|
How do I locate a Delta Dental PPO network dentist?
- Contact your current dentist's office and ask them if the dentist is already a part of the Delta Dental PPO network;
- or call Delta Dental: (800) 427-3237 and follow the easy voice prompts;
- or check Delta Dental's online directory.
What is the difference between a Delta Dental dentist and a Delta Dental PPO dentist?
Three out of four dentists in the U.S. are Delta Dental dentists. Delta Dental dentists have an agreement with Delta Dental, which means their fees are preapproved, they handle claims paperwork free of charge and they call Delta Dental directly with any inquiries. Because Delta Dental pays these dentists directly, you do not need to pay the entire bill and wait for reimbursement. Instead, you pay only the patient portion of the bill.
Delta Dental PPO dentists are a select group of Delta Dental dentists who, in addition to the above conveniences, also charge lower fees. And, when you visit a Delta Dental PPO dentist, you maximize your benefits. There are approximately 50,000 Delta Dental PPO dental offices around the U.S.
What are the advantages to using a network dentist versus a non-network dentist?
- You save money because dentists in the Delta Dental network have agreed to charge lower fees for services. If you use a Delta Dental PPO dentist, your diagnostic and preventive services are covered at 100% with no deductible.
- Network dentists file the claim forms for you.
- You are not required to pay the entire bill in advance. You may be required to pay your portion of the covered services at the time of initial service. The dentist will bill Delta Dental for the balance.
What if I use a dentist who is not a Delta Dental network dentist?
- You may be required to pay the entire bill in advance.
- You must file a claim form and submit it to Delta Dental. If your dentist's fees exceed the Plan's allowance, you are also responsible for the difference between the Plan's payment and the dentist's actual charges.
How do I file a claim form?
All dental claim forms, including claims for services performed outside the United States, should be sent to:
Delta Dental of California
Claims Department
P.O. Box 997330
Sacramento, CA 95899-7330
Claim forms may by ordered from the Plan Office by calling (800) 777-4013 or downloaded from the Plan's Web site: www.sagph.org.
You can also order forms directly from Delta Dental by calling (800) 846-7418 or you can download a claim form from Delta Dental's site. But remember, if you use a Delta Dental network dentist there are no claim forms to file.
Where can I obtain a list of dentists?
A directory of Delta Dental PPO dentists and one for Delta Dental Premier dentists in your state will be mailed to all out-of-California participants in December of this year. You may request listings for additional areas by calling Delta Dental at (800) 427-3237. Please allow 7 to 10 business days for delivery.
To obtain a list now or to check if your current dentist is a Delta Dental PPO or Delta Dental Premier dentist, check our online dentist directory. This directory also offers mapping and routing information.
If you need the names of a few Delta Dental PPO dentists right now, call Delta Dental at (800) 846-7418.
In addition, a directory of Delta Dental PPO dentists and one for Delta Dental dentists in your state will be mailed to all out-of-California participants in December of this year.
Can I nominate my current dentist to become a network Delta Dental dentist?
Yes. You may nominate your dentist for Delta Dental PPO network membership by filling out a Dentist Nomination form. The form is included in the printed material we'll be sending you in early December.
After I nominate my dentist for admission into the Delta Dental PPO network, how long does the process take? Can I use my dentist during the nomination process? Will my dentist automatically be admitted?
The nomination process takes about 90 days. Not all dentists will choose to participate. Admittance is not automatic and until your dentist is accepted into the Delta Dental network, he or she is considered an out-of-network dentist.
Why are claims processed in California?
All claims are processed in California for administrative efficiency; however, Delta Dental PPO is a nationwide network.
Back to Top
|
