Main Menu
Access the DeltaCare USA emergency preauthorization form online
When your DeltaCare® USA patients need referral for emergency treatment, you can easily download the emergency preauthorization form online.
What is the emergency preauthorization form?
The emergency preauthorization form allows you as a primary care DeltaCare USA dentist to refer your patients to a specialist for emergency treatment.
The form captures the issues you’ve diagnosed as well as your recommendations for treatment. It also informs specialists that such treatments may not normally be covered under the patient’s DeltaCare USA plan.
How to find the emergency preauthorization form
To download the form from our website, visit the Administrative and claim forms page. The form is listed under Dentist Administrative Forms and Resources.
Recent posts
- Upcoming webinars and more: Provider Tools, Community Care Network
- Celebrate your hygienists this National Dental Hygienist Week
- Screen your patients for their health this Oral Cancer Awareness Month
- Continuing to strengthen our partnership in 2024 — a letter from our CEO, Sarah Chavarria
- We’re joining efforts with the American Heart Association to improve health
- Promote your practice this month
- Delta Dental Smile Star has a career based in service
- Stay up-to-date on fee schedules and other important documents with Provider Tools
- The connection between a healthy mouth and a healthy heart
- This American Heart Month, tell patients about SmileWay Wellness Benefits