Dental Claim Payment Timelines
Please be advised that the State of Illinois group plans are self-funded. This means that claims are paid by the State as funds are available. Currently, reimbursement time for network dentists is different than that for non-network dentists as indicated below.
Claim payments are made when funding has been approved from the State for claims that are received. The delay time for approved and processed claims is listed below:
|Quality Care Dental Plan
||9/19/2021 (9 weeks)
||7/4/2021 (20 weeks)
|Local Care Dental Plan
|College Choice Dental Plan
||6/14/2020 (74 weeks)
||3/22/2020 (86 weeks)
Delta Dental network dentists cannot bill you upfront for any charges other than applicable deductible and coinsurance amounts.
If you use a non-network dentist, you generally must pay the entire bill at the time of service and/or file your own claim, depending on the payment arrangements you make with your dentist. Network dentists – those who participate in Delta Dental PPO or Delta Dental Premier – are reimbursed directly by Delta Dental of Illinois. You may elect to have reimbursement sent directly to a non-network dentist, referred to as assignment of benefits, if the dentist accepts assignment. You must consent to authorize payment of benefits directly to a non-network dentist. If you do, the dentist cannot collect any payment from you at the point of service other than any applicable fees such as deductibles, copayments and amounts over the Schedule of Benefits.