Helping Your Patients with Pre-Treatment Estimates
With so many variances between members' benefits, it is helpful for Delta Dental network dental offices to clearly identify the network they participate in to avoid confusion or misunderstanding on how services are covered for Delta Dental patients.
Please specify your in-network status – such as identifying yourself as a Delta Dental Premier network dentist or Delta Dental PPO network dentist – rather than simply noting that you are part of a Delta Dental network. Doing this will help eliminate any miscommunications regarding benefit plan coverage and associated costs upfront.
Delta Dental of Illinois encourages all members to request a pre-treatment estimate for services over $300.
We highly recommend them for treatment plans that include major or extensive dental care. A pre-treatment estimate provides you with an estimate of how the claim will process according to the patient’s dental plan, detailing what Delta Dental of Illinois will cover, network discounts, and what the patient may owe.
Why should dental offices submit a pre-treatment estimate? We offer the top four reasons below:
Eliminates the Guesswork
You and/or your staff don’t have to estimate what the patient’s out-of-pocket costs will be. Help your patients prepare. With a pre-treatment estimate, you can help your patients prepare financially for essential treatments and ensure they’re getting the most out of their dental benefits.
Determines if Procedures are Covered
Pre-treatment estimates outline if/how planned procedures are covered under the patient’s benefit plan selected by their group/employer or purchased by an individual member.
Fosters Two-Way Communication
A pre-treatment estimate not only opens the line of communication between you and your patients by discussing treatment options and associated costs, but it also encourages communication between you and Delta Dental of Illinois.
Enables an Effective Process
Pre-treatment estimates are easy to submit – submit them as you would a claim. They are especially easy if you submit them electronically. Learn more about electronic claims submissions (ECS). Pre-treatment estimates are processed within 7 to 10 business days.
You have received a pre-treatment estimate. Now what?
Once you have your pre-estimate, you may either:
- Add the dates of service to the approved estimate and return to Delta Dental of Illinois OR
- Submit a new claim and it will process based on the pre-estimate if there are no changes to the services and the claim detail (treatment rendered) matches the pre-treatment estimate.
We recommend you submit pre-treatment estimates separate from a dated claim for a faster response.