2.5 million lives covered by Delta Dental of Ohio
Thank you for your continued dedication to our members!
Celebrate National Children's Dental Health Month
One of our favorite months has arrived!
First observed on February 8, 1949, National Children’s Dental Health Month raises awareness about the importance of oral health. (Fun fact—it began as a one-day event in Cleveland in 1941!)
Developing good oral health habits at an early age can make all the difference for children as they get older.
Thank you for being a role model for children, and for setting them up for a lifetime of healthy teeth and gums!
Are you doing anything special to celebrate National Children’s Dental Health Month? You can find fun downloads and videos to share with your youngest patients on the Delta Dental Kids Club page.
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Customer service and operations corner
This month—meet the operations team!
The operations team is a combination of data entry and mail services, totaling 40 employees. They process claims for Delta Dental Plan of Michigan, Delta Dental Plan of Ohio, and Delta Dental Plan of Indiana, plus Delta Dental companies in Arizona, Minnesota and North Carolina.
The best and fastest way to submit a claim or pre-treatment estimate is through the Dental Office Toolkit®(DOT).
- When you submit a claim through DOT, there is no mix-up on where the claim should go.
If you need to submit a paper claim, no worries! Our operations team is ready to handle each claim with care and efficiency. Here’s a look at our process:
- Our mail services team opens, sorts and scans all mail using an optical character reader (OCR) to convert the paper claims into an electronic data interchange (EDI) format so the claim can be processed.
- If there is something the OCR cannot convert properly, our capable data entry operators will key and process those claims manually, as well as returned updated information requests, Explanations of Benefits and pre-treatment estimates in for pay.
Some things to keep in mind for faster processing of paper claims submitted by USPS mail:
- Most plans have separate P.O. boxes for claims processing and written inquiries. Check the member’s plan for the correct P.O. box. This information can be found in DOT.
- Avoid using tape or staples.
- The ADA standard claim form is the best form to utilize.
- Rather than sending paper X-rays or hard copy radiographs, use electronic attachments, such as NEA.
- If you’re submitting claims for separate Delta Dental member companies, mail them in separate envelopes to ensure accurate processing.
Some fun facts when it comes to paper claims:
- On average, Delta Dental receives around 5,900 envelopes a day. This is tracked using our newly integrated mail tracker system.
- About 10 percent of the claims we process pass through our operations team as paper claims.
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Take online courses at no cost
Looking to add continuing education courses to your schedule? Check out Delta Dental’s CE course lineup!
- Delta Dental participating providers and their hygienists, assistants and office staff can take courses at no cost.
- Each course includes course content, an assessment and a certificate of completion.
- Earn .5 to 1 CE credit per course.
Consider these courses in conjunction with February as American Heart Month and National Children’s Dental Health Month:
- How to Complete an Age 1 Dental Visit
- Infant and Toddler Oral Health Care
- Dental Care for Children With Special Health Care Needs
- The Seal is the Deal
- Fluoride
- Nutrition for Oral and Overall Health
- Nutrition for Health and Disease Prevention
Additional course offerings include:
- HPV and Head and Neck Cancer
- Human Trafficking—Modern Day Slavery
- Opioids, the Opioid Epidemic and Opioid Use Disorder
- Periodontal and Peri-Implant Diseases and Conditions
- Safe Opioid Prescribing Practices, New Laws and Regulations
- The Proper Handling of Amalgam and its Wastes—Complying With the New EPA Rules
Visit www.deltadentaloh.com/onlineeducation to learn more.
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Delta Dental partners with Devoted Health
Effective January 1, 2023, Delta Dental Insurance Company and Devoted Health’s Medicare Advantage plan partnered to provide dental services to approximately 33,000 members nationally with 4,500 located in Ohio. Eligible members will utilize Delta Dental of Ohio’s Medicare Advantage™ PPO network.
Provider services and contacts
Call 855-251-9742 or visit the Provider Tools Portal for Devoted plan confirmation and member benefits at https://www1.deltadentalins.com/dentists/provider-tools.html.
Claim submission for Devoted members
Delta Dental Claims Department
Delta Dental Insurance Company
PO Box 1809
Alpharetta, GA 30023
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Using provider pay form
If a Delta Dental Medicare Advantage or Medicaid member requires services not covered in their benefit plan, be sure to obtain a signed private pay form from that member or member’s guardian before rendering services.
Payment for non-covered services is the responsibility of the member or the responsible party. Before providing non-covered services, the cost of the non-covered service(s) must be discussed with the member or responsible party. Treatment can only be provided if and when the member or member’s guardian signs a private pay form (to be signed on the day non-covered services are rendered), where they agree in writing to pay for the non-covered (or alternate) service(s).
You may use any form for the private pay form as long as it includes the cost associated with the non-covered service(s), the responsible party’s signature and the date. (See Delta Dental’s sample form here). Keep the signed form in your files as Delta Dental may request a copy.
The Delta Dental member’s or responsible party’s approval to proceed with non-covered services via the private pay form should be included in the patient’s record. If a member agrees to pay for a non-covered service, Delta Dental dentists will be held to the lesser of the submitted fee or the applicable Delta Dental fee schedule for any charges to the patient or responsible party.
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Fee increase
There was another fee increase January 1. Check the Dental Office Toolkit for an updated fee schedule.
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