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Delta Dental manage your practice

Managing your practice

Get started managing your practice with Delta Dental. 

Getting started

Stay connected with Provider Tools, a one-stop shop that allows you to access eligibility and benefits information, remaining maximum and deductible amounts, claim submission with attachments, claim status, treatment history and more. 

Learn more about Provider Tools

Use Provider Tools to simplify your office administration. Start by registering for an account and logging in to use Provider Tools.

With Provider Tools, you can:

  • Sign up for direct deposit (use the “EFT and ERA” tool).
  • Transmit free, real-time, pre-populated claims with digital attachments and pre-treatment estimates.
  • See processed claims in minutes (when clinical review isn’t necessary), including Delta Dental’s payment and the patient’s payment portion.  Maximums and deductibles are updated in real-time, too.
  • Obtain reliable, up-to-date eligibility.
  • View (or download and print) benefits details, per procedure, per network.
  • Make a claims adjustment and get a predetermination to claims.

Provider Tools also gives you a list of your Delta Dental patients, claim status, treatment history and a reference library.

Stay informed by attending a free, live webinar. We’ll help you simplify your administrative processes with Provider Tools demonstrations and other new ideas for increasing efficiency.

Use your practice management software to do more, including to communicate with insurance carriers electronically. Get started by calling your practice management software vendor’s support center for details about how to submit claims and attachments, check benefits and eligibility, and accomplish other activities electronically.

Payer IDs

If you conduct electronic transactions, you’ll need the Payer ID of the insurance carrier.

Electronic Data Interchange (EDI) hours and information

Find EDI system maintenance schedules and downloadable, printable guides that provide details on specific EDI real-time transactions.

  1. Get started by contacting different vendors and asking for product information and pricing. See our list of third-party vendors on this page for contact information. You can also consider asking other dentists for their recommendations.
  2. Compare the more important features offered:
    • Customer service support
      • How will the vendor help you if you have a question?
      • How fast are they to respond?
    • Appointment tracking, recall and billing features
      • Are these easy to use?
      • Do these features support all your business needs?
    • Reports
      • Do the reports provide the level of detail you need to run your business effectively?
      • Are the reports easy to understand?
  3. Compare pricing and features to find the best fit for your office.

A tax ID number (TIN) is a nine-digit identifier used by the International Revenue Service (IRS) to identify a business, individual or entity in tax documents. Did you know that your TIN and practice name on file with Delta Dental must match IRS records exactly? If they do not, the IRS requires us to withhold 28% of the dollars owed to you from future payments until the matter is resolved.

To verify that we have the right TIN on file for you, review the next payment check you receive from Delta Dental. Compare the TIN on the check to your name or the business name and associated TIN that the IRS has on file for you. If the TINs do not match, notify us immediately.

TIN tips

  • If two or more names are used (such as Chris James, DMD, dba Market Street Dental), please report to Delta Dental the first name that appears on the IRS records.
  • If you are unsure of how your practice name and the associated TIN are recorded with the IRS, check what is printed on the mailing labels that are supplied by the IRS for quarterly tax payments. Or, you may contact the IRS to request a letter (#147C) that will confirm its record of your name and TIN. The IRS phone number is 800-829-1040.

Please  submit a new TIN form when you:

  • Add a new practice location
  • Make any changes to your tax identification number or type of business entity, such as a partnership or corporation
  • Open or close an office location
  • Change your name
  • Change your address
  • Buy or sell a practice

Patients rely on accurate directory information to help them choose a network provider. They check for convenient locations (close to their home or workplace), office hours (including weekends), language services, proximity to public transportation, handicap accessibility and other amenities that are important to them and their families.

Help patients choose your office! Make sure your dentist directory profile is up to date with your correct office name, address, contact information, services and amenities. Log in to Provider Tools and visit My Account Directory profiles to review and update your information. Or, complete and return the  Practice Location Information form.

Did you know that periodic attestation of your office profile in our directory is required by many state and federal regulations?* Be sure to log in and visit Directory Profiles when you receive a reminder from us to review and update your information.

*We’re required to take action if we don’t hear from you. Action can range from removing your listing from our directory to contract termination, depending on the state regulation.

It's easy to update your practice information online in Provider Tools.

However, keep in mind that you need to let us know in writing when you:

  • Change your address
  • Sell, buy, open or close an office
  • Add a dentist
  • Change your name or specialty
  • Change your Tax Identification Number (TIN)

Download forms

These forms require Adobe Acrobat Reader.

Important note: If you change your TIN, you will need to re-register for Provider Tools with your new TIN.

Submitting your updated information

Mail or email completed forms to your local Delta Dental. Whenever possible, it's preferable that you email your forms. 

Running a paperless office is easy with Provider Tools. 

Simplify with Provider Tools

Start by registering for a free, secure online account then log into to use Provider Tools. Sign up to receive electronic documents by selecting "Welcome (your name)" followed by "My profile" from the drop-down at the beginning of the page. From the “Preferences” section, select “Online with email alerts.” You’ll receive an email when new documents are ready to review. 

Leveraging your practice management system (PMS)

You can save money and time, streamline your office processes and help the environmental by using your practice management software.

Through your PMS, you can do the following for all payers, not just Delta Dental:

  • Submit claims
  • Verify eligibility
  • Check claims status and processed claims
  • Send attachments and much more

Our savings calculator lets you easily calculate your savings from switching to electronic claims submission.

As detailed in the third-party vendors section on this page, we partner with a variety of vendors to make it easy for you to communicate electronically through your PMS. Call your vendor to get started.

Delta Dental is required to confirm the professional qualifications of dentists and specialists who treat our members. Each treating dentist is credentialed as part of the initial application when joining Delta Dental networks and is re-credentialed every three years thereafter.

The Delta Dental credentialing and re-credentialing process is based on the standards of national, federal and state accrediting and regulatory agencies.

The Provider Services department will initiate the re-credentialing process approximately 90 to 180 days in advance of the end of the three year period. When you receive the information, please complete and return it promptly. The process should take no longer than 60 days to complete. Failure to participate in
re-credentialing or continuous credentialing activities may result in termination from Delta Dental networks.

Have a dispute or claim resubmission request? Fill out and submit the  Provider Inquiry Form.

Third-party vendors and resources

The following websites and vendors listed are for information only. Delta Dental does not endorse or guarantee any websites, vendors or companies. The vendors listed have demonstrated the ability to send electronic claims and/or digital attachments to Delta Dental.

Helpful information and reviews of practice management systems:

Provider Tools

Learn how Provider Tools can help simplify your practice management.

800-576-6412 ext. 455

800-267-ABEL (2235)

800-450-0220

800-942-4884

866-937-4277

800-944-6365

800-704-8494

800-DENTRIX

800-273-5033

800-544-2345

800-821-6054

855-510-6398

866-239-0469

800-328-2925

800-845-9379

The following vendors offer the ability to send attachments electronically such as digital x-rays, along with claims submissions:

  • NEA (National Electronic Attachment)

800-782-5150

The following companies provide "stand-alone" electronic claims solutions. These solutions allow you to submit all of your insurance claims electronically and provide your office with the benefits of using electronic data interchange (EDI) without having to invest in a complete practice management solution.

877-363-3666

800-576-6412 ext. 455

800-451-9723

800-724-7240

  • Secure EDI - Direct data entry system; submit claims and check eligibility for multiple payers

800-466-9656