Do not submit a new claim for any services that have been submitted for a pre-treatment estimate. You may be responsible for the cost of procedures or services not covered by your plan. Compare pricing and features to find the best fit for your office. 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. 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. You only have to date each service, sign and return the form for processing. View (or download and print) benefits details, per procedure, per network. Dales una vida llena de sonrisas con Delta Dental Protege lo más querido Planes individuales para toda la familia CONOCE MÁS AQUÍ ¡Sonríe! Cada sonrisa cuenta una historia, protégela. 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. Skip to main content Important COVID-19 updates for enrollees and providers All individual health care providers (including dentists) and organizations such as clinics and group practices are eligible to obtain an NPI. Username or Appointment tracking, recall and billing features. Delta Dental FEDP will be the secondary coverage. Delta Dental of Washington is a part of Delta Dental Plans Association. 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). Use of this website in no way increases or decreases the benefits available under a dental benefit plan. Check eligibility, benefits and claims status. Under the guidance of the California Department of Health Care Services, the Medi-Cal Dental Program aims to provide Medi-Cal members with access to high-quality dental care. 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. Payer #CDAR1 California Delta Dental of California P.O. If you need to file a claim with Delta Dental for care received before Jan. 1, 2019: Download the TRDP Claim Form Consider asking other dentists for their recommendations. Box 173803 Denver, CO 80217-3803 800-610-0201 www.deltadentalco.com Payer #84056 Delta Dental of Connecticut (See Delta Dental of New Jersey) Payer #22189 Save Time By Using Dental Office Toolkit (DOT), Delta Dental’s Federal Employees Dental Program, Use fees with decimal points (for example, 100.00; not 100). View our cost-effective choices for individual dental insurance and get an instant online quote. Get started by contacting different vendors and ask for product information and pricing. No changes to the ID number can be made on the 1099 statements once they have been processed. Delta Dental -the largest dental network in the US. Simply tell your dental office the Delta Dental company through which you receive benefits and provide your name, your date of birth, your enrollee ID or social security number and the name of your employer (if you have an employer-sponsored plan). 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: 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. Password? Estimates may vary depending on your benefit plan and the state you live in. The IRS phone number is 800-829-1040. No changes to the ID number can be made on the 1099 statements once they have been processed. Box 537007 Sacramento, CA 95853-7007 844-825-8111 Payer #CDCA1 FSPS@delta.org TRICARE RETIREE DENTAL PROGRAM trdp.org Submit the correct ID number as printed on the ID card and the subscriber’s date of birth. If you conduct electronic transactions, you’ll need the Payer ID of the insurance carrier. Forgot Use your practice management software to do more, including to communicate with insurance carriers electronically. If the claim does not have this field, please list each item on a separate line. Please consult each dental plan's Evidence of Coverage for detailed information and plan limitations. Indicate a quantity (the number of x-rays, for example) in the field on the claim specifically for this purpose. Claims will be processed when received according to your plan provisions. Estimates may vary depending on your benefit plan and the state you live in. NOTE: TRDP, provided by Delta Dental, ended in 2018. The tax identification number and practice name on file with Delta Dental must match the IRS records exactly. We’ll help you simplify your administrative processes with Provider Tools demonstrations and other new ideas for increasing efficiency. You may be responsible for the cost of procedures or services not covered by your plan. 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. Claims will be processed when received according to your plan provisions. Start by registering for an Online Services account and logging in to use Provider Tools. Use Provider Tools to simplify your office administration. Questions may be submitted in writing to: Customer Service Department Delta Dental of Michigan P.O. EDI system maintenance schedules and downloadable, printable guides, Your Tax Identification Number (TIN, EIN or SSN), Medicare Fraud Waste and Abuse Attestation, Communicate With Your Patients Who Speak Another Language, Register your National Provider Identifier (NPI), English to Spanish phrase guide for dentists, Continuous Orthodontic Coverage Form for DeltaCare USA. Line through (single line) any treatment that has not been completed. 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