When there is other coverage and it is not FEHB, please indicate that coverage by checking the “Other Coverage” box and be sure to complete all the other information fields in this same area on the claim form. Radiographs and/or other documentation will not be returned. For Delta Dental PPO, DPO and Delta Dental Premier claims. Box 173803 Denver, CO 80217-3803 800-610-0201 deltadentalco.com Payer #84056 Delaware Delta Dental of Delaware, Inc. Payer #51022 See Delta Dental of Pennsylvania Kentucky When the patient has a FEHB plan that has any dental coverage, it always will be the primary carrier. Delta Dental’s Federal Employees Dental Program is administered by the Federal Government Programs division of Delta Dental of California through its subsidiary Delta Dental Insurance Company (DDIC). Indicate a quantity (the number of x-rays, for example) in the field on the claim specifically for this purpose. Delta Dental FEDP will be the secondary coverage. Box 997330 Sacramento, CA 95899-7330 888-DELTA CS 888-335-8227 www.deltadentalca.org Payer #77777 Delta Dental of Colorado P.O. The Dental Plan outlined in this Certificate is administered by Delta Dental Plan of Michigan, Inc., under an agreement with the Office of Retirement Services for Michigan Public School Employees’ Retirement System, Client Number 3250. AARP DENTAL INSURANCE PLAN Delta Dental Insurance Company P.O. Delta Dental uses this information to ensure the claim is processed under the correct member. En Delta Dental te damos seguridad CONOCE TU PLAN AQUÍ Conéctate Eligibilidad, beneficios, reclamaciones Disponible desde nuestro portal CONÉCTATE AQUÍ hoy mismo ¡Buscanos en Facebook! Get started by contacting different vendors and ask for product information and pricing. Stay informed by attending a free, live Estimates may vary depending on your benefit plan and the state you live in. Claims will be processed when received according to your plan provisions. Box 14181, Lexington, KY 40512. Important information for dentists with patients covered by the State of Illinois Dental Plan. The form is designed so that the name and address (Item 3) of the third-party payer receiving the claim (insurance company/dental benefit plan) is visible in a standard #10 window envelope. Additionally if you verify claims status or access patient enrollment and/or benefits information online you are required to use a NPI. When submitting claims, the NPI-1 will always be required for the rendering/treating dentist. Preventive services such as cleanings and X-rays are covered at 100% and you'll have access to … Transmit free real-time, pre-populated claims with digital attachments and pre-treatment estimates. This website is the home of Delta Dental of California; Delta Dental Insurance Company; Delta Dental of Pennsylvania; Delta Dental of New York, Inc.; Delta Dental of the District of Columbia; Delta Dental of Delaware, Inc.; Delta Dental of West Virginia, Inc. and their affiliated companies. The Tax ID you use on your claims affects your year-end 1099 statement. The Dental Care Cost Estimator provides an estimate and does not guarantee the exact fees for dental procedures, what services your dental benefits plan will cover or your out-of-pocket costs. Box 537007 Sacramento, CA 95853-7007 844-825-8111 Payer #CDCA1 FSPS@delta.org TRICARE RETIREE DENTAL PROGRAM trdp.org Please consult each dental plan's Evidence of Coverage for detailed information and plan limitations. You may receive an ID card as part of your welcome package when you get a Delta Dental plan. If you have questions regarding errors or to request an “Electronic Claims Submission” guide, contact Delta Dental… Payer #CDAR1 Delta Dental of California P.O. Forgot Payer ID of the insurance carrier. Do these features support all your business needs? Simply tell your dental office the Delta Dental company through which you receive benefits and provide your name, your date of birth, your enrollee ID or social security number and the name of your employer (if you have an employer-sponsored plan). You may be responsible for the cost of procedures or services not covered by your plan. NOTE: TRDP, provided by Delta Dental, ended in 2018. If you conduct electronic transactions, you’ll need the Payer ID of the insurance carrier. Or, you may contact the IRS to request a letter (#147C) that will confirm their records of your name and ID number. Evaluate the Workforce Plan; State of California Succession Management Model. Through our national network of Delta Dental companies, we offer dental coverage in all 50 states, Puerto Rico and other U.S. territories. Delta Dental offers individual and family dental insurance plans. The IRS phone number is 800-829-1040. Delta Dental of Illinois does not control the timing or funding of claims payments to State of Illinois dental members or the dentists who treat them. You only have to date each service, sign and return the form for processing. The following chart provides a comparison of costs for certain procedures covered by the state-sponsored dental plans. The tax identification number and practice name on file with Delta Dental must match the IRS records exactly. Delta Dental -the largest dental network in the US. EDI system maintenance schedules and downloadable, printable guides, Your Tax Identification Number (TIN, EIN or SSN), Medicare Fraud Waste and Abuse Attestation, Communicate With Your Patients Who Speak Another Language, Register your National Provider Identifier (NPI), English to Spanish phrase guide for dentists, Continuous Orthodontic Coverage Form for DeltaCare USA. The plan limits the amount of paid coverage for each specific type of dental treatment. webinar. In all cases when Delta Dental is the secondary carrier the primary carrier’s Explanation of Benefits or remittance advice is not required; please just indicate the amount paid by the primary carrier on the claim in the “Other Coverage” area. Line through (single line) any treatment that has not been completed. The office will use that information to … Dental Offices Online Inquiry: Email Phone: 844-825-8111 (24 hours automated) Mail Inquiries, Claims and Appeals Mail Inquiries and Claims Delta Dental of California Federal Government Programs P.O. Your dentist’s office staff can use your ID card to quickly look up your benefit and coverage information. Username or The following may cause delays, inaccurate processing and possible denials: If you have submitted a pre-treatment estimate, once services are provided use the notification of pre-treatment estimate form. Any changes to this ID number during the year should be verified through your local Delta Dental Member Company no later than the end of each year. Estimates should not be construed as financial or medical advice. TRICARE Retiree Dental Program. For other Delta Dental Plans Association member companies, visit the Delta Dental Plans Association website. Save Time By Using Dental Office Toolkit (DOT), Delta Dental’s Federal Employees Dental Program, Use fees with decimal points (for example, 100.00; not 100). See processed claims in minutes (when clinical review isn’t necessary), including Delta Dental’s payment and the patient’s payment portion (maximums and deductibles are updated in real-time, too). No changes to the ID number can be made on the 1099 statements once they have been processed. Member login or account registration to view plan information, download forms, view claims, and track dental activity. You may be responsible for the cost of procedures or services not covered by your plan. Send TRICARE Dental Program Claims Prior to May 1st, 2017 to: Metlife Claims, P.O. Do the reports provide the level of detail you need to run your business effectively? Indicate a quantity (the number of x-rays, for example) in the field on the claim specifically for this purpose. Compare the more important features offered: How will the vendor help you if you have a question? If this field is not available, list each item on a seperate line. If the claim does not have this field, please list each item on a separate line. Electronic Data Interchange (EDI) Hours and Information Link to information about EDI system maintenance schedules and downloadable, printable guides that provide details on specific EDI real-time transactions. We have dental plans for individuals, families, seniors, aarp members, and costco executive members. Check eligibility, benefits and claims status. Sign up for direct deposit (use the “EFT and ERA” tool). Claims will be processed when received according to your plan provisions. Box 997330 Sacramento, CA 95899-7330 888-335-8227 deltadentalins.com Payer #77777 Colorado Delta Dental of Colorado P.O. We accept duplicate films and paper copies of digital images. If you conduct electronic transactions, you’ll need the Copies of radiographs must be of diagnostic quality. View (or download and print) benefits details, per procedure, per network. Box 173803 Denver, CO 80217-3803 800-610-0201 www.deltadentalco.com Payer #84056 Delta Dental of Connecticut (See Delta Dental of New Jersey) Payer #22189 Delta Dental of Washington is a part of Delta Dental Plans Association. Use of this website in no way increases or decreases the benefits available under a dental benefit plan. The address for our administrative office is: Delta Dental of California Federal Employees Dental Program PO Box 537009 Sacramento , CA 95853-7009 Box 9089 Questions may be submitted in writing to: Customer Service Department Delta Dental of Michigan P.O. Payer #CDAR1 California Delta Dental of California P.O. Link to information about Password? If they do not, the IRS requires Delta Dental to withhold 28 percent of the dollars owed to you from future payments until the matter is resolved. Please fold the form using the ‘tick-marks’ printed in the margin. Attach the primary carriers EOB or write the amount primary paid in the remarks sections, Non-treatment related messages in the remarks section (for example, 2nd submission; please process), A 10-point font and all capital letters (Courier is a good font choice), Six-digit dates with no spaces, slashes or dashes (for example, 050312 for May 3, 2012), Fees with decimal points (for example, 100.00; not 100). Skip to main content Important COVID-19 updates for enrollees and providers If your plan didn't include an ID card or you don’t have yours with you, don’t worry! Submit the correct ID number as printed on the ID card and the subscriber’s date of birth. All individual health care providers (including dentists) and organizations such as clinics and group practices are eligible to obtain an NPI. There are two types of NPIs: Type 1, for individual health care providers, such as dentists and hygienists, and Type 2 for incorporated businesses, such as group practices and clinics. Cada sonrisa cuenta una historia, protégela. We’ll help you simplify your administrative processes with Provider Tools demonstrations and other new ideas for increasing efficiency. Estimates may vary depending on your benefit plan and the state you live in. If you are unsure of how your practice name and the associated ID number are recorded with the IRS, check what is printed on the mailing labels that are supplied by the IRS for quarterly tax payments. View our cost-effective choices for individual dental insurance and get an instant online quote. Use of this website in no way increases or decreases the benefits available under a dental benefit plan. Box 537007 Sacramento, CA 95853-7007 Appeals Delta Dental of California Federal Government Programs P.O. EDI system maintenance schedules and downloadable, printable guides that provide details on specific EDI real-time transactions. Compare pricing and features to find the best fit for your office. Dales una vida llena de sonrisas con Delta Dental Protege lo más querido Planes individuales para toda la familia CONOCE MÁS AQUÍ ¡Sonríe! A 10-digit random number unique to each health care provider or organization, An NPI contains no coded information about the provider or organization, A permanent identifier that does not change over time or expire, Not a replacement for social security numbers, DEA numbers, taxpayer ID numbers (TIN or EIN), specialty identifiers (taxonomy) or state license numbers, Issued by the government through a third-party group, the National Plan & Provider Enumeration System (NPPES), which is responsible for processing applications and assigning numbers. This brochure describes the benefits of Delta Dental’s Federal Employees Dental Program under Delta Dental of California contract OPM01-FEDVIP-01AP-3 with OPM, as authorized by the FEDVIP law. In these instances, please simply indicate the amount paid by the FEHB carrier on the claim in the “Other Coverage” area. Do not submit a new claim for any services that have been submitted for a pre-treatment estimate. The Medi-Cal Program currently offers dental services as one of the program's many benefits. Box 2059 Mechanicsburg, PA 17055-2059 866-261-4275 deltadentalins.com/AARP Payer #AARP1 DELTA DENTAL FEDERAL GOVERNMENT PROGRAMS Delta Dental of California P.O. Part 1 - Identify and Prioritize Key Positions; ... Delta Dental PPO plus Premier Basic Plan for Represented Employees. Start by registering for an Online Services account and logging in to use Provider Tools. Tesia Clearinghouse 1540 West Edgewood Avenue Indianapolis, IN 46217 Phone: (866)712-9584 2016-07-14 Electronic Remittance Advice Enrollment – Delta Dental Plans *Provider Name: If they do not, the IRS requires Delta Dental to withhold 28 percent of the dollars owed to you from future payments until the matter is resolved. Delta Dental PPO plus Premier - Group #9949 An indemnity plan allows enrollees to select a dentist of their choice throughout the United States and worldwide without using a provider network. Use your practice management software to do more, including to communicate with insurance carriers electronically. Use Provider Tools to simplify your office administration. No changes to the ID number can be made on the 1099 statements once they have been processed. If applicable, attach the primary carrier’s EOB or write the amount primary paid in the remarks section, Using free-form text — Use ditto marks or arrows to indicate duplicate information, Stray marks in spaces that should be left blank, Putting a slash through zeros or crossing sevens, Writing on top of lines or outside of boxes, Using correction fluid or a highlighter pen, Using more than one font style on a claim, Submitting photocopied claims as they are generally received blurred or skewed, Using nicknames for either the subscriber or patient. If you need to file a claim with Delta Dental for care received before Jan. 1, 2019: Download the TRDP Claim Form Get started by calling your practice management software vendor’s support center for details about how to submit claims and attachments, check benefits and eligibility, and accomplish other activities electronically. Under the guidance of the California Department of Health Care Services, the Medi-Cal Dental Program aims to provide Medi-Cal members with access to high-quality dental care. Provider Tools also gives you a list of your Delta Dental patients, claim status, treatment history and a reference library. Prepaid Dental Plan Premiums Level of Coverage If two or more names are used (such as Chris Smith, DMD, dba Market Street Dental), please give us the first listing that appears on the IRS records, in this example Chris Smith, DMD. Consider asking other dentists for their recommendations. Locate a network dentist for your Delta Dental plan in FEDVIP and save on your out-of-pocket costs. Notes: (1) Managerial, supervisory, confidential and all other employees excluded from collective bargaining. News. The tax identification number and practice name on file with Delta Dental must match the IRS records exactly. Box 537015 Sacramento, CA 95853-7015 © Delta Dental. 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