Dental Set-up & Office Design | Use your FastAttach connection, a service available through NEA, to electronically transmit digitizedx-rays, narratives, intra-oral pictures, Explanation of Benefits (EOB) Statements or any other document needed to adjudicate the claim. D7410D7415, D7440D7461, D7465, Description of service: If you are experiencing a medical or dental emergency, you should seek appropriate emergency medical or dental assistance, such as calling "911." During clinical review of claims and pre-treatment estimates, Delta Dental reserves the right to request radiographic images and/or documentation for procedures that otherwise may be identified as not requiring the submission of documentation. Dental Evacuation | P.O. Dental Forceps & Extraction Tools | Member perks for your smile and beyond How will the NPI affect other numbers I've used in the past? The NPI Enumerator will help you with your NPI application and to update your information in the NPPES. Use of this website in no way increases or decreases the benefits available under a dental benefit plan. Use Provider Tools forfreereal-time claims with digital attachments and pre-treatment estimates. Dental CAD/CAM: Dental CAD/CAM Milling Machine | Delta Dental may also terminate the dentists participation agreement if a dentist regularly waives patient copayments. Once you submit your claim adjustment request, it can take up to 21 calendar days for it to process. (1) Network Fee: This fee represents what most dental service providers 2018 MetLife Services and Solutions, LLC. DentalPlans detailed profile of Roshanak Rastegar , DDS - Dentist in 20152. Look at you smiling. If any data related to your NPI changes (name, address, etc. simple just enter your dental service providers office zip code, then click on contain certain exclusions and limitations. U. S. Mail: Delta Dental of California,ATTN: Provider Onboarding,P.O. This means Delta Dental has overpaid weve paid 100% of $80 instead of 80% of $80. Sign in to get a more accurate range that includes in-network savings. To find The data is based on actual, non-discounted charges that providers have billed. Writing on top of lines or outside of boxes. The AMA does not directly or indirectly practice medicine or dispense medical services. The dental provider listings on DentalPlans.com are provided directly from each dental network or discount dental plan, which are responsible for their accuracy and completeness. November 2018 Page 1 . A pretreatment . However, some programs may require you to submit claims within a shorter period of time (e.g., 90 days for Texas CHIP program). Pre-treatment estimates are especially beneficial when expensive or extensive treatment is being considered and/or dental plan annual maximum, limitations and/or exclusions may affect coverage. The changes are not as radical. Dental Office Dcor Reception Room Furniture | Consult with your provider prior to beginning any treatment. Or, you may mail a paper claim to Delta Dental. Delta Dental PPOSM, PF, 1500A, 100*/90/50, 50 Calendar year costs Deductible $50 per person / $150 family Out-of-pocket maximum (under age 19) $375 for one member / $750 for two or more members (in-network only) Annual maximum (age 19+) $1,500 Class 1 does not apply to max Minimum number of subscribers N/A Class 1 Appliance name used to control harmful habit. Example:If the dentist submits a fee on a claim for $120, and the maximum contract allowance is $100, Delta Dental will calculate its payment and the patients payment based on $100. Since Estimated fees for Zip Code Delta Dental of California and Affiliates is a part of Delta Dental Plans Association. For more detailed information on your actual dental care costs, please consult your dentist or your Delta Dental. See Related Links below for information about each specific fee schedule. Dental Financing and Related Services | *Not sure where your company is headquartered? No data found. Federal Employees Dental Program . A patient may have dual coverage through the same Delta Dental company (for example, your patient may have her own Delta Dental of California coverage and also be covered as a spouse through her husbands plan, which is also a Delta Dental of California plan). Free-form text use the Tooth number or letter field to indicate quadrant or arch(e.g., UR or L) and the Remarks box for necessary comments or notes. Members have a fixed copayment for all covered services and cannot be balance billed. You should always talk to your health care professionals for information concerning diagnosis and treatment, including information regarding which drugs or treatment may be appropriate for you. Smiles for Children (SFC) is Virginia's Medicaid and FAMIS dental program for adults and children. If you are experiencing a medical or dental emergency, you should seek appropriate emergency medical or dental assistance, such as calling "911." Connect with your Delta Dental to learn more. Be sure to include the following information on dual coverage claims: For adults, the member's plan through his or her employment is primary. Delta Dental. If you live outside the U.S., you may see information on this cost estimator about products or services that are not available or authorized in your country. Enter the NPI of the billing dentist or dental entity, as well as the treating dentists NPI (if they are different). The Content on this website is not medical advice. Dental coverage is now available for adults! Dual coverage with the same Delta Dental company, California rule for coordination of benefits, How to request a real-time pre-treatment estimate, What to include on an orthodontics treatment claim. The national network of Delta Dental companies protects more smiles than any other insurance company. %PDF-1.6 % Dental Patient Financing | Dental Financing | Here's what you need to know about NPIs. Your actual cost may be higher or lower than the estimate for various reasons. TechCentral - Advanced Technology Solutions and Dental IT Support | Estimated fees for Zip Code The procedure fee displayed can differ if your dental service providers office is located outside the zip code indicated. If there is any conflict or discrepancy between the Content on this website and your coverage documents, your coverage documents will control. At Henry Schein, you can Rely on Us for all of your dental practice needs. Dental Diagnostic Equipment | DentalPlans.com makes it easy for dentists who accept Dental Savings Plans from one or more of our network partners to confirm patients plan membership. Health information changes quickly. Estimates should not be construed as financial or medical advice. Then, select the Submit Claim icon under Actions. P.O. Always notify Delta Dental of the actual fee charged. The cost estimates provided may be different from your actual costs for several reasons, including but not limited to, your unique dental circumstances and the decisions made by you and your dental professionals as to what services you will receive, deviations between the anticipated scope of services and the services actually provided, and the characteristics of your particular plan. These listings are updated on a regular basis, and every effort has been made to ensure that only participating active providers are listed. based on the circumstance and specialty of the Provider. Privacy Statement Terms of Use Social Media Policy, I receive dental insurance through my employer, I receive dental insurance via my employer, The 2022 State of Americas Oral Health and Wellness Report, Sports mouth guards to protect against dental injuries. Your knowledge and expertise about dentistry will likely come across clearly if you remember that your audience is a dentist just like you. Resources. Charges for clear aligners (e.g., Invisalign, SureSmile) should be submitted using theappropriate orthodontic procedure code (D8010-D8090). Example: to claim your profile. Dental Staff Education | Glossary. For other Delta Dental member companies, please check how they prefer to register your NPI. Use the My Claims tool to see Delta Dentals estimated payment and the patients portion (often within moments when clinical review is not necessary). 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 NPI contains no embedded intelligence no coding that would identify the dentists state or license number, for example. If you are not submitting claims electronically, talk with your practice management system vendor about activating your systems electronic claims component. Sharps Disposal Containers - Small & Large Sizes | Locate your processed claims by entering your claim number and selecting "Search.". Example:If your fee for a service is $100 and you wish to give the patient a 20% discount, then $80 becomes the fee that is actually charged and $80 should be entered on the claim as the total fee. This cost estimator is intended for use in the 50 states, Puerto Rico and other U.S. territories. Already have a dentist? Reasonable efforts include: Maximum contract allowances are the total reimbursement amounts, under the member's benefit plan, on which Delta Dental calculates its payment and the patients financial obligation. The information and content (collectively, "Content") on this website is for your general educational information only. Vinyl Polysiloxane (VPS) Dental Impression Material | Eliminates the need to maintain and match identification numbers to specific payers for transactions, Allows you to relocate your practice or change specialties without requiring new identifiers from multiple payers, Helps reduce costs and simplify health care transactions, Contributes to more efficient coordination of benefits. Contact your company's human resources department. Please register your NPI with Delta Dental by providing us with a copy of the confirmation containing your NPI that you receive from the National Plan & Provider Enumeration System (NPPES). The Content cannot, and is not intended to, replace the relationship that you have with yourhealth careprofessionals. Type 1 or Type 2 - Which NPI is right for you? Here are some suggestions to speed up claim payments. Daniel Ribeiro , has not yet specified details about his education and training. It is simply a random number that does not expire. Fax: 617-886-1414. The same principle applies to treatments that address cosmetic needs rather than dental disease. Delta Dental recommends that the NPI be used on all claims. The SFC program is managed by Dentaquest. There is no need to resubmit the claim. We offer vision coverage through DeltaVision in 15 states and the District of Columbia. We strongly recommend that you confirm that a provider is currently participating before you receive any services from that provider. This is a10-digit random number unique to each health care provider or organization. On claims, the Type 2 NPI identifies the payee, and may be submitted in conjunction with a Type 1 NPI to identify the dentist who provided the treatment. hb```g``Zpj1 X{ y `` Box 9304 . In this case, generally, the plan through current employment is primary. You have entered an Invalid User ID and/or Password. Already registered with :DP Verify? Fee schedules and savings may vary by ZIP code and by Provider within a ZIP code. Cosmetic Dentistry: Teeth Whitening & Alignment | Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. 118 0 obj <> endobj Checking the patients Evidence of Coverage for both plans will help you determine when a medical plan is primary. For example, if a retiree is employed, the active coverage is primary; the coverage resulting from retirement is secondary. This brochure describes the benefits of Delta Dental's Federal Employees Dental Program under Delta Dental of California contract OPM02-FEDVIP-02AP-05 with OPM, as authorized by the FEDVIP law. Dental Continuing Education Seminars & Resources | Virtual Consult In the following states, you can change your dentist any time without contacting Delta Dental: AK, CT, LA, ME, MS, MT, NC, ND, NH, OK, SD, VT, WY. Dental Infection Control Supplies & Products | Pediatric Dental Supplies & Instruments | *Not sure where your company is headquartered? Our Dental Care Cost Estimator tool provides estimated cost ranges for common dental care needs. Simply submit a separate Confidential Fee Filing Form for each update. Dental Periodontic Products | P.C., (Adam Diasti, DDS, DN11634) or Coast Dental of Texas, PC (Adam Diasti, DDS, Lic 32327) Coast Dental Services, LLC complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. Delta Dental Premierand Delta Dental PPO Claims. If the dentist makes no effort to collect the remaining $20 from the patient, then the dentists actual fee for the service is $80, not $100. plan terms. D3310-D3330, D3921. Dental Equipment Parts - Dental Repair Parts | If you dont conduct any electronic transactions governed by HIPAA, you arent required to obtain an NPI. Maximize your oral health and make the most of your dental benefits right from your mobile device by downloading the Delta Dental Mobile App. My Contracted Fees 1. We have dental insurance that empowers you to protect the oral health of you and your loved ones. Prior approval is not required when you refer a patient to a specialist. Preventive services are included in this tool. Latex Free Exam Gloves | This can jeopardize the stability of the patients dental coverage by driving up costs because we assume the overbilled fee to be accurate, then base our premiums on inflated dental costs.
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