Will Insurance Companies Continue Sending Checks After Dropping Plans?

As a dentist working toward reducing insurance dependence, payment logistics are understandably a source of concern. One question comes up repeatedly: "Will insurance companies continue sending us checks once we're out of network?" The answer is more nuanced than a simple yes or no—but there's a clear strategy to handle whatever situation emerges.

The Direct Answer: It Depends

The honest answer to whether insurance companies will continue sending you checks is: it depends. Some insurance companies will continue to assign benefits to you after you go out of network, while others will change the payment structure to send checks directly to patients. The variability comes down to individual insurance company policies—but we can predict some patterns based on historical behavior.

Many insurance companies will continue assigning benefits to your practice out of network, which is the most favorable situation for you and your patients. However, some carriers—most notably Delta—have a specific policy of sending checks directly to patients once you go out of network. This is intentional on their part, and understanding why will help you navigate it effectively.

The Two Payment Scenarios

Scenario 1: Insurance Company Continues Sending Checks to Your Office

When this occurs, very little changes operationally. Patients still go through their normal claim processes, and you receive payment directly from the insurance company, just as you did when you were in-network. Your billing team's workflow remains largely unchanged, and patients face no additional out-of-pocket expenses during the reimbursement process.

Scenario 2: Insurance Company Sends Checks Directly to Patients

This is the less convenient option from an operational standpoint, but it's not the obstacle many dentists fear it to be. We know with certainty that Delta uses this approach—they intentionally shift payment to patients as a mechanism to discourage practices from going out of network. But this doesn't mean you shouldn't drop Delta plans. It means you need a strategy to handle the shift.

Why Insurance Companies Do This: Understanding Their Motivation

Delta's strategy of sending checks to patients is no accident—it's deliberate. They understand that this creates friction in the patient experience and hope it will discourage dentists from leaving their network. But here's the critical insight: this friction is temporary and manageable.

The insurance companies know the patient's primary concern is hassle and confusion, not the actual out-of-pocket cost. They're banking on the fact that patients will prefer the convenience of insurance paying the dentist directly, even if it means accepting reduced reimbursement rates. This is their leverage.

Knowing this gives you power. You're not ignorant of their strategy; you're prepared for it. And when you have a strategy, the leverage disappears.

How to Handle Direct Patient Reimbursement Successfully

When you're in a situation where insurance sends checks to patients, here's the system that works consistently well with our coaching clients:

Step 1: Set Expectations Clearly

Have a conversation with the patient that sounds something like this:

The key is presenting this as a simple procedural change, not as a negative development. Your tone and confidence matter significantly here.

Step 2: Offer a Simple Payment Option

Guide patients toward using a credit or debit card for their out-of-pocket portion:

"What most of our patients do is charge today's services to their debit or credit card. We'll file your insurance claim immediately—electronically, so it goes out today and arrives at Delta by end of business. You should receive your check well before your credit card statement is due. You can then send that check to your credit card company, and you've essentially never gone out of pocket."

This is the psychological magic: patients aren't actually paying out of pocket if they know they'll be reimbursed before their statement arrives. The process is efficient enough that there's minimal financial burden.

Step 3: Provide a Backup Plan

Not every patient will receive their check within the expected timeframe. Have a system ready:

"If you don't receive your check from Delta within about two weeks, contact your benefits supervisor at work—don't just call Delta, have your benefits supervisor reach out to them on your behalf. Your benefits supervisor has leverage with Delta that you don't have. They'll contact the insurance company and get your check moving. This rarely takes long because Delta cares about keeping your employer happy, and a happy employer means addressing employee complaints quickly."

This is a crucial point: Delta cares about employers, not patients. By empowering patients to involve their employer, you're activating the one party Delta actually responds to immediately.

What to Expect from Patient Reactions

Be prepared for some initial pushback. Most patients haven't had to pay at time of service before, and the change creates emotional resistance, even if the practical burden is minimal.

Common Patient Response

"I've never had to pay before. Why do I have to pay now?"

This is valid frustration, and you should acknowledge it with empathy:

"I understand. That is a change. Ideally, Delta would continue sending us the check directly like they used to—I wish they would. But they've changed their policy for out-of-network providers. We're going to help you make this as easy as possible, and most of our patients are surprised by how manageable it is."

The key here is sharing Delta's role in the change without blame toward the patient. You're allies against the system, not opponents with the patient.

Building Flexibility Into Your Policy

While most patients handle direct payment without issue, some situations warrant flexibility. Consider establishing predetermined boundaries with your financial coordinator:

• Can you allow payment plans for patients in genuine hardship? (Yes, in most cases)
• What constitutes genuine hardship versus inconvenience? (Define this clearly)
• How many installments can you accommodate? (Perhaps two or three, not ongoing)

The critical point: flexibility doesn't mean unlimited accommodation. It means having thoughtful boundaries that you can apply consistently. Your financial coordinator and clinical team should discuss these boundaries together so everyone's definition of flexibility aligns.

How Quickly Patients Adapt

One aspect that surprises many practices: patients adapt quickly. After patients receive their first reimbursement from Delta—typically within a week—the process becomes routine. You'll hear comments like:

"I got my check yesterday. Put it right toward my credit card balance. No big deal."

This normalization happens fast. One successful experience trains patients that the system works. The psychological burden is far greater than the actual burden, and once they've experienced it once, the psychological component disappears.

The Fear Is Often Worse Than Reality

Many dentists cite the direct payment issue as a reason to avoid dropping insurance plans. But this is what we call "fear—False Evidence Appearing Real." The fear of what will happen is rarely as bad as the imagined scenario.

Could some patients leave because of this change? Theoretically, yes. But in practice, it rarely happens when you handle it well. Could some patients complain? Yes. Could some require accommodations? Yes. But none of these outcomes are practice-threatening when you're prepared for them.

The practices that execute this most smoothly are those that:

1. Expect the change and have a plan before implementing it
2. Communicate clearly and confidently with patients
3. Have systems in place to handle exceptions
4. Don't catastrophize the patient experience

The Marketing Advantage: Risk Mitigation Through New Patient Flow

One powerful observation: practices with strong marketing programs and consistent new patient flow handle insurance transitions with significantly less anxiety. Why? Because they're not dependent on retaining every existing patient.

This doesn't mean they don't care about retention—they do. But they approach transitions from a position of strength rather than desperation. If a patient is bothered by the payment process change, the practice can afford to let them go because they have a pipeline of new patients coming through marketing efforts.

This confidence—that you have patients choosing you for reasons other than insurance—translates to patient communication. Patients feel your confidence and are more likely to accept the process change. Meanwhile, practices operating from a position of fear tend to communicate that fear, which increases patient anxiety about the change.

Contacting Insurance Companies Before You Transition

When you're ready to terminate your PPO agreements, you'll have an opportunity to ask the insurance company directly about their out-of-network payment policy. The conversation might go like this:

"When I terminate my contract with your company, how will you handle benefit payment assignments? Will you continue to assign benefits to me as an out-of-network provider, or will you send payments directly to patients?"

The insurance company won't always give you a definitive answer. That's fine—you'll find out the real answer once you're actually out of network. And by then, you'll be prepared for either scenario because you've read this article and have a system ready.

Key Takeaway: It's Not the Obstacle You Think It Is

The insurance payment question is real, but it's manageable. The practices that successfully navigate this transition do so because they:

• Understand that some payment method shift is likely with certain carriers
• Have a clear system for handling patient-direct payments
• Communicate proactively and confidently with patients
• Don't let fear paralyze them into inaction
• Recognize that adaptation is quick once the patient experiences one successful reimbursement

This is not a reason to stay trapped in PPO dependency. This is a detail to address as part of your transition planning.

Reviewed by

Naren Arulrajah

CEO & Founder, Ekwa Marketing

Naren Arulrajah is the CEO and Founder of Ekwa Marketing, a 300-person dental marketing agency that has helped hundreds of practices grow through SEO, reputation management, and digital strategy. A published author of three books on dental marketing, contributor to Dentistry IQ, co-host of the Thriving Dentist Show and the Less Insurance Dependence Podcast, and a member of the Academy of Dental Management Consultants. He has spent 19 years focused exclusively on helping dental practices succeed online.