Join the Delta Dental of Illinois Medicaid Network!

Delta Dental of Illinois continually explores ways in which we can help improve access to oral health care. To help fulfill this mission, we are building a dental network by supporting a Medicaid contract. Learn more about joining the Delta Dental of Illinois Medicaid Network!

Delta Dental of Illinois Medicaid Network FAQ

• Have Illinois Medicaid dental carriers changed?

  Illinois' Medicaid dental carriers have not changed; this is an opportunity for Delta Dental of Illinois to partner with a state-approved Medicaid medical carrier that cannot otherwise offer dental.

• What are the patient benefits under Medicaid?

  Delta Dental of Illinois would use the current plan designs and frequencies as listed in the current HFS Dental Office Reference Manual: https://hfs.illinois.gov/content/dam/soi/en/web/hfs/sitecollectiondocuments/11082021dormfinal.pdf 

• How would we enroll with Delta Dental of Illinois Medicaid?

  You would follow the same credentialing process you do today through IMPACT.  Delta Dental of Illinois would require a signed contract. 

• Do I need a Medicaid contract for every dentist in my office?

  No, you would need one signed contract per location with each dentist providing services at that location listed.  

• Who signs the Medicaid contract?

  The contract would be signed by the owner dentist, or for offices not owned by a dentist, the signee should be an executive director or similar level position.

• Will participation in Medicaid affect participation with other Delta Dental Networks?

  No, the Medicaid network would be independent of the Delta Dental PPO^TM and Delta Dental Premier® networks.

• What is the associated fee schedule?

  We anticipate adopting the current HFS Dental Program Fee Schedule for Child and Adult Beneficiaries:  https://hfs.illinois.gov/medicalproviders/medicaidreimbursement/dental.html

• We are an FQHC, would we get paid by encounters?

  Yes, we would adopt the current process for paying by encounter.

• We are a school-based provider, would we get paid for school-based services?

  Yes, we would adopt all the same rules surrounding parallel billing in the schools independent of an office claim.

• Can we limit the ages of the patients that we see?

  Yes.

• What if the patient has coverage under both Delta Dental Medicaid and Delta Dental private coverage?

  The members Delta Dental commercial coverage (Delta Dental PPO, Delta Dental Premier or DeltaCare®) would be primary. Medicaid is payer of last resort and would be billed after the members private insurance has paid.