Glossary of Terms
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Continuity of Care
Benefits, Limitations and Exclusions
Emergency Services
Specialist Services
Coordination of Benefits
Renewal and Termination of Benefits
Cancellation of Enrollment
Schedule A
Description of Benefits and Copayments

Schedule B
Limitations and Exclusion

 
 
 
SPECIALIST SERVICES  
 

Specialist Services must be referred by the assigned Contract Dentist and preauthorized in writing by Delta Dental. All preauthorized Specialist Services will be paid by us less any applicable Copayments. If an Enrollee is assigned to a dental school clinic for Specialist Services, those services may be provided by a Dentist, a dental student, a clinician or a dental instructor.

If the services of a Contract Orthodontist are needed, please refer to Orthodontics in the Description of Benefits and Copayments, and Limitations and Exclusions to determine which procedures are covered under this Program.

 
 
 
 
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