|
Does Delta Dental offer individual plans?
No. Delta Dental offers only employer-sponsored plans to groups of two employees or more.
Does Delta Dental have a toll-free number I can call if I have a question?
Delta Dental's nationwide toll free number is 1-800-323-1743.
What are your customer service hours?
Our customer service representatives are available Monday through Friday from 7:30 a.m. to 5:00 p.m. central time. You can reach Customer Service at 1-800-323-1743.
Our automated inquiry system is available 24 hours a day, seven days a week. It can be used to check claim status and obtain dentist referral information. In addition, we have a message center, available 24 hours a day, seven days a week, where you can leave a message and have a customer service representative call you back on the next business day.
How can I find out if my regular dentist is a Delta Dental Dentist, or get a list of dentists near me?
To search for a particular dentist or to find a list of dentists in your area, use our Dentist Search or call Customer Service at 1-800-323-1743.
If I don't find my regular dentist on the Delta Dental Dentist Search, what can I do?
You can refer your dentist to Delta Dental. Once we receive your request, we will contact your dentist and ask him or her to join our network provided he or she meets our qualifying criteria.
Do I need a claim form when I visit a dentist?
Delta Dental PPO and Delta Dental Premier network dentists automatically submit claim forms (hard copy or electronic) on your behalf at no additional charge. Since network dentists are reimbursed directly, when you visit a network dentist, you do not have to pay your bill upfront (only any copayments or deductibles) and wait for reimbursement. Out-of-network dentists are not contracted to submit claim forms to Delta Dental of Illinois. If you go to an out-of-network dentist, the dentist may require you to pay the total fee in full at the time of service. If you need a claim form, you can ask your benefit administrator at your company for one or you can download a form. DeltaCare enrollees do not have to submit claim forms.
How will I know when my claim is processed?
You can check on the Subscriber Connection. You must register first. Or you can call our automated phone system at 800-323-1743. You can also contact Customer Service through this number.
How do I appeal a denied claim?
You may appeal a claim denied in whole or in part by written request within 60 days from the date of the denial notice. Send you written request for review to: Re-evaluation Committee, Delta Dental of Illinois, 801 Ogden Avenue, Lisle, IL 60532. If you have any additional documents or records in support of your appeal, they should accompany your written request for review. DDPIL will provide a written decision on your request within 60 days. In unusual situations, additional time may be necessary to make a decision. In that instance, you will receive a notice that more time is necessary prior to the expiration of the 60-day period. In no instance will a decision take more than 120 days.
How do I check if I have met my deductible and/or what is remaining on my maximum?
You can check on the Subscriber Connection. You must register first. Or you can call our automated phone system at 800-323-1743. You can also contact Customer Service through this number.
In addition, this information is displayed on all our Explanation of Benefits (EOB) forms.
What changes can I make at Open Enrollment?
You may add or delete dependents, switch plans (i.e., from a PPO to a DHMO), or enroll for the first time. Your company benefit administrator can give you more details and advise you when your company's open enrollment will occur.
When can I switch plans (i.e., from a PPO to a DHMO)?
Only during your company's Open Enrollment period. If your employer-sponsored plan is the Dual Choice Dental Monthly Switch Option, you can switch between the PPO and DeltaCare on a monthly basis. How do I change from one primary dentist to another?
Call DeltaCare's toll-free number at 1-800-942-3772.
How often can I change DeltaCare dentists?
As often as you like - as long as you have not visited a dentist within the month you want to change. Changes must be called in by the 20th of the month in order to be effective the first of the following month.
Do I need a claim for when I visit a DeltaCare dentist?
No. That is one of the great things about DeltaCare - there are no claim forms!
I am a DeltaCare member, and I need to see a specialist. What do I do?
First, you need to see your regular DeltaCare dentist. If your DeltaCare dentist agrees that you need to see a specialist, he or she will complete the paperwork necessary to refer you to a specialist.
|
Search
Site Map
Contact Us