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DeltaCare® is a dental HMO that offers maximum cost savings for employers and enrollees while assuring quality controls. The DeltaCare network has dentists practicing in over 61,000 locations nationwide.

Click on the links below to view the documents. 

Encounter Form

Specialty Listing

DeltaCare Specialty Claim Form

This claim form is for DeltaCare specialty claims.  DeltaCare specialists submit claim forms for DeltaCare patients.