Access our guide to find a Delta Dental PPO or Premier network dentist and our guide to find a DeltaCare dentist.
Delta Dental PPO and Premier networks are among the largest in the nation with more than 80 percent of participating dentists in one of our networks. That means better access, savings and protections. Learn more about our Delta Dental PPO Plus Premier network solution.
Dentists in the Delta Dental PPO network have agreed to accept Delta Dental’s established PPO fees as payment in full for services. On average, these fees are 30 percent less than what the dentist would typically submit for a claim. Delta Dental PPO network dentists have also agreed not to “balance bill” patients. That means they can’t bill members for the difference between what they usually charge and the Delta Dental established PPO fee. Visiting a Delta Dental PPO dentist means lower out-of-pocket costs and the best value for members.
Delta Dental Premier® is a safety net to our Delta Dental PPO network. Members will pay more out-of-pocket with a Delta Dental Premier dentist compared to a Delta Dental PPO dentist. However, members may save more money with a Delta Dental Premier dentist compared to a non-network dentist. Delta Dental Premier dentists agree to our maximum plan allowances as payment in full, which may be lower than what a dentist would typically charge. Delta Dental Premier dentists can’t bill members for the difference between what they would usually charge and the Delta Dental Premier maximum plan allowance.
Non-network dentists have not agreed to accept a lower fee as payment in full. The dentist can charge the difference between their usual fee and the allowed fee for out-of-network (this fee depends on your plan).
Access a sample savings sheet for your members. Please note: this is based on non-network dentists being reimbursed at the Delta Dental Premier maximum plan allowance.
Members can check claims status through the Member Connection or the Delta Dental mobile app.
Self-funded groups can check claim status through the Employer Connection.
Help members understand how to read their EOBs with this guide.
Read the Delta Dental of Illinois assignment of benefits.
Below are guides to use with your members for standard and non-duplication of benefits coordination of benefits, whichever is applicable to your plan.
Download the Delta Dental of Illinois orthodontia payment and takeover policy and procedures.
Members are asked to request a predetermination from their dentist when a proposed treatment plan is estimated to cost more than $200. Share this guide to help your members get an idea of how much a dental treatment will cost before they take a seat in the dentist chair.
Delta Dental PPO and Delta Dental Premier dentists automatically file claims on members’ behalf. If you visit a non-network dentist, you may have to file your own claim. Download the claim form.
Members will only need to complete this form if they are visiting a provider that is not a participating provider in the EyeMed network. Not all DeltaVision plans have out-of-network benefits, so members should consult their benefits information to ensure coverage of services and/or materials from non-participating providers.
Delta Dental of Illinois maintains direct control over network management and owns our dental network. Local staff members foster strong relationships with dentists – and all dentist recruitment is managed locally from our Naperville headquarters. This approach helps maintain network stability.
Members can refer a dentist to join a Delta Dental network using this form.
Members who are out of the country and need to access dental treatment can file a claim using these instructions.
90th percentile does not mean the 90th percentile does not mean 10 percent savings or 10 percent discount. Actual savings are determined by the fees in the sample and where the fee in question fits within that sample. Read our guide to percentiles