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.
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:
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.
Direct deposit, also known as electronic funds transfer (EFT), allows payments to be deposited directly into your bank account. This offers more security and quicker access to your funds. In addition, claim payment details and pre-treatment estimates are safely stored and accessible online. You can enroll in direct deposit by logging in to your Provider Tools account.
Log in to Provider Tools and select EFT and ERA to enroll. You will need to provide your name, address and email address, as well as a contact name and phone number. In addition, you’ll need to provide:
Note that if you have more than one practice location under a TIN, you will need to enroll separately for each location.
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.
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.
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.
Please submit a new TIN form when you:
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:
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:
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.
The following vendors offer the ability to send attachments electronically such as digital x-rays, along with claims submissions:
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.
800-576-6412 ext. 455