Broker

Working with DDKS

Can I access my client’s online account?

Yes, your group clients can give you certain permissions to have access to the online employer account. The Online Employer Account form must be completed and signed by your client to give you permission for access.

Access forms

What can I access on the online broker account?

With a Delta Dental online account, you can access:

  • Commission agreements
  • Pool Plan Rates
  • Forms
  • Plan descriptions
  • And more

How do I sell Delta Dental’s Group Plans?

For more information on becoming a Delta Dental of Kansas broker, contact our Sales team.

We will set you up with a Delta Dental of Kansas broker account where you can access commission agreements, pool rates and more. 

Have a request for proposal? Contact our Sales team or fill out this RFP form.

How do I sell Delta Dental’s Individual Product?

Interested in selling Delta Dental of Kansas’ Individual & Family plans? It’s easy to get started. Use this contact form to contact our Sales team. We’ll work with you to set up your own unique online enrollment URL that you can share with your clients. When your clients use your unique enrollment URL to enroll in one of your plans, you receive commissions. Contact our Sales team to learn more.

My Clients

Can a group change its new hire waiting period?

The contract signed by the group defines the waiting period. The waiting period applies to all new employees. Some contracts may allow changes to the waiting period. Please contact your Delta Dental Account Executive to inquire about contract revisions.

How far back can a group’s account be credited for changes/terminations?

Credits for changes and terminations on your group’s account are generally limited to 60 days prior to the current billing cycle in accordance with the Delta Dental contract.

When are groups’ Delta Dental premiums due each month?

Payment should be submitted to Delta Dental by the due date printed on the invoice (billing statement).

When should groups expect their billing statement to arrive?

Delta Dental generates billing statements (electronic and paper) on the 25th of each month. Groups that have selected electronic billing will receive an email notification that their bill has been posted to our website.

How do I confirm that a group’s employee is eligible for coverage?

Group administrators can log in through their employer account to check an employee’s eligibility status. 

If your client would like you to have access to their employer account, you must fill out an employer account registration form with the Employer authorization for broker & agency online access section completed and signed by the employer group.

Can I access my client’s online account?

Yes, your group clients can give you certain permissions to have access to the online employer account. The Online Employer Account form must be completed and signed by your client to give you permission for access.

Access forms

Community Involvement

Applying for Grants

Does Delta Dental of Kansas have a grant cycle?

Delta Dental of Kansas announced funding focus changes for 2019. 

The Delta Dental of Kansas Charitable Giving Committee of the Board and our staff have been holistically reviewing our charitable giving program. 

Delta Dental of Kansas will not be holding an open grant cycle for 2019. Our process for the donation of Smile Kits (toothbrush kits) will remain as it currently stands, however please bear in mind we will not be awarding Oral Health Grants in 2019.

We have chosen to focus our areas of impact on funding direct care/access, education/prevention and workforce training. Our Board and staff have identified organizations we will be partnering with in 2019. 

Applying for Smile Kits

I applied for Smile Kits. When will I know if my request was approved?

You will be notified via email within one week if your request was approved.

How can I get Smile Kits after I apply?

We ask that requests for Smile Kits be submitted at least four weeks before kits are needed. Donations are granted based on availability at the time of request, at the sole discretion of Delta Dental of Kansas.

How often can I apply for Smile Kits?

Each organization can apply for Smile Kits once every 12 months.

Matching Gift Program for Dentists

I am a participating dentist. How do I submit a matching gift request?

Complete the Matching Gift Application. Send your application along with your donation tax receipt to DDKS Community Benefit by: 

Email — corpcomm@deltadentalks.com 

Mail — 1619 N Waterfront Pkwy, P.O. Box 789769, Wichita, KS 67278-9769 

Fax — 316-462-3372

I am a participating dentist. Will DDKS match my donation to any non-profit?

Delta Dental of Kansas matches gifts to any non-profit charitable health care, education, civic or cultural organization provided it is located in Kansas and recognized as a tax exempt organization by the Internal Revenue Service under Section 501(c)(3). Please see more information on eligible organizations in the DDKS Matching Gift application.

Who can take advantage of DDKS’ matching gift program?

Delta Dental of Kansas participating dentists can use our matching gift program. Participating dentists’ approved charity donations may be matched up to $100.

Dentist

Accessing Patient Information

My patient is covered under two dental plans. How is his/her coverage handled?

If your patient is covered by both Delta Dental of Kansas and another dental carrier or a medical plan that offers dental coverage, Delta Dental coordinates benefits with the other carrier. Generally, if the patient is covered as an employee and also as a dependent of an employee at another company, the coverage through the patient’s employer is primary. Children covered by parents who work for different employers are usually primary under the plan of the parent whose birthday occurs first in a calendar year (not necessarily the oldest parent). Total payments from both carriers cannot exceed 100% of the approved fee for the service. Some groups have specified a “carve-out” clause in their dental programs that might limit a secondary carrier’s payment. If you have questions about Coordination of Benefits, please contact our Customer Service team.

How do I get a rundown of my patient’s dental coverage?

You can easily and quickly view your patient’s benefits/eligibility through your online account. Log in to your account by clicking here. Once logged in, select the Kansas Provider Toolkit, and then select Patient Benefits or Benefit Rundown.

You can also use Benefits Faxback to verify benefits and eligibility via fax by dialing 1-877-FAX-DDKS. You will get an automated voice response that will lead you through simple instructions. Once you’re done inputting all of your patient’s identification numbers, a fax will be sent to you immediately.

My patient has an exclusive Delta Dental PPO plan. How do I know if my patient is eligible for benefits?

If the group has selected an option that limits access based on the dentist’s participation level, indication is made on the top right hand corner of the dental insurance card — “Must see a PPO provider for benefits.” With these particular plans, if the patient chooses to see a provider outside his/her network, no benefits will be paid and full payment is the responsibility of the patient. For a patient’s specific plan details, visit your online account or contact our Customer Service team.

Claims

What date do I use on the claim form?

We recommend that you apply your normal billing procedures to all patients — “bill all on prep date or bill all on delivery.” (Excludes partials or dentures, which must be billed on seat date). While third-party claim submission policy offers dentists some latitude as to whether claims may be submitted at the commencement of procedures or at their conclusion, no ethical principle allows a dentist to bill and retain money for work that is not performed (ADA Ethics). Please note, however, that the policy for Delta Dental’s national coverage groups continues to be that “benefits for multi-stage procedures are only available for completed services as determined by the date of insertion.”

Do I have to submit a claim form every month for orthodontic work?

Submitting a monthly claim for orthodontics is not necessary. Normally, the claim is filed for the entire treatment, and Delta Dental automatically makes a payment each month until the treatment is completed, terminated, or the patient is no longer eligible.

Am I required to submit a predetermination of benefits before beginning treatment on a patient?

In most cases, predeterminations are not required, yet they are strongly encouraged. However, Delta Dental does have multiple groups that require predeterminations for payment on specific procedures. 

Predeterminations allow your patient the opportunity to make proper financial arrangements for their portion of the treatment cost before actual work begins. Predeterminations also reduce patients’ confusion about coverage levels and enhance goodwill among the dentist, the patient and Delta Dental. 

Which procedures require X-rays to be submitted with the Delta Dental of Kansas claim?

X-rays are required for veneers, anterior crowns, bridgework, crown buildups and implants. Copies of these X-rays need to be included when filing the claim. If you must send the original and need it returned to you, please clearly indicate your wishes on the X-ray and claim form.

Why doesn’t Delta Dental of Kansas allow for posterior composite fillings?

Posterior composites are an optional benefit and must be selected by the employer in order to be included in the patient’s plan. Currently, more than 79% of our groups cover posterior composites.

My patient is covered under two dental plans. How is his/her coverage handled?

If your patient is covered by both Delta Dental of Kansas and another dental carrier or a medical plan that offers dental coverage, Delta Dental coordinates benefits with the other carrier. Generally, if the patient is covered as an employee and also as a dependent of an employee at another company, the coverage through the patient’s employer is primary. Children covered by parents who work for different employers are usually primary under the plan of the parent whose birthday occurs first in a calendar year (not necessarily the oldest parent). Total payments from both carriers cannot exceed 100% of the approved fee for the service. Some groups have specified a “carve-out” clause in their dental programs that might limit a secondary carrier’s payment. If you have questions about Coordination of Benefits, please contact our Customer Service team.

Participating in the Delta Dental Network

Does Delta Dental of Kansas offer any continuing education classes/seminars?

Yes, Delta Dental of Kansas schedules seminars and workshops in various locations around the state to assist dental office personnel in how to complete claim forms for Delta Dental and to answer any questions on Delta Dental’s processing policies.

How often does Delta Dental of Kansas update maximum allowable charges and how do I find a copy of a fee schedule?

Maximum allowable charges are reviewed on an annual basis. 

Delta Dental of Kansas notifies you via email when updated PPO fee schedules are made available in your online dentist account in the Documents & Dentist Handbook section. (To update or verify we have your correct dental office email, please contact our Professional Relations team)

Additional practice-specific details about both Premier and PPO allowances are available in your online dentist account by accessing Reporting in the Kansas Provider Toolkit section.

Can I bill the patient the difference between my fee and your allowance?

When you participate with Delta Dental, if your fee or a service exceeds Delta Dental’s maximum plan allowance, participating dentists agree to write-off any difference and not charge the remaining balance to the patient.

Do I have to take a write-off on a procedure that isn’t covered by the patient’s dental plan?

No, participating Delta Dental provider is not required to take write-offs on procedures that are excluded by the patient’s dental plan.

If you have questions regarding this policy, please contact your Professional Relations representative. If you have questions about a specific patient’s benefits and whether a specific procedure is covered, please contact our Customer Service team.

If I don’t participate with Delta Dental, do my patients with Delta Dental insurance still have benefits?

Under most plans, your patient will still receive benefits, but he or she may have more out-of-pocket expenses, and the Delta Dental payment will go directly to the patient.

If your patient has a PPO-only plan (or an Exclusive Provider Option Plan), that means that patient would only receive benefits if they visit a Delta Dental PPO dentist.

Can I participate with only one of Delta Dental’s groups?

When you sign an agreement for Delta Dental Premier® or Delta Dental PPOSM, you agree to see members of all groups who have purchased the program for their employees.

Can I choose to participate only with Delta Dental of Kansas?

By signing the contract to participate with Delta Dental of Kansas, you also agree to see patients who have coverage through other Delta Dental Member Companies nationwide.

What are the benefits of participating with Delta Dental?

As a participating dentist, 1) you have the convenience of submitting claims and checking claim status online, 2) you are eligible for electronic funds transfer and 3) you may even be eligible for daily claims payment. When you participate with Delta Dental, we will send payments directly to you based on your fees or Delta Dental’s maximum allowance. In addition, we will include your name in the participating dentist directory available to all groups and members covered by Delta Dental of Kansas, plus your name will be listed in Delta Dental’s national directory of participating dentists.

Employer

Employee Eligibility

Can I change my group’s waiting period?

The contract signed by the group defines the waiting period. The waiting period applies to all new employees. Some contracts may allow changes to the waiting period. An employer may contact their broker or Delta Dental Account Executive to inquire about contract revisions.

When does coverage begin after a qualifying event occurs?

Coverage begins the first of the month following the date of the qualifying event. Delta Dental must receive notice of the change in eligibility status with 31 days of the qualifying event, otherwise the change may only be made at the renewal date of the group contract if the employer allows such open enrollment.

What if an employee wants to elect coverage during a contract year?

Coverage can be elected during the employer’s open enrollment period or if a qualifying event occurs.

What does Delta Dental consider a qualifying event?

The following are considered qualifying events:

  • Birth / legal custody / adoption
  • Death
  • Loss of other dental insurance coverage
  • Marriage/divorce

Can my employee add a family member to his/her dental coverage at any time?

No. Dependent family members can only be added at the renewal date of the group contract if the employer allows open enrollment periods or when a qualifying event occurs.

My employee has a fully disabled dependent. How long can the dependent’s dental benefit coverage continue?

As long as the individual remains disabled and is fully dependent on the member for support and is unmarried, he or she can remain a dependent on the member’s dental policy. Written proof is required from the attending physician to verify the dependent’s disability.

What happens if an employee’s child reaches the maximum dependent age and is no longer a full-time student?

Dental coverage terminates at the end of the month in which the child reaches the maximum dependent age or is no longer a full-time student. However, the child may be eligible for COBRA benefits if the employer is required to offer COBRA.

How do my employees verify their children’s full-time student status?

Please provide Delta Dental with a copy of a document that proves the student is enrolled at a secondary institution and is taking at least 12 credit hours. Acceptable documentation includes a copy of a paid tuition bill or a letter from the registrar. Documentation should be sent to our Eligibility team at eligibility@deltadentalks.com or by fax to 316-462-3394.

How do I confirm that an employee is eligible for coverage?

Log in through your employer account to check an employee’s eligibility status.

Member Tools

What member tools do you have available for my employees?

Delta Dental of Kansas offers members access to their online member account and Delta Dental mobile app. 

Through the member account your employees can:

  • Review their benefits and eligibility
  • See how their claims paid
  • Print their member ID card
  • View their Explanation of Benefits (EOBs) and sign up to receive them electronically
  • Access member-only discounts

Through the mobile app your employees can:

  • Find an in-network dentist
  • Estimate their out-of-pocket costs before their appointment
  • Schedule a dentist appointment
  • Check their annual maximum and eligibility
  • Use their mobile ID card at their dentist appointment
  • Check their claims after their dental appointments
  • Use the toothbrush timer to keep up on their oral health routine

Visit the Employer Toolkit to download flyers about these helpful member tools and share with your employees.

How can I get a dental benefits summary for my employee?

A summary of dental coverage is available on your employer account.

My employee would like additional ID cards. How can they get them?

ID cards can be printed from the member account. The employee should log in, click “ID Cards”, then click the print icon. Your employee can also download the Delta Dental mobile app and simply log in to view their ID card, show it at the dental office or email it to a dependent or dentist.

Online Employer Account

How can I get a dental benefits summary for my employee?

A summary of dental coverage is available on your employer account.

When should I expect my billing statement to arrive?

Delta Dental generates billing statements (electronic and paper) on the 25th of each month. Groups that have selected electronic billing will receive an email notification that their bill has been posted to our website.

How do I confirm that an employee is eligible for coverage?

Log in through your employer account to check an employee’s eligibility status.

Billing

How far back can our account be credited for changes/terminations?

Credits for changes and terminations on your group’s account are generally limited to 60 days prior to the current billing cycle in accordance with the group’s Delta Dental contract.

When is my Delta Dental premium due each month?

Payment should be submitted to Delta Dental by the due date printed on the invoice (billing statement).

When should I expect my billing statement to arrive?

Delta Dental generates billing statements (electronic and paper) on the 25th of each month. Groups that have selected electronic billing will receive an email notification that their bill has been posted to our website.

Individual & Family Plans

Enrolling

How do I update my account information?

Log in to your member account and click on “Account Summary” to update your payment information or contact information.

I just enrolled; when will I receive my ID card?

You will receive your ID card in 7-10 days.

72 hours after enrolling, you will also have access to your ID card via your online member account and the Delta Dental mobile app.

Can I add a dependent to my plan?

You can only add a dependent to your plan at the time of your yearly renewal or if you’ve experienced a qualifying life event. (A qualifying life event is marriage, divorce, adoption, etc.)

If you are not at your plan renewal, or have not experienced a qualifying life event, you will need to cancel your current policy and re-enroll with the added dependent(s).

When can I switch plans?

You may only switch Delta Dental Individual and Family plans at your time of renewal.

How long are the rates guaranteed?

Your rates are guaranteed for one full year. For example, if you enroll in May 2019, your rate is guaranteed until May 2020. You will be notified 60 days prior to your renewal date of any future rate changes.

When does my coverage start?

If your application is received on or before the 25th of the month, coverage will start on the first of the following month. If your application is received after the 25th of that month, coverage will start on the first of the next month.

What are my payment options?

Delta Dental of Kansas has two payment options.

  1. If you enroll online, you may choose to pay with a credit/debit card or through automatic withdrawal from a checking or savings account. Monthly premiums will be charged within the first five business days of the month. 
  2. If you prefer to pay using a check, you may purchase a year’s worth of premiums and send your check to DDKS with the paper application. You will find a paper application by clicking here.

How do I enroll in a Delta Dental Individual and Family Plan?

You may enroll in a Delta Dental Individual and Family plan by completing an online application or print and mail a paper application to Delta Dental of Kansas, P.O. Box 3806, Wichita, KS 67201-3806. 

Visit the Enroll Now page.

How can I find out if my current dentist is part of the Delta Dental network?

The easiest and most up-to-date listing can be found through our online Find a Dentist tool. You can search for dentists by their name, practice name, location and more. Results can be sorted by name, practice name or driving distance, and your list can be printed, emailed or viewed as a PDF.

You can also locate a dentist through Delta Dental’s mobile app. Delta Dental’s mobile app is available for smartphones and tablets using iOS (Apple) or Android. To download and install the app, visit the Apple App Store or Google Play and search for Delta Dental.

What is the difference between the Platinum, Gold, Silver and Bronze plans?

The biggest difference is in the services that are covered. The Bronze plan has a focus on preventive services, including coverage for check-ups and cleanings, and basic dental services such as fillings and non-surgical extractions. The Platinum, Gold and Silver plans are more comprehensive plans with coverage for major services such as crowns, dentures and surgical extractions. The Platinum plan is the only plan with implant coverage. Please refer to our View Plans page for more detailed information about each option.

Who is eligible to purchase a Delta Dental Individual and Family dental plan?

You are eligible to enroll in a Delta Dental Individual and Family plan if you are a Kansas resident and are at least 18 years of age. You may not be covered by another Delta Dental of Kansas plan. Dependents are covered to age 26, if they are unmarried. Acceptance is guaranteed regardless of dental history or pre-existing conditions.

My Benefits & Coverage

How do I update my account information?

Log in to your member account and click on “Account Summary” to update your payment information or contact information.

I enrolled online. When will I be charged for my premiums each month?

Monthly premiums will be charged within the first five business days of the month.

Can I add a dependent to my plan?

You can only add a dependent to your plan at the time of your yearly renewal or if you’ve experienced a qualifying life event. (A qualifying life event is marriage, divorce, adoption, etc.)

If you are not at your plan renewal, or have not experienced a qualifying life event, you will need to cancel your current policy and re-enroll with the added dependent(s).

Why was my exam not covered when my dentist referred me to a specialist?

According to your plan, an examination is a covered benefit once every six months. This is true whether the examination is performed by a general dentist or by a specialist.

What are pre-determinations?

A predetermination of benefits (or pre-treatment estimate) allows you to know in advance what procedures are covered, the amount your plan will pay toward treatment and your financial responsibility. Predeterminations are submitted by your dentist. 

Some conditions require a predetermination of benefits before treatment is performed (i.e. implants under the Platinum Plan). Please refer to your Benefit Booklet to see the exact services for which predeterminations are required. Even if it is not required, Delta Dental encourages predeterminations for extensive treatments, or if you visit an out-of-network dentist. If submitted by an in-network dentist, there is no charge for a predetermination, and it is valid for 6 months. 

Are implants covered?

Implants are covered under the Platinum plan. Covered services such as implants are subject to a pre-determination and other limitations as explained by the Policy/Benefit Booklet.

How do I check to see if I am eligible for coverage?

If you’re a Kansas resident, age 18 or older, you’re eligible to enroll in a Delta Dental Individual and Family plan. Once enrolled, it’s easy to check your current eligibility status and view a summary of your plan’s dental benefits online using the member account. Or you can contact our Customer Service team.

Do I need a referral to see a specialist?

If you’re a member of Delta Dental, you do not need a referral to receive care from a specialist. However, we strongly encourage you to use the services of a Delta Dental participating specialist to maximize your benefit coverage. Locate a participating specialist.

What is a deductible?

A deductible is the annual amount you pay before your dental plan will begin to pay. Visit the View Plans page to see which services require a deductible.

Does my coverage run on a calendar year?

No, your coverage runs on a contract year. For example, if you enroll in a plan in May 2019, your coverage will renew in May 2020. The anniversary date for coverage varies depending on when you enrolled. For specific information on your benefits or benefit year, log in to your member account. You can also contact our Customer Service team.

I just received something in the mail from Delta Dental that looks like a bill. What is it?

You probably received an Explanation of Benefits (EOB) statement. This statement is not a bill; it explains what services your dentist provided and how Delta Dental processed and paid for the services.

What is Delta Dental of Kansas’ mailing address?

P.O. Box 789769, Wichita, KS 67278-9769

I have a fully-disabled dependent; how long is he/she covered under my policy?

As long as the individual remains disabled and is fully dependent on you for support and is unmarried, he or she can remain a dependent on your insurance policy. Written proof is required from the attending physician to verify the dependent’s disability.

My child has braces, and we just switched to a Delta Dental Individual and Family plan. Are our orthodontic payments covered under our Delta Dental Individual and Family insurance?

No, Delta Dental Individual and Family plans do not cover orthodontia (braces).

Who should I contact with questions about my coverage?

If you have questions about your Delta Dental Individual and Family plan, including your coverage and eligibility, you can contact our Customer Service team.

Where can I find my complete plan information?

Complete plan information is available by logging in to your online member account to view your benefits and eligibility.

What if I permanently move out of Kansas?

Your coverage would terminate at the end of the month in which you change residency. Delta Dental of Kansas plans are open to Kansas residents only, which means that you must reside in Kansas at least six months of the year. You can search for a Delta Dental plan in a different state here.

With my Delta Dental Individual plan, do I have coverage outside of Kansas?

Yes, your Delta Dental coverage travels with you. Delta Dental’s networks are nationwide. Common examples are: full-time students attending college in another state, traveling outside of Kansas within the United States.

Are there services that are not covered?

Yes. Services that are not covered include braces and cosmetic procedures (e.g., teeth whitening). Covered services are plan-specific and subject to Exclusions and Limitations. Please see our View Plans page.

Are there waiting periods?

There are no waiting periods for diagnostic and preventive services, such as exams or cleanings. There is a 6-month waiting period for all plans for basic restorative services, such as fillings and non-surgical extractions. If you enroll in the Platinum, Gold or Silver plans, there is a 12-month waiting period for major services such as crowns, oral surgery, dentures and implants. Waiting periods may be shorter if you’ve had previous dental coverage in the past 60 days.

When does my coverage start?

If your application is received on or before the 25th of the month, coverage will start on the first of the following month. If your application is received after the 25th of that month, coverage will start on the first of the next month.

Using My Plan

Are implants covered?

Implants are covered under the Platinum plan. Covered services such as implants are subject to a pre-determination and other limitations as explained by the Policy/Benefit Booklet.

Do I need a referral to see a specialist?

If you’re a member of Delta Dental, you do not need a referral to receive care from a specialist. However, we strongly encourage you to use the services of a Delta Dental participating specialist to maximize your benefit coverage. Locate a participating specialist.

What is a deductible?

A deductible is the annual amount you pay before your dental plan will begin to pay. Visit the View Plans page to see which services require a deductible.

I just received something in the mail from Delta Dental that looks like a bill. What is it?

You probably received an Explanation of Benefits (EOB) statement. This statement is not a bill; it explains what services your dentist provided and how Delta Dental processed and paid for the services.

What is Delta Dental of Kansas’ mailing address?

P.O. Box 789769, Wichita, KS 67278-9769

How do I handle claims submitted by an out-of-network dentist?

Please note that if you visit an out-of-network dentist, you may be required to submit a claim form for the services rendered and possibly pay the entire amount upfront. You can find a claim form here. When visiting an out-of-network dentist, any payment made by Delta Dental will be made directly to you, the member. 

May I visit any dentist I wish for treatment? What if my dentist doesn’t participate with Delta Dental?

Delta Dental of Kansas’ Individual & Family plans are Delta Dental PPO plans. That means you will most likely have the least out-of-pocket cost when visiting a dentist in the PPO network. 

You are free to visit any dentist. However, if the dentist is not in-network, you may have more out-of-pocket expense and will be responsible for the difference between Delta Dental’s payment and the dentist’s fee, along with your co-insurance.

Locate a participating dentist using our Find a Dentist tool or by contacting our Customer Service team.

How do I access my ID card?

You can also print ID cards from your member account or you can use your mobile ID card by downloading the Delta Dental mobile app. If you don’t have a member account, you will need to register for one here.

If you’ve lost your ID card and would like another copy, contact our Customer Service team.

Do I need my ID card for my dentist appointment?

No, your dental office will be able to look you up by your social security number or member identification number if you don’t have your ID card with you. They may also call our office to verify coverage.

You can also print ID cards from your member account or you can use your mobile ID card by downloading the Delta Dental mobile app. If you don’t have a member account, you may register for one here.

If you’ve lost your ID card and would like another copy, contact our Customer Service team.

Who should I contact with questions about my coverage?

If you have questions about your Delta Dental Individual and Family plan, including your coverage and eligibility, you can contact our Customer Service team.

Where can I find my complete plan information?

Complete plan information is available by logging in to your online member account to view your benefits and eligibility.

What if I permanently move out of Kansas?

Your coverage would terminate at the end of the month in which you change residency. Delta Dental of Kansas plans are open to Kansas residents only, which means that you must reside in Kansas at least six months of the year. You can search for a Delta Dental plan in a different state here.

With my Delta Dental Individual plan, do I have coverage outside of Kansas?

Yes, your Delta Dental coverage travels with you. Delta Dental’s networks are nationwide. Common examples are: full-time students attending college in another state, traveling outside of Kansas within the United States.

How can I cancel my policy?

You can cancel your policy by sending written notice to Delta Dental of Kansas at least 5 days prior to your requested termination date. You may email eligibility@deltadentalks.com

Terminations will always be the last day of the month. 

Are there waiting periods?

There are no waiting periods for diagnostic and preventive services, such as exams or cleanings. There is a 6-month waiting period for all plans for basic restorative services, such as fillings and non-surgical extractions. If you enroll in the Platinum, Gold or Silver plans, there is a 12-month waiting period for major services such as crowns, oral surgery, dentures and implants. Waiting periods may be shorter if you’ve had previous dental coverage in the past 60 days.

How can I find out if my current dentist is part of the Delta Dental network?

The easiest and most up-to-date listing can be found through our online Find a Dentist tool. You can search for dentists by their name, practice name, location and more. Results can be sorted by name, practice name or driving distance, and your list can be printed, emailed or viewed as a PDF.

You can also locate a dentist through Delta Dental’s mobile app. Delta Dental’s mobile app is available for smartphones and tablets using iOS (Apple) or Android. To download and install the app, visit the Apple App Store or Google Play and search for Delta Dental.

What is the difference between Delta Dental PPOTM, Delta Dental Premier® and out-of-network dentists?

The Delta Dental Premier network is our largest network with more than 95% of Kansas dentists participating, and the Delta Dental PPO network includes more than 65% of Kansas dentists. Generally, patients in a Delta Dental Individual and Family plan who receive services from a Delta Dental PPO dentist experience greater out-of-pocket savings.

With your Delta Dental Individual and Family plan, you may see any dentist you wish. Even if your dentist does not participate in a Delta Dental network, you can receive treatment and still receive Delta Dental benefits. However, there are many advantages to seeing a dentist who is a member of the Delta Dental PPO or Delta Dental Premier networks. By going to a Delta Dental PPO or Delta Dental Premier dentist, you will have lower out-of-pocket expenses than going to an out-of-network dentist.

Renewing My Plan

How do I update my account information?

Log in to your member account and click on “Account Summary” to update your payment information or contact information.

Can I add a dependent to my plan?

You can only add a dependent to your plan at the time of your yearly renewal or if you’ve experienced a qualifying life event. (A qualifying life event is marriage, divorce, adoption, etc.)

If you are not at your plan renewal, or have not experienced a qualifying life event, you will need to cancel your current policy and re-enroll with the added dependent(s).

How do I renew my plan?

Depending on your communication preference, you will either receive an email from us or a letter in the mail letting you know it’s time to renew your Individual and Family plan. At renewal, you can change the plan you have with us.

For those that receive an email, there will be a link to your online member account where you will be able to re-enroll online and make any necessary plan changes. If you do nothing, your current plan will automatically re-enroll (please keep in mind that rates may change from year to year; for the most current rates, click here). 

For those that receive a letter, there will be a renewal form attached to your letter. To continue your plan, you must fill out the renewal form and submit it along with a check for a year’s worth of premiums.

When can I switch plans?

You may only switch Delta Dental Individual and Family plans at your time of renewal.

How long are the rates guaranteed?

Your rates are guaranteed for one full year. For example, if you enroll in May 2019, your rate is guaranteed until May 2020. You will be notified 60 days prior to your renewal date of any future rate changes.

Canceling My Plan

Is there a penalty for canceling my plan?

No, there is no penalty for canceling your plan, and you can re-enroll in one of our individual and family plans at any time if you decide to come back. If you cancel your plan midway through the year but you’ve already paid for the whole year via check, you will receive a pro-rated refund.

How can I cancel my policy?

You can cancel your policy by sending written notice to Delta Dental of Kansas at least 5 days prior to your requested termination date. You may email eligibility@deltadentalks.com

Terminations will always be the last day of the month. 

Member

My Benefits & Coverage

Can I add family members to my dental coverage at any time?

Dependent family members can only be added during open enrollment periods through your employer or when a qualifying event occurs.

I have a fully disabled dependent; how long is he/she covered under my policy?

As long as the individual remains disabled and is fully dependent on you for support and is unmarried, he or she can remain a dependent on your insurance policy. Written proof is required from the attending physician to verify the dependent’s disability.

What do I need to send to Delta Dental to verify my child’s full-time student status?

Please provide Delta Dental with a copy of a document that proves the student is enrolled at a secondary institution and is taking at least 12 credit hours. Acceptable documentation includes a copy of a paid tuition bill or a letter from the registrar.

Why was my child taken off my dental policy?

Under some group dental plans, dependents over age 19 are not eligible for dental coverage unless they are full-time students, earning at least 12 credit hours per semester. If your child is eligible for student coverage, please notify your group so your child can be reinstated on your policy.

My child has braces and we just switched to Delta Dental. Are our orthodontic payments covered under our Delta Dental insurance?

Depending on your group contract regarding orthodontic takeover coverage, Delta Dental may or may not assume coverage of orthodontic benefits. To determine if your plan includes coverage for orthodontic services that are in progress, check your Benefit Booklet or contact our Customer Service team.

I had individual X-rays taken and Delta Dental paid for a full mouth X-ray. Why?

It is Delta Dental’s policy that the fee for individual (periapical) X-rays cannot be higher than the fee for a full-mouth X-ray series. If this occurs, Delta Dental will pay the amount for a full-mouth X-ray series.

Why was my exam not covered when my dentist referred me to a specialist?

According to your group contract, examinations are covered benefits that may be subject to frequency limitations. This is true whether the examination is performed by a general dentist or by a specialist. To review your frequency limitations, log in to your member account to view your Benefit Booklet.

Why did Delta Dental pay for a silver (amalgam) filling my my back tooth when my dentist filled the tooth with a white (composite) filling?

Your plan may only cover the cost of a silver (amalgam) filling in a posterior (back) tooth. If you and your dentist decide to restore the tooth with a white (composite resin) filling, Delta Dental will pay for the cost of the silver (amalgam) filling, and you will be responsible for the remaining cost (the difference in cost between the silver and white fillings).

Why does Delta Dental reimburse orthodontic payments monthly instead of paying the entire amount upfront?

Delta Dental’s policy is to pay for completed services, so once the monthly visit is completed, a payment will follow. Orthodontic payments from Delta Dental are distributed throughout the period of time the services are received.

I had a tooth surgically pulled (extracted) and the insurance claim was filed with my medical insurance. Why doesn’t my dental insurance cover the claim?

Depending on your group coverage, claims for surgical extraction of wisdom teeth may need to first be submitted to your medical insurance carrier and then to your dental insurance. Some medical plans pay up to 100% of this procedure, so filing this type of extraction with your medical insurance could be of benefit to you. If there are any remaining charges after the medical insurance carrier has paid, your dental plan may cover the remainder or a portion of the remaining balance. Contact our Customer Service team for specific details regarding your plan.

When does coverage begin after a qualifying event occurs?

Coverage begins the first of the month following the date of the qualifying event. Delta Dental must receive notice of the change in eligibility status within 31 days of the qualifying event, otherwise the change may only be made at the renewal date of the group contract if the employer allows an open enrollment.

Can I join the plan during the Plan Year?

Coverage can be elected at your employer’s renewal date if your employer allows an open enrollment period or if a qualifying event occurs. We need to be notified within 31 days of the qualifying event.

A qualifying event includes:

  • Birth / legal custody / adoption 
  • Death
  • Loss of other dental insurance coverage
  • Marriage/divorce 

Can I add a family member to my dental coverage at any time?

No, dependent family members can only be added at the renewal date of the group contract if the employer allows open enrollment periods or when a qualifying event occurs. We need to be notified within 31 days of the qualifying event.

A qualifying event includes:

  • Birth / legal custody / adoption 
  • Death
  • Loss of other dental insurance coverage
  • Marriage/divorce

How do I check to see if I am eligible for coverage?

It’s easy to check your current eligibility status and view a summary of your plan’s dental benefits by logging into your member account. You can also contact our Customer Service team.

Do I need a referral to see a specialist?

If you’re a member of Delta Dental, you do not need a referral to receive care from a specialist. However, we strongly encourage you to use the services of a Delta Dental participating specialist to maximize your benefit coverage. Find an in-network specialist.

I’m covered under two dental plans. How is my coverage handled?

Delta Dental will coordinate benefit with other dental plans. One of your dental plans will be considered “primary”, meaning that dental plan would receive the claim first for payment, and then the claim would go to your second, or “secondary” dental plan. Generally, if you are covered as an employee and also as a dependent of an employee at another company, the coverage through your employer is “primary”. Children covered by parents who work for different employers are usually “primary” under the plan of the parent whose birthday occurs first in the calendar year (not necessarily the oldest parent).

In determining coverage, total payments from both dental plans cannot exceed 100% of the approved fee for the service. Please note, that some groups have specified a “carve-out” clause in their dental programs that might limit a secondary carrier’s payment. If you have a question about the Coordination of Benefits between two plans, please contact our Customer Service team.

When am I eligible for dental coverage? Does Delta Dental have waiting periods for services?

Some employer group and individual plans have various waiting periods. You can log in to your member account to check your Benefit Booklet to see if your plan has waiting periods for certain services.

Does my group coverage run on a calendar year or a contract year?

The anniversary date for coverage varies from group to group. For specific information on your benefits or benefit year, log in to your member account. You can also contact our Customer Service team.

What are predeterminations and are they mandatory?

A predetermination of benefits (or pre-treatment estimate) allows you to know in advance what procedures are covered, the amount your plan will pay toward treatment and your financial responsibility. Predeterminations are submitted by your dentist.

Some groups and some conditions require a predetermination of benefits before treatment is performed in order for your treatment to be covered by your benefits. Treatment plans that involve prosthodontic services, orthodontic services, individual crowns (except stainless steel), gold restorations, surgical periodontics, endodontics and oral surgery (except for simple extraction of a single tooth) should be submitted to Delta Dental for a predetermination of benefits. Please refer to your Benefit Booklet to see the exact services for which predeterminations are required. Even if it is not required, Delta Dental encourages predeterminations for extensive treatments or if you visit an out-of-network dentist. If submitted by an in-network dentist, there is no charge for a predetermination, and it is valid for 6 months.

I just received something in the mail from Delta Dental that looks like a bill. What is it?

You probably received an Explanation of Benefits (EOB) statement. This statement is not a bill; it explains what services your dentist provided and how Delta Dental processed and paid for the services.

You can sign up to receive these by email instead of mail through your member account.

May I visit any dentist I wish for treatment? What if my dentist doesn’t participate with Delta Dental?

This depends on your plan type. You can find your plan type in your Benefit Booklet on your member account or by logging in to the mobile app and tapping on the “My Coverage” icon. 

If you have a PPO-only (or EPO — exclusive provider option) plan, you will only receive benefits when you visit a Delta Dental PPOTM Network dentist. You can search for PPO dentists here. Make sure to choose Delta Dental PPO as your network.

If you don’t have a PPO-only plan, then you are free to visit any dentist (in or out-of-network); however, you may have more out-of-pocket expenses if you visit an out-of-network dentist. Depending on your benefits plan, your coverage may involve a larger deductible and/or different co-insurance percentage if you go to a dentist who doesn’t participate with your specific plan. Locate a participating dentist in our Delta Dental Premier or Delta Dental PPO networks or contact our Customer Service team.

Using My Plan

I have an upcoming dentist appointment. How do I know how much it’s going to cost?

Use Delta Dental’s Dental Care Cost Estimator to estimate your out-of-pocket costs before you go. You can use the Dental Care Cost Estimator by logging in to Delta Dental’s mobile app.

How do I register for a Delta Dental of Kansas member account?

It’s simple! Under the member account login, click “Register”. You will enter your name, member ID, date of birth and ZIP code. You’ll create your username and password that you’ll use on both the online member account and on the Delta Dental mobile app.

Do I need a referral to see a specialist?

If you’re a member of Delta Dental, you do not need a referral to receive care from a specialist. However, we strongly encourage you to use the services of a Delta Dental participating specialist to maximize your benefit coverage. Find an in-network specialist.

When am I eligible for dental coverage? Does Delta Dental have waiting periods for services?

Some employer group and individual plans have various waiting periods. You can log in to your member account to check your Benefit Booklet to see if your plan has waiting periods for certain services.

Does my group coverage run on a calendar year or a contract year?

The anniversary date for coverage varies from group to group. For specific information on your benefits or benefit year, log in to your member account. You can also contact our Customer Service team.

What are predeterminations and are they mandatory?

A predetermination of benefits (or pre-treatment estimate) allows you to know in advance what procedures are covered, the amount your plan will pay toward treatment and your financial responsibility. Predeterminations are submitted by your dentist.

Some groups and some conditions require a predetermination of benefits before treatment is performed in order for your treatment to be covered by your benefits. Treatment plans that involve prosthodontic services, orthodontic services, individual crowns (except stainless steel), gold restorations, surgical periodontics, endodontics and oral surgery (except for simple extraction of a single tooth) should be submitted to Delta Dental for a predetermination of benefits. Please refer to your Benefit Booklet to see the exact services for which predeterminations are required. Even if it is not required, Delta Dental encourages predeterminations for extensive treatments or if you visit an out-of-network dentist. If submitted by an in-network dentist, there is no charge for a predetermination, and it is valid for 6 months.

What is Delta Dental of Kansas’ mailing address?

Delta Dental of Kansas
P.O. Box 789769
Wichita, KS 67278-9769

My dentist isn’t in the Delta Dental network. How does Delta Dental pay for my benefits?

Please note that if you visit an out-of-network dentist, you may be required to submit a claim form for the services rendered and possibly pay for them upfront — and then wait for reimbursement from Delta Dental.

When you visit an out-of-network dentist, any payment made by Delta Dental will be made directly to you. Download the dental claim form and submit to Delta Dental of Kansas by email, mail or fax.

You can nominate your dentist to participate in Delta Dental’s networks by filling out this form.

Click here to access forms.

May I visit any dentist I wish for treatment? What if my dentist doesn’t participate with Delta Dental?

This depends on your plan type. You can find your plan type in your Benefit Booklet on your member account or by logging in to the mobile app and tapping on the “My Coverage” icon. 

If you have a PPO-only (or EPO — exclusive provider option) plan, you will only receive benefits when you visit a Delta Dental PPOTM Network dentist. You can search for PPO dentists here. Make sure to choose Delta Dental PPO as your network.

If you don’t have a PPO-only plan, then you are free to visit any dentist (in or out-of-network); however, you may have more out-of-pocket expenses if you visit an out-of-network dentist. Depending on your benefits plan, your coverage may involve a larger deductible and/or different co-insurance percentage if you go to a dentist who doesn’t participate with your specific plan. Locate a participating dentist in our Delta Dental Premier or Delta Dental PPO networks or contact our Customer Service team.

Do I need my ID card for my dentist appointment?

No, your dental office will be able to look you up by your social security number or member identification number if you don’t have your ID card with you. They may also call our office to verify coverage.

You can print ID cards from your member account or you can use your mobile ID card by downloading the Delta Dental mobile app. If you don’t have a member account, you will need to register for one here.

If you would like us to send you additional ID cards, contact our Customer Service team.

Mobile App

I have an upcoming dentist appointment. How do I know how much it’s going to cost?

Use Delta Dental’s Dental Care Cost Estimator to estimate your out-of-pocket costs before you go. You can use the Dental Care Cost Estimator by logging in to Delta Dental’s mobile app.

How do I register for a Delta Dental of Kansas member account?

It’s simple! Under the member account login, click “Register”. You will enter your name, member ID, date of birth and ZIP code. You’ll create your username and password that you’ll use on both the online member account and on the Delta Dental mobile app.

How do I use the Dental Care Cost Estimator on the Delta Dental mobile app?

After logging in to the mobile app, tap on the Cost Estimator icon at the bottom center of your screen. Select who the estimate is for, your ZIP code, the treatment you would like to look up and your dentist. To find your dentist, start by typing their last name in the search box and then tap the search button to the right and select your dentist. 

Tap on “Get Cost Estimate”. You will see a screen that will show your estimated out-of-pocket costs based on your plan details. You will see if your deductible is applied and how much of your maximum would be remaining. 

The Dental Care Cost Estimator provides an estimate and does not guarantee the exact fees for dental procedures.

Learn more about Delta Dental’s mobile app.

I found a problem in the app. How do I report it?

Please report any bugs or glitches in the mobile app to support@deltadental.com.

I tried to log in to the mobile app, but my account is locked. How do I unlock my account?

For security reasons, your account is locked after a certain amount of failed attempts to log in. To unlock your account, contact our Customer Service team.

To prevent your account from being locked in the future, use the “Forgot Username” and “Forgot Password" links on the login screen.

How do I log in to the mobile app?

You use the same username and password you use to log in to your Delta Dental of Kansas member account. If you haven’t registered for a member account yet, you can register online or through the mobile app.

May I visit any dentist I wish for treatment? What if my dentist doesn’t participate with Delta Dental?

This depends on your plan type. You can find your plan type in your Benefit Booklet on your member account or by logging in to the mobile app and tapping on the “My Coverage” icon. 

If you have a PPO-only (or EPO — exclusive provider option) plan, you will only receive benefits when you visit a Delta Dental PPOTM Network dentist. You can search for PPO dentists here. Make sure to choose Delta Dental PPO as your network.

If you don’t have a PPO-only plan, then you are free to visit any dentist (in or out-of-network); however, you may have more out-of-pocket expenses if you visit an out-of-network dentist. Depending on your benefits plan, your coverage may involve a larger deductible and/or different co-insurance percentage if you go to a dentist who doesn’t participate with your specific plan. Locate a participating dentist in our Delta Dental Premier or Delta Dental PPO networks or contact our Customer Service team.

Do I need my ID card for my dentist appointment?

No, your dental office will be able to look you up by your social security number or member identification number if you don’t have your ID card with you. They may also call our office to verify coverage.

You can print ID cards from your member account or you can use your mobile ID card by downloading the Delta Dental mobile app. If you don’t have a member account, you will need to register for one here.

If you would like us to send you additional ID cards, contact our Customer Service team.

Member Account

How do I register for a Delta Dental of Kansas member account?

It’s simple! Under the member account login, click “Register”. You will enter your name, member ID, date of birth and ZIP code. You’ll create your username and password that you’ll use on both the online member account and on the Delta Dental mobile app.

I tried to log in to my member account, but my account is locked. How do I unlock my account?

Simply contact us and we will unlock your account.

How do I sign up to receive Explanation of Benefits (EOBs) by email instead of mail?

It’s easy! Log in to your member account. Click on “Explanation of Benefits”, then click on “Go Green — Explanation of Benefits Online”. From there, you can edit your Subscriber Profile so that you receive explanation of benefit notifications via email for you to view online.

How do I check to see if I am eligible for coverage?

It’s easy to check your current eligibility status and view a summary of your plan’s dental benefits by logging into your member account. You can also contact our Customer Service team.

When am I eligible for dental coverage? Does Delta Dental have waiting periods for services?

Some employer group and individual plans have various waiting periods. You can log in to your member account to check your Benefit Booklet to see if your plan has waiting periods for certain services.

Does my group coverage run on a calendar year or a contract year?

The anniversary date for coverage varies from group to group. For specific information on your benefits or benefit year, log in to your member account. You can also contact our Customer Service team.

May I visit any dentist I wish for treatment? What if my dentist doesn’t participate with Delta Dental?

This depends on your plan type. You can find your plan type in your Benefit Booklet on your member account or by logging in to the mobile app and tapping on the “My Coverage” icon. 

If you have a PPO-only (or EPO — exclusive provider option) plan, you will only receive benefits when you visit a Delta Dental PPOTM Network dentist. You can search for PPO dentists here. Make sure to choose Delta Dental PPO as your network.

If you don’t have a PPO-only plan, then you are free to visit any dentist (in or out-of-network); however, you may have more out-of-pocket expenses if you visit an out-of-network dentist. Depending on your benefits plan, your coverage may involve a larger deductible and/or different co-insurance percentage if you go to a dentist who doesn’t participate with your specific plan. Locate a participating dentist in our Delta Dental Premier or Delta Dental PPO networks or contact our Customer Service team.

Do I need my ID card for my dentist appointment?

No, your dental office will be able to look you up by your social security number or member identification number if you don’t have your ID card with you. They may also call our office to verify coverage.

You can print ID cards from your member account or you can use your mobile ID card by downloading the Delta Dental mobile app. If you don’t have a member account, you will need to register for one here.

If you would like us to send you additional ID cards, contact our Customer Service team.

COBRA Coverage

How do I terminate my COBRA coverage?

If you wish to terminate your COBRA coverage, for which Delta Dental is the billing authority, please send written notification to our Eligibility team at P.O. Box 789769, Wichita, KS 67278-9769. Please include your name, date of birth, ID number, the requested termination date and contact information. If your former employer or a third-party administrator is the billing authority for your COBRA coverage, you will need to contact them directly.

I have not received a bill for my COBRA coverage. What do I do?

COBRA billing authority varies by employer. Your COBRA premium may be collected by Delta Dental, your former employer or by a third-party administrator hired by your former employer. Contact your former employer to inquire about payment procedures for your group.

Federal law does not require us to provide a monthly billing statement. If Delta Dental is responsible for collecting your payment, we may issue COBRA coupons to attach to your monthly payment, but it is the responsibility of the COBRA participant to make sure that their payment reaches the billing authority by the last day of the month for which the premium is due. If payment is not received by the last day of the month for which the premium is due, COBRA coverage will be terminated and cannot be reinstated. For example, my premium for October coverage is due on October 1. Coverage will terminate if payment is not received by October 31.

When does my COBRA coverage start?

Normally, COBRA coverage begins the day following your last day of coverage under the active employee plan. However, please check with your former employer for specific information regarding your individual situation.

Are all employers required to offer COBRA coverage?

Not all employees are obligated to offer COBRA coverage. Please check with your former employer for information on COBRA coverage. COBRA enrollment periods may vary, so please ask about enrollment deadlines and length of coverage as well.

How do I apply for COBRA coverage?

You should contact your former employer regarding eligibility for COBRA coverage and to request an application for continuation of group dental coverage.

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