeat until all ERA items are posted

Manual posting is slower but may be necessary for complex situations.

Critical Verification Points

Regardless of method, verify:

Correct patient: Payment goes to the right account.

Correct date of service: Payment applies to the correct visit.

Correct procedures: Each procedure line is addressed.

Correct adjustments: Contractual adjustments are posted.

Patient balance accurate: Remaining balance reflects true patient responsibility.

Step 5: Reconcile the Posting

After posting, verify everything balances.

Check Payment Totals

Total payments posted for this ERA should equal:

• The ERA payment total
• The bank deposit amount

If they do not match, find the discrepancy before finalizing.

Check Adjustment Totals

Total adjustments posted should equal the ERA adjustment total. Adjustment variances indicate posting errors.

Review Patient Balances

Spot-check a few patient accounts:

• Does the remaining balance make sense?
• Is patient responsibility correctly stated?
• Are there any unexpected credits or balances?

Document Completion

Record that this ERA has been reconciled:

• ERA reference number
• Deposit date and amount
• Date reconciled
• Who performed reconciliation
• Any issues noted

Step 6: Handle Exceptions

Not everything posts cleanly. Handle exceptions systematically.

Unmatched Claims

If the ERA includes claims you cannot match:

• Verify patient name spelling variations
• Check for date of service discrepancies
• Confirm the claim was actually submitted
• Contact Delta if patient appears unfamiliar

Denied Claims

For claims denied on the ERA:

• Review the denial reason
• Determine if the denial is valid
• Appeal if appropriate
• Adjust patient responsibility if necessary
• Write off if truly non-collectible

Take-Backs

For recouped amounts:

• Find the original payment that is being reversed
• Understand why the take-back occurred
• Adjust the original posting if it was incorrect
• Bill the patient if they now owe
• Appeal if the take-back is unjustified

Short Payments

If payment is less than expected:

• Review the EOB explanation
• Check if a different fee schedule was applied
• Verify the procedure code was correct
• Appeal if the underpayment is unjustified

Tracking Unresolved Items

Not every issue resolves immediately. Track outstanding items.

Create a Follow-Up Log

Maintain a log of items needing action:

• Patient name
• Date of service
• Issue description
• Action needed
• Deadline
• Status

Set Deadlines

Insurance follow-up has time limits. Track:

• Appeal deadlines (typically 30-90 days from denial)
• Refiling deadlines if claims need correction
• Take-back dispute deadlines

Review Weekly

Do not let items age. Review outstanding Delta items weekly and take action on anything approaching deadlines.

Common Delta Reconciliation Mistakes

Posting to Wrong Date of Service

Delta ERAs reference specific dates of service. Posting to a different date creates incorrect patient balances and reconciliation problems.

Prevention: Always verify the date of service on the ERA matches the claim you are posting to.

Missing Contractual Adjustments

Posting the payment without the adjustment leaves an incorrect patient balance.

Prevention: Always post adjustments when posting payments. Use ERA auto-posting when possible.

Ignoring Take-Backs

Take-backs buried in an ERA can be missed, leaving prior postings incorrect.

Prevention: Review ERAs for negative amounts before posting. Investigate each one.

Not Reconciling ERA to Deposit

Assuming the ERA matches the deposit without verifying leads to accumulated discrepancies.

Prevention: Always verify ERA total equals bank deposit before posting.

Building a Delta Reconciliation Routine

Daily

• Check bank account for new Delta deposits
• Match each deposit to an ERA
• Post or queue for posting
• Flag any unmatched deposits

Weekly

• Review aged unmatched items
• Follow up on denials
• Process appeals
• Clear exceptions

Monthly

• Reconcile total Delta deposits to total Delta payments posted
• Review Delta AR aging
• Analyze denial patterns
• Report on Delta collection rate

Managing Delta Dental reconciliation across multiple practices? Whether you are a practice owner, a bookkeeper serving dental clients, or a DSO finance team, Zeldent automatically matches Delta deposits to your PMS records and flags discrepancies before they age. Schedule a demo to see payer-specific reconciliation that just works.