Benefits by procedure code -
When looking up patient benefits by procedure code, you will now be able to see the patient's coinsurance benefit percentage for all three network participation levels - PPO, Premier (Par), and non-participating (NonPar). Our goal is to provide transparency in benefit levels.
Benefit Rundown -
Your patient's coinsurance benefit percentages for all three network participation levels have also been added to the Benefit Rundown portion of the Provider Toolkit.
In addition we've added a new link so you can easily access the same patient's Group Benefits, Dates of Service and Accumulators from the Benefit Rundown page without reentering the patient's member ID number. Simply click the "Group Benefits, Dates of Service and Accumulators" link.
What does "Paid as PPO?" mean?
When looking at your Patient's Group Benefits, Dates of Service and Accumulators in the Provider Toolkit, "Patient Benefits", you'll notice a line that says "Paid as PPO?". This will tell you if the payment is made using the Delta Dental PPO fee schedule or the Premier Maximum Plan Allowance (MPA).
Yes = PPO Fee Schedule
No = Premier MPA
Are you registered for an online dentist account?
It's an easy and quick way to look up your Delta Dental patient benefits, access forms and other important information.