How to file a dental claim
Delta Dental dentists will handle all claims and paperwork for you. However, if you visit a non-Delta Dental dentist, you may need to file the claim yourself.
If you do need to file a claim form:
- Download the claim form for your Delta Dental plan:
- Complete the patient and subscriber information on the claim form.
- Provide a copy of the dentist's Statement of Treatment or a detailed receipt that includes:
- Name, address and complete phone number of dentist
- Date each service was performed
- Description, procedure code and fee of each service performed
- List of affected teeth
- Total cost of services performed
- Dentist's National Provider Identifier (NPI)
- Dentist’s Tax Identification Number (TIN)
- State license number
- Specialty code
Important note: If the Statement of Treatment or similar document you receive from your dentist is missing any of the information listed in Step 3, please enter it on the claim form. A dental office staff member can provide you with the dentist and treatment information.
We usually process claims within two weeks unless additional information is required from you or the dentist.