When did the State of Illinois Group Dental Plans transition to Delta Dental of Illinois?
July 1, 2011.
The State of Illinois Group Delta Dental of Illinois Dental Plans consists of the Quality Care Dental Plan (QCDP), Local Care Dental Plan (LCDP) and the College Choice Dental Plan (CCDP).
Are members being encouraged to use a network dentist?
Yes, members are encouraged to use Delta Dental network dentists. If you are not currently a Delta Dental network dentist and wish to participate in our networks, please contact us by email at PR@deltadentalil.com, fax at (630)983-4085 or contact our Professional Relations department at (630) 718-4990.
How can members find network dentists?
Members can find participating network dentists through Delta Dental of Illinois's online network dentist search tool. Members can access it directly at https://www.deltadentalil.com/find-a-provider/dental/.
How are claim payments made?
The State of Illinois is a self-funded plan and as such, Delta Dental of Illinois reimburses dentists once it receives funding from the State. Delta Dental of Illinois does not control the timing or funding of claims payments to State of Illinois dental members or the dentists who treat them. The State of Illinois has not communicated a revised payment schedule for dental claims at this time.
When is a claim eligible for Late Payment Interest (LPI)?
Claims may be paid on a delayed basis. LPI will be paid in accordance with Illinois law. LPI is calculated beginning on the 31st day after receipt of a clean claim in the amount of 9% annually. Interest amounting to less than one dollar is not paid.
Will Explanation of Payments (EOPs) show late payment interest (LPI)?
No, EOPs will not show LPI. LPI will be issued on a separate check.
Is a Predetermination of Benefits Required?
No, but we recommend that dentists predetermine services over $200. This way, dentists and the member will know up front how much will be covered under the plan and how much the member will be required to pay for services. A pre-determination of benefits is not a guarantee of benefits.
How do I check eligibility and claim status?
Get real-time benefits and eligibility information and claim status on Dentist Connection. You can also get this information through our interactive voice response (IVR) phone system at 800-323-1743.Through our IVR, you can also request a "FaxBack" by saying FaxBack at the prompt. FaxBack will send a fax with eligibility, benefit, and claim information for Delta Dental of Illinois patients.
How is work in progress being handled?
Payment for treatment-in-progress is based on the service completion date, regardless of the type of treatment (except for orthodontia which is pro-rated, based on remaining treatment time).