Mailed applications may require up to 20 days to process. Dental Staff Education | Use new claim forms that accommodate the NPI by providing a specific space for it. Daniel Ribeiro , Dentist has not uploaded any photos. Lysol IC Spray | Some procedures are not covered under your patient's plan, no matter what documentation is submitted. Mailing addresses for your Delta Dental Premier and Delta Dental PPO claims. Once you submit your claim adjustment request, it can take up to 21 calendar days for it to process. Sacramento, CA 95853-7007 We can provide a plan thatll help ensure your smile stays healthy for years to come. National Dental Supply and Dental Products Manufacturers | These updates are required to be filed first for approval by state regulatory agencies in many locales. who participate in MetLife's Preferred Dentist Program will charge, but may vary Dental Finishing Supplies | In such cases, its important to understand that a recommended treatment may be perfectly appropriate. . The NPI contains no embedded intelligence no coding that would identify the dentists state or license number, for example. Receiving reports of all successfully transmitted encounter forms, reducing follow-up on unpaid submissions. Through our national network of Delta Dental companies, we offer dental coverage in all 50 states, Puerto Rico and other U.S. territories. Highlighted fees represent the lowest available discounted fee for each procedure, based on the plans available in the ZIP code entered. Welcome, DeltaCare USA members | Delta Dental Estimates should not be construed as financial or medical advice. %PDF-1.6 % Delta Dentals allowance for orthodontic procedures includes all appliances, adjustments, insertion, removal and post-treatment stabilization (retention). Delta Dental has the largest network of dentists nationwide. For more detailed information on your dental care costs, please consult your dentist or your Delta Dental. The Content on this website is not medical advice. Daniel Ribeiro , Dentist has not yet indicated the hospitals that he is affiliated with. Dentists are encouraged to seek their own legal advice about how the NPI pertains to their practices and circumstances. Confidential Filed Fee Schedule In this case, the secondary carrier would pay $14 ($80 x 80% - $50 = $14). Dental UCR Fee Analysis | Henry Schein Dental Business Solutions Keep in mind, a pre-treatment estimate is not a guarantee of payment and it does not check the patients: At any time, you can review the patients current eligibility and benefits information, including remaining maximum and deductible amounts. Look at you smiling. No dentist found that matches your criteria, I receive dental insurance through my employer, Please enter a treatment type and/or valid 5-digit ZIP code. Pre-treatment estimates are especially beneficial when expensive or extensive treatment is being considered and/or dental plan annual maximum, limitations and/or exclusions may affect coverage. Eliminates the need to maintain and match identification numbers to specific payers for transactions, Allows you to relocate your practice or change specialties without requiring new identifiers from multiple payers, Helps reduce costs and simplify health care transactions, Contributes to more efficient coordination of benefits. offers available in all markets. That was pretty easy. The amount that would have been payable by Delta Dental may not be charged to the patient. You will receive the discount off the providers usual and customary This brochure describes the benefits of Delta Dental's Federal Employees Dental Program under Delta Dental of California contract OPM02-FEDVIP-02AP-05 with OPM, as authorized by the FEDVIP law. Costs Locate Providers Insurance Appeals and Assistance Quality of Care, Literacy and Reform Wellness Dental/ Oral Health Disability and Condition-Specific Palliative Care Surprise Billing By State. Dental Curing Lights - LED Curing Lights | Dental Equipment Parts - Dental Repair Parts | the START SEARCH button thats all you need! For DeltaCare USA, maximum contract allowances are not applicable. Dental Set-up & Office Design | If you live outside the U.S., you may see information on this cost estimator about products or services that are not available or authorized in your country. Contact DentaQuest at 1-888-912-3456 or search the DentaQuest website to find a listing of dentists who accept Medicaid in your zip code. The Dental Care Cost Estimator sometimes groups together, into "treatment categories," services that are often delivered together to address a particular dental problem. Please note that this fee If you dont conduct any electronic transactions governed by HIPAA, you arent required to obtain an NPI. Implant supported prosthetics, Description of service: To begin using the Dental Care Cost Estimator tool, click the Agree button below. P.O. Here's what you need to know about NPIs. Endodontic Instruments & Supplies | If there is any conflict or discrepancy between the Content on this website and your coverage documents, your coverage documents will control. Include all required x-rays, documentation and/or written narratives. PDF Dental-Related Services Program Billing Guide - Washington Participation is free and all licensed dentists are eligible to participate. Otherwise, the natural parent the child lives with provides primary coverage. DELTA DENTAL PATIENT DIRECT GENERAL DENTIST FEE SCHEDULE ALL PROCEDURES Effective from 06/01/2022 D2712 Crown - Resin-Based Composite (Indirect) $305 D2720 Crown - Resin With High Noble Metal $648 D2721 Crown - Resin With Predominantly Base Metal $561 D2722 Crown - Resin With Noble Metal $625 D2740 Crown - Porcelain/Ceramic $725 Delta Dental had "allowed" $41 for full reimbursement for a two-surface amalgam (D2150). Email: CustomerCare.Credentialing@greatdentalplans.com. Contact your company's human resources department. Unfortunately, we cannot provide pre-treatment estimates by telephone. Discounted fees listed under "Routine Dental Fees", "Fillings & Crowns" and Root Canals, Perio & Dentures tabs are for participating General Dentists. Rubber Dam | Rubber Dam Clamps | However, there are exceptions, such as theTRICARE Retiree Dental Program (TRDP), a federal plan that follows the effective date rule. All Rights Reserved. plan terms. %%EOF To expedite the processing of your claim, utilize the requirements below to identify the necessary documentation and/or clinical information required for review of specific procedure codes. Box 2105 You will be notified separately when processing of secondary coverage is completed. By clicking, you agree that you have read the informationbelow,are accessing this information for purposes of determining treatment cost estimates for dental care services you are considering receiving, and will not use the information in this tool for a commercial or anti-competitive purpose. PDF 2022 Delta Dental's Federal Employees Dental Program - BENEFEDS "Delta Dental" refers to the national network of 39 independent Delta Dental companies that provide dental insurance. After confirmation of the receipt of your application, you should receive your NPI via e-mail within one to five business days if you submitted the application online. View plans, sample savings & pricing, patient reviews & practice information. Dental Tools & Instruments - Hand & Surgical Instruments | Glossary. Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. Here are the benefits of creating an account. U. S. Mail: Delta Dental of California,ATTN: Provider Onboarding,P.O. Do not avoid getting dental care based on the cost information provided on this website. If the fathers birth date is 10/3/67 and the mothers birth date is 5/15/68, then the mothers coverage is primary. Dental Continuing Education Seminars & Resources | Dental Cements - Temporary & Permanent - Dental Liners | Delta Dental recommends that the NPI be used on all claims. D6055-D6077, D6082-D6088, D6094, D6097-D6099, D6110-D6123, D6194-D6195, Description of service: Miscellaneous services. For other Delta Dental member companies, please check how they prefer to register your NPI. We strongly recommend that you confirm that a provider is currently participating before you receive any services from that provider. Register on DPVerify.com to confirm eligibility of your current or future patients. The discounts are available through participating healthcare providers For joint custody, the plan that has covered either stepparent longest provides primary coverage. The secure version (available only after you sign in) uses procedure costs or cost ranges as reflected in provider fee schedules and aggregated historical cost data. PDF Using My Contracted Fees - Delta Dental *Not sure where your company is headquartered? For example, if both the primary and secondary carrier pay for the service at 80% level but the primary allows $100 and the secondary carrier normally allows $80 for the same treatment, the secondary carrier would not make any additional payment. Sitemap - Henry Schein Dental. The national network of Delta Dental companies protects more smiles than any other dental insurance company. Be sure to enter the treating dentists license number or National Provider Identifier (NPI). This website shows estimates of certain dental care costs. Include all patient information on claims. This is important because some services may be included in the patients basic coverage, even if the patient does not have specific orthodontic coverage. However, contracted Delta Dental dentists may not charge their Delta Dental patients more than the amount determined by Delta Dental to be the patients portion. On a standard ADA Dental Claim Form (#J400), the treating dentists NPI is entered in field 54 and the billing entitys NPI is entered in field 49. However, if the primary carrier only pays 50% of the dentists allowed fee, then the secondary carrier would reduce its payment by the amount paid by the primary plan and pay the difference. Pre-authorizations or referrals are required for certain benefit plans and certain dental care providers. *Not sure where your company is headquartered? Use the My Claims tool to see Delta Dentals estimated payment and the patients portion (often within moments when clinical review is not necessary). A pretreatment estimate is recommended before the start of extensive dental treatment. Fargo, ND 58108-6059. Copyright 2023 Henry Schein, Inc. All rights reserved. Patients may change their coverage, usually in the fall or spring, during their open enrollment periods. Delta Dental Premierand Delta Dental PPO Claims. These listings are updated on a regular basis, and every effort has been made to ensure that only participating active providers are listed. You will receive by mail a pre-treatment estimate showing the amount Delta Dental is estimated to pay and the amount of the patients responsibility. Unscheduled dressing change, Procedure codes: To find If you do not agree with Delta Dentals determination of benefits, and you have additional information to provide, you may request reevaluation by submitting: Mail this information to theDelta Dental member companythat originally processed the claim or pre-treatment estimate. Mechanicsburg, PA 17055. Estimated fees for Zip Code The procedure fee displayed can differ if your dental service providers office is located outside the zip code indicated. Did you know that dental benefit contracts are initially determined by your UCR fee schedule? Box 997330,Sacramento, CA 95899-7330. Have a question about coverage or looking for dental insurance? Dental CAD/CAM: Dental CAD/CAM Milling Machine | More Information On Dental Supplies | When you submit claims as soon as possible after treatment is completed, you help us process claims more efficiently, using the patients most current eligibility and benefits to determine payment. Have a question about coverage or looking for dental insurance? MEMBER FEE SCHEDULE MEMBER PAYS DENTAL SERVICE (Maximum Charge) Delta Dental of Illinois DDIL.PD.FS.0802 Diagnostic Services D 0120 Periodic oral evaluation $23 D 0140 Limited oral evaluation-problem focused $34 . Dental Infection Control Supplies & Products | Some Delta Dental groups that are not subject to the provisions of California Health and Safety Code 1374.19 have a non-duplication of benefits clause in their contract. Better yet, send the documentation on a separate attachment (8.5 x 11 inch paper) or transmit it digitally(submit digitized attachments free with Provider Tools; use the Submit Claim or My Patients tool). PDF Delta Dental Patient Direct General Dentist Fee Schedule (This might require you to upgrade your software. You should always talk to your health care professionals for information concerning diagnosis and treatment, including information regarding which drugs or treatment may be appropriate for you. Already registered with :DP Verify? Dental Diagnostic Equipment | You no longer need to send us paper claims just because you need to send an attachment. This cost estimator is intended for use in the 50 states, Puerto Rico and other U.S. territories. Oral surgery (impacted tooth), Description of service: Save time and money while helping the environment by electronically submitting your encounter forms to DeltaCare USA. Anticipate what questions a dental consultant may have regarding a particular claim and provide the reason it should be paid. The sample table is a small selection of common procedures discounted by these discount dental plans and programs. Delta Dental of California, Delta Dental Insurance Company, Delta Dental of Pennsylvania and affiliates, Submitting claims for dependents age 19 and over, Electronic encounter forms for DeltaCare USA. Note not all plans and P.C., (Adam Diasti, DDS, DN11634) or Coast Dental of Texas, PC (Adam Diasti, DDS, Lic 32327) Coast Dental Services, LLC complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. The costs provided in this tool are estimates only and are not a guarantee of payment or benefits. Survey of Dental Fees | American Dental Association You can ask the patient to advise us by calling our Customer Service department, or you can send a copy of the notice from the patients former carrier that includes this information. An itemized Explanation of Benefits is required for all procedures when Delta Dental is the secondarycarrier. 465 Medford Street, Ste 400. 2Fee schedules and savings may vary by ZIP code and by Provider within a ZIP code. Dental Scrubs & Uniforms - Fashion Seal Scrubs | Stray marks in spaces that should be left blank. Dental Office Supplies & Essentials | This is a10-digit random number unique to each health care provider or organization. PDF Delta Dental Patient Direct Member Fee Schedule A retiree plan and a spouses active plan: Usually, the patients retiree plan is primary (a persons own coverage is primary for himself/herself); however, check the Evidence of Coverage for the retiree plan there may be a provision making it secondary to an active plan. (1) Network Fee: This fee represents what most dental service providers Be sure to include the following information on dual coverage claims: For adults, the member's plan through his or her employment is primary. The SFC program is managed by Dentaquest. Have a question about coverage or looking for dental insurance? to California residents or on Fully Insured Plans. Dental Products - Professional Services | Your actual cost may be higher or lower than the estimate for various reasons.