DeltaCare Electronic Claim Submission

Electronic claim submission is now available for your monthly Delta Care utilization/ encounter submissions!*   

To submit your DeltaCare utilization/encounter information via Electronic Claim Submission (ECS), use the payer information below.  If you use ECS, you can send utilization/encounter information daily rather than batching monthly.

Payer Name: DeltaCare IL DHMO Encounters


*Please note: ECS is available for utilization/encounter submissions by general dentists for Illinois DeltaCare members who appear on your DeltaCare monthly rosters. DeltaCare USA has a different payer name and ID for ECS.  Additionally, the specialty claim payer name and ID for DeltaCare has not changed.

Frequently Asked Questions

What is required to begin?

You will need to update your practice management system to take advantage of this new connection Please contact your Practice Management System Vendor or Clearinghouse for the appropriate setup and dental EDI connectivity information.

If I use ECS (electronic claim submission), can I submit daily and no longer batch my monthly encounters at the end of each month?

Yes with ECS, you can send utilization/encounter submissions daily.

Does this apply to specialty claims that are submitted by our specialist?

No, this payer number is exclusive to utilization/encounters only.  Please continue to use the Payer ID 05030 for any DeltaCare DHMO specialty claims you submit on behalf of your specialists.

Does this include DeltaCare USA utilization/encounter submissions? 
No, this would only apply to your DeltaCare DHMO patients listed on your Delta Dental of Illinois monthly roster.  DeltaCare USA does have ECS availability also, however you will need to use their Payer ID DDCA3 for your Delta Care USA patients listed on the Delta Care USA monthly roster.

Do I still have the option to mail my batched utilization/encounter submissions at the end of the month? 

Batched utilization/encounter submissions can be mailed at the end of the month to:

DeltaCare IL DHMO Encounters

PO Box 3178

Lisle, IL 60532

If I have additional questions who do I contact?  
Please contact DeltaCare Customer Service support at 1-800-942-3772.