What happens if a Delta Dental PPO-covered patient is treated by a nonparticipating dentist?
Plan purchasers determine how out-of-network claims are handled, so Delta Dental encourages dentists to verify coverage before treatment is rendered. Delta Dental PPO plan payment options include:
- Delta Dental PPO (Point-of-Service): Members are covered by Delta Dental Premier® for treatment rendered by a dentist who does not participate with Delta Dental PPO.
- Delta Dental PPO (Standard): Benefits may be limited, or there may be no coverage for services rendered by a nonparticipating PPO dentist.
- Delta Dental PPO (Standard): Payments may be based on a nonparticipating dentist fee schedule. This schedule is lower than the published PPO fee schedule.