Line through (single line) any treatment that has not been completed. 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). Box 537015 Sacramento, CA 95853-7015 For other Delta Dental Plans Association member companies, visit the Delta Dental Plans Association website. No changes to the ID number can be made on the 1099 statements once they have been processed. Delta Dental of Washington is a part of Delta Dental Plans Association. Username or 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 Box 997330 Sacramento, CA 95899-7330 888-DELTA CS 888-335-8227 www.deltadentalca.org Payer #77777 Delta Dental of Colorado P.O. Box 9089 Please consult each dental plan's Evidence of Coverage for detailed information and plan limitations. Transmit free real-time, pre-populated claims with digital attachments and pre-treatment estimates. You may receive an ID card as part of your welcome package when you get a Delta Dental plan. If you need to file a claim with Delta Dental for care received before Jan. 1, 2019: Download the TRDP Claim Form Payer #CDAR1 California Delta Dental of California P.O. If your plan didn't include an ID card or you don’t have yours with you, don’t worry! You may be responsible for the cost of procedures or services not covered by your plan. 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. 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 FEDP will be the secondary coverage. Get started by contacting different vendors and ask for product information and pricing. Copies of radiographs must be of diagnostic quality. The State of Illinois is a self-funded plan and as such, Delta Dental of Illinois reimburses dentists once it receives funding from the State. If you have questions regarding errors or to request an “Electronic Claims Submission” guide, contact Delta Dental… View (or download and print) benefits details, per procedure, per network. 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). The following chart provides a comparison of costs for certain procedures covered by the state-sponsored dental plans. Through our national network of Delta Dental companies, we offer dental coverage in all 50 states, Puerto Rico and other U.S. territories. Locate a network dentist for your Delta Dental plan in FEDVIP and save on your out-of-pocket costs. Preventive services such as cleanings and X-rays are covered at 100% and you'll have access to … 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. 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. Radiographs and/or other documentation will not be returned. You only have to date each service, sign and return the form for processing. 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. All individual health care providers (including dentists) and organizations such as clinics and group practices are eligible to obtain an NPI. Use the tips here when submitting your claims: The federal Health Insurance Portability and Accountability Act (HIPAA) requires you to obtain a NPI if you submit claims electronically. Forgot Skip to main content Important COVID-19 updates for enrollees and providers EDI system maintenance schedules and downloadable, printable guides that provide details on specific EDI real-time transactions. Delta Dental -the largest dental network in the US. 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. Indicate a quantity (the number of x-rays, for example) in the field on the claim specifically for this purpose. No changes to the ID number can be made on the 1099 statements once they have been processed. 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). We accept duplicate films and paper copies of digital images. Do the reports provide the level of detail you need to run your business effectively? 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. Provider Tools also gives you a list of your Delta Dental patients, claim status, treatment history and a reference library. Claims will be processed when received according to your plan provisions. Consider asking other dentists for their recommendations. Link to information about When submitting claims, the NPI-1 will always be required for the rendering/treating dentist. 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. The plan limits the amount of paid coverage for each specific type of dental treatment. Do these features support all your business needs? 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. 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. 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. 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! Box 537007 Sacramento, CA 95853-7007 Appeals Delta Dental of California Federal Government Programs P.O. NOTE: TRDP, provided by Delta Dental, ended in 2018. Use Provider Tools to simplify your office administration. If this field is not available, list each item on a seperate line. Stay informed by attending a free, live Member login or account registration to view plan information, download forms, view claims, and track dental activity. 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. If you conduct electronic transactions, you’ll need the The tax identification number and practice name on file with Delta Dental must match the IRS records exactly. 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. Use your practice management software to do more, including to communicate with insurance carriers electronically. 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. Box 997330 Sacramento, CA 95899-7330 888-335-8227 deltadentalins.com Payer #77777 Colorado Delta Dental of Colorado P.O. Claims will be processed when received according to your plan provisions. Dales una vida llena de sonrisas con Delta Dental Protege lo más querido Planes individuales para toda la familia CONOCE MÁS AQUÍ ¡Sonríe! View our cost-effective choices for individual dental insurance and get an instant online quote. 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: Cada sonrisa cuenta una historia, protégela. Delta Dental uses this information to ensure the claim is processed under the correct member. 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. Password? 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. Delta Dental offers individual and family dental insurance plans. 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. 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. Additionally if you verify claims status or access patient enrollment and/or benefits information online you are required to use a NPI. 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