Delta Dental’s allowance for orthodontic procedures includes all appliances, adjustments, insertion, removal and post-treatment stabilization (retention).
Orthodontic Treatment Claims
Be sure to include:
- Total fee (including the initial fee/down payment and monthly payment amounts)
- Banding date
- Type of appliance
- Total length of active treatment
- Brief description of the dentition, appliance and treatment
When Delta Dental is secondary in dual coverage cases, please include the primary coverage’s total liability including copayment/coinsurance percentage and the explanation of benefits (EOB).
Include the amount paid by the previous carrier on the claim.
Specialized Orthodontic Appliances
For special appliances like Invisalign, we will make an allowance for comparable standard treatment and the patient is responsible for any additional fee. On claims, submit the total fee (you may list your standard fee separately from any additional fee for the specialized appliance). Note: Invisalign is not a covered benefit for DeltaCare ® USA enrollees.