Dentist FAQ

How do I join the Delta Dental network?

Please contact the professional relations department at your local Delta Dental to request information on joining our networks. 

What are the advantages of joining the Delta Dental network?

Delta Dental focuses on getting patients into your office as an essential part of achieving and maintaining good oral and overall health.

Joining our network gives you exposure to the nation's largest dental insurance customer base. Your practice will be listed in our national dentist directory, and patients have an incentive to visit an in-network dentist, as this generally means lower out-of-pocket expenses. And, research shows that people with dental insurance visit their dentist twice as often as those without.

We also provide easy administration, a local presence and professional relations teams. Delta Dental network dentists are paid directly when they treat Delta Dental members, and our quick, accurate claims processing – ensures you'll be paid promptly and easily.

Is there a charge to join any of your networks?

Participation is free and all licensed dentists are eligible to participate. For more information, please contact the professional relations department at your Delta Dental.

If I am a Delta Dental network dentist, do I participate with all other Delta Dental companies nationwide?

Yes, by signing a Delta Dental Participating Provider Agreement with your local Delta Dental, your participation is honored throughout the national Delta Dental System.

Please keep in mind that patient claims must be submitted to the appropriate Delta Dental member company for processing. You can determine eligibility for all Delta Dental members by signing in to your dentist dashboard on deltadental.com.

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

No. When you join our network, you agree to see enrollees of all groups and individuals who purchase Delta Dental insurance.

What if I am not in the specific Delta Dental network covered by the patient's plan?

In most cases, as long as you are enrolled in one of our networks, a Delta Dental patient who visits your office will still receive benefits, but their out-of-pocket expenses may be higher if you are not in the network covered by their plan. Your patient may also need to pay you up front for the services.

Patients enrolled in DeltaCare® (our DHMO plan), Medicare Advantage, and certain exclusive PPO (EPO) plans must visit a dentist in the specific Delta Dental network to receive benefits.

Am I required to notify Delta Dental of changes to my practice?

Yes, if you are a Delta Dental network dentist. In order for us to maintain accurate records, you are required to notify your local Delta Dental company's professional relations department, in writing, of any changes to your practice. Changes may include:   

• Your tax identification.
• Office address.
• Telephone number.
• Participation status.
• A new dentist practicing in your office.
• A dentist leaving your office.
• Addition of another office location.

Please note that changes are not automatically made when claims are submitted. Failure to notify your local Delta Dental of practice changes may result in payment delays or errors.

Which Delta Dental network(s) do I participate in?

If you are unsure of which network(s) you participate in, contact your local Delta Dental.

This information is important because it determines how your patient's benefits are paid. When a patient asks if you participate with Delta Dental, please be specific about which Delta Dental network you participate in. 

What is Delta Dental Premier®?

Delta Dental Premier® is one of our five contracted national network-based programs. Participating dentists agree to adhere to Delta Dental processing policies and are prohibited from billing a patient above the pre-negotiated fee, and agree to accept that fee as payment in full.  This plan allows enrolled patients to visit any dentist, but offers additional savings when they visit a Delta Dental Premier dentist, and often greater savings when seeing a Delta Dental PPO-network dentist.

What is Delta Dental PPO™ ?

Delta Dental PPO™  is one of our five contracted national network-based programs. Participating dentists agree to scheduled fees as payment in full.

As with all of the Delta Dental networks, dentists agree to processing policies and are prohibited from billing and collecting charges in excess of the agreed-upon fee. This plan allows enrolled patients to visit any dentist, but offers additional savings when a patient sees a Delta Dental PPO-network dentist.

What is DeltaCare®/DeltaCare® USA?

DeltaCare® USA is Delta Dental's national Dental Health Maintenance Organization (DHMO). Enrolled patients must select from the DeltaCare® network of primary care dentists. These dentists manage their patients' comprehensive dental needs, including referrals to specialists, and each dentist receives a monthly capitation amount.

What is DeltaUSA?

DeltaUSA® assists Delta Dental companies in administering dental benefit programs for Delta Dental national business in all 50 states, Puerto Rico and other U.S. territories.

Some of my patients are uninsured. Does Delta Dental offer individual dental insurance that I can suggest to them?

Delta Dental offers individual dental plans. To see which plans may be available in your state, use our Delta Dental locator or direct your patients to this tool.

How do I determine patient benefits and eligibility?

You can access your patient's benefits and eligibility by signing in to your dentist dashboard on deltadental.com. You will need the patient's member ID, name and date of birth.

How do I know which network(s) a patient has access to?

You can check your patient's benefits and eligibility by signing in to our dentist dashboard on deltadental.com. You will need the patient's member ID, name and date of birth.

I'm having trouble checking my patient's benefits and eligibility because they don't remember their member ID.

We recommend that the patient contact the Delta Dental member company with whom they have their coverage.

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

Typically, one of the dental plans will be considered the primary plan for your patient. It will pay first, and any additional plans will pay whatever portion of the charge is remaining and reimbursable. Your patient's plan contains a coordination of benefits provision that explains this process. In no event will the plans pay more than 100 percent of the cost of treatment.

Where do I mail my claims?

Claims are sent to the Delta Dental company which provides your patient's insurance, not the local Delta Dental with which you've signed a participation agreement. You can confirm your patient's Delta Dental company by signing into your dentist dashboard on deltadental.com.

Once you've determined which Delta Dental to send the claim to, you can find their address on our website. 

How do I check the status of a claim?

You may view a claim status at any time on our website. Simply register for an account if you do not already have one. 

Once you have an account, sign in to the site and click the "Claim Status" link. You may also contact customer service at the Delta Dental member company that is responsible for the claim.

How can I sign up for direct deposit?

Delta Dental member companies offer direct deposit. Contact your local Delta Dental for more information on how to sign up.

How do I register for an account on deltadental.com?

Visit the sign in/registration page.

I forgot my username/password

If you forget your username or password, there are links under the sign in box to help you retrieve them. You'll need to know your business tax ID, dentist license ID and dentist name in order to retrieve your sign in information.

Which website should I use, deltadental.com or my Delta Dental member company's website?

Our national website is a great place to check your patients' benefits and eligibility and view claims status regardless of which Delta Dental member company covers your patients.

However, some Delta Dental member companies offer more information and additional tools on their websites than we do on deltadental.com, so you may benefit from visiting their website to access these additional services.

In many cases, you can sign in at deltadental.com and be automatically logged in to your Delta Dental member company’s website without having to sign in a second time.