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FYI - Partnering with you to create healthy smiles

FYI

Partnering with you to help create healthy smiles

Start the year strong: Key reminders to support your practice in 2026

As we begin the new year, we want to empower you to set your practice up for success. Below is a quick summary of a few important topics that’ll help you enhance patient experiences, achieve clearer communication and run smoother operations.
 

Deliver high-quality, patient-first care

Expand quality care beyond clinical treatment

Every interaction your patients have with your practice is critical to their experience. We encourage you to:

  • Maintain a warm, professional and respectful environment throughout the visit.
  • Support equitable, inclusive care by training your staff in cultural competence.

    Start-of-the-year tip: Consider holding a team huddle focused on patient experience and communication expectations.

    Communicate benefits clearly and confidently

    To help your patients make informed decisions and avoid unexpected costs, we encourage you to:

    • Verify eligibility, coverage levels, frequency limits and annual maximums before treatment begins.
    • Submit pre-treatment estimates to Delta Dental to support transparent conversations.
    • Explain coverage in simple, patient-friendly language.
    • Keep documentation clear and complete — including treatment plans, financial consent forms and clinical notes.

    Start-of-the-year tip: Check out this benefit conversation guide for best practices.

    Ensure appropriate access to care through scheduling standards

    Meeting access-to-care expectations supports your patients and strengthens the overall patient experience. Please ensure that:

    • PPO patients can access:
      • Non-urgent initial appointments within 36 business days.
      • Preventive/hygiene visits within 40 business days.
    • DeltaCare® USA (DHMO) patients receive:
      • Non-urgent initial appointments within 36 business days.
      • Preventive dental care appointments, such as hygiene appointments, should be available within 40 business days of the patient's request.
      • 24/7 triage or after-hours support for severe pain and emergencies.
      • Wait times of no more than 30 minutes when patients arrive on time.
    • Missed or cancelled appointments are followed up promptly to reschedule. 

    Start-of-year tip: Review your scheduling processes to ensure access standards are consistently met.

    Strengthen billing accuracy for faster claims processing

    Accurate billing is a key part of helping patients understand their costs and ensuring your claims process smoothly. We recommend that you:

    • Verify benefits prior to appointments, particularly for potentially non-covered or elective services.
    • Obtain signed financial agreements for any upgrades or non-covered care.
    • Avoid unbundling — bill the procedure as indicated when components are included in the primary service.
    • Follow billing requirements specific to Delta Dental PPO™, DeltaCare USA and Delta Dental Premier®.
    • Maintain detailed, accurate clinical documentation to support claims.

    Start-of-year tip: Review your billing processes to ensure your team is following the latest guidelines.

    Understand the Grievances & Appeals process

    To help us resolve cases quickly and ensure regulatory compliance, please:

    • Confirm that your practice’s contact information with us is current.
    • Respond to record requests within 7 calendar days.
    • Submit complete documentation to streamline review and improve turnaround times.

    Start-of-year tip: Double-check that your office phone, email, and fax numbers are current in our system by reviewing your details in Provider Tools.