FYI

Accuracy and transparency in billing builds patient trust, reduces administrative burdens and ensures timely reimbursement. Follow these key practices for smoother claims processes:

Billing covered & non-covered services

• Verify coverage using Provider Tools before treatment.
• Get signed financial agreements for non-covered services and elective upgrades.
• Don't bill separately for inclusive / bundled procedures already covered under primary services. This may lead to claim denials or reimbursement delays. Check our Dentist Handbook for more info.

Plan-specific billing
Different plans require different processes:

• Delta Dental PPO™, DeltaCare® USA (HMO), Delta Dental Premier® each have unique billing requirements.
• Use Provider Tools for quick online claims submissions for free.
• Check our Dentist Handbook for plan-specific guidance and correct mailing addresses.

Patient education
Clear communication prevents confusion and builds satisfaction:

• Ensure coverage is thoroughly explained at the point of care. For best practices, review our Benefit Conversation Guide.
• Submit pre-treatment estimates to better inform patients.
• Get patient consent if treatment plans change during procedures.

Complete documentation
Protects provider and patient by confirming understanding and consent for out-of-pocket costs.

• Include all required information and supporting documents (X-rays, narratives). For more information, review the claims processes page.
• Ensure all documentation is available if needed for treatment planning or member concerns.
   

Key reminders

• Don't bill patients beyond approved cost-sharing (copays, coinsurance).
• Always verify coverage before services are rendered.
   

For any questions about billing processes, please review your Dentist Handbook and for patient coverage details, log in to Provider Tools.