Frequently Asked Questions
Which Delta Dental network should I recommend to my client—Delta Dental Premier® or Delta Dental PPOSM?
The Delta Dental Premier® Network offers the greatest access to providers with more than 80 percent of providers nationwide participating with this network. The Delta Dental PPOSM Network includes nearly 50 percent of the dentists nationwide and typically offers greater savings to employers and employees.
My client has employees across the country. Is coverage different for employees who live out of state?
Out-of-state employees have the same coverage as employees who live within the state where your client is headquartered. In fact, because Delta Dental offers the nation's largest network, it's easy to find an in-network provider in all 50 states.
What are the benefits of visiting a dentist who participates in a Delta Dental network?
When members visit dentists in a Delta Dental network, they will receive the following benefits:
- They pay lower out-of-pocket costs than if they received care from a non-participating dentist because our network dentists have agreed to accept reduced fees.
- Balance billing is not allowed because participating dentists agree to accept Delta Dental's established fee, with the patient co-payment or deductible (if applicable) as payment in full.
- They will not have to fill out any forms, because participating dentists submit claims directly to Delta Dental.
- We pay the dentist directly, so members don't have to pay the dentist and wait for a reimbursement check.
- They can have confidence that we have an ongoing relationship with our participating dentists and have ensured they meet national credentialing standards.
Will my clients also have access to dentists who do not participate with Delta Dental?
Many of our plans allow members to visit any dentist they choose, while others require them to visit a network dentist in order to receive benefits. However, even for plans that do allow members to visit out-of-network dentists, services performed by out-of-network dentists may be covered at a lower benefit level and out-of-pocket costs may be higher. Overall, members receive the greatest value when they visit a participating dentist.
Where can I find rate information for my clients?
Plans and rates vary by location and group size. Your Delta Dental sales representative can assist you in choosing the best coverage and rates for your clients. Also, you can use our RFP Assistant to find local contact information and submit a request for proposal for your client.
Does Delta Dental offer individual dental insurance?
Yes, Delta Dental of South Carolina offers Delta Dental Individual and Family programs for South Carolina residents and their families. Delta Dental Individual and Family plan members will receive comprehensive coverage, the freedom to select their own dentist, convenient access to quality dental care and affordable rates. Click here for more information or to enroll in these plans.
Does Delta Dental of South Carolina cover teledentistry?
Yes. Delta Dental of South Carolina covers teledentistry. Delta Dental – Virtual Visits, delivered by TeleDentistry.com, provides 24/7 access to a dentist, 365 days a year conveniently with the use of a smartphone, tablet or computer with audio/visual capabilities. A teledentistry visit is counted as an oral examination under a member’s plan. Learn more.
When should members use Delta Dental – Virtual Visits?
Members should use Delta Dental – Virtual Visits when:
• they have a dental emergency and they do not have a dentist
• they need access to a dentist after hours and their dentist is not available
• they would like to consult with a dentist without leaving their home
How does Delta Dental – Virtual Visits work?
Members follow these four easy steps to access our teledentistry service:
• Step 1: Visit the Delta Dental - Virtual Visits patient portal
• Step 2: Fill out their e-documents
• Step 3: Take photos of the problem area
• Step 4: Connect with a TeleDentistry.com dentist and begin their consultation
TeleDentistry.com dentists provide initial consultation services and can write prescriptions when appropriate. Members will be referred to a Delta Dental network dentist for definitive diagnosis and treatment.
The TeleDentistry.com dentist will email consultation notes to members’ Delta Dental network dentist for further treatment. If they have not established care with a Delta Dental network dentist, with their authorization, TeleDentistry.com will refer them to an in-network dentist. Learn more.
Is there a copay for a teledentistry visit?
A teledentistry visit is counted as an oral examination under the member’s plan. The copay depends on the member’s dental plan.
How are teledentistry claims processed?
Teledentistry claims are processed under code D0140 – problem focused exam. A teledentistry visit is counted as an oral examination under the member’s plan.