Box 2059 Dental Digital Radiography & Digital X-Ray Equipment | ), Birth date for the patient and eachmember, If parents are divorced, the parent with whom the child lives, When Delta Dental is the secondary carrier, Explanation of Benefits (EOB) from the primary carrier. D4210-D4212, D4240-D4245, D4260-D4285, D4341-D4342, D4381. plan booklet for complete plan details. Use new claim forms that accommodate the NPI by providing a specific space for it. The amount that would have been payable by Delta Dental may not be charged to the patient. Claims will be processed when received according to your plan provisions. For more details see our privacy policy. Affordable Care Act. Delaware, District of Columbia, Maryland, New York, Pennsylvania and West Virginia: E-mail:ddpdentist_services@deltadentalpa.org Our Dental Care Cost Estimator provides estimated cost ranges for common dental care needs. Periodontal charting. If you receive notification that no payment was made because of late submission: Amounts due from Delta Dental may be paid to your professional corporation, partnership or association. Repair requiring lab work, Procedure codes: The changes are not as radical. Enter a ZIP Code to see the cities it covers. Use Provider Tools to avoid surprises with a free, real-time pre-treatment estimate. endstream endobj 119 0 obj <. Sign in to get a more accurate range that includes in-network savings. Did you know that dental benefit contracts are initially determined by your UCR fee schedule? No dentist found that matches your criteria, I receive dental insurance through my employer, Please enter a treatment type and/or valid 5-digit ZIP code. The procedure fee displayed can differ if your dental service providers office is For more detailed information on your actual dental care costs, please consult your dentist or your Delta Dental. However, some programs may require you to submit claims within a shorter period of time (e.g., 90 days for Texas CHIP program). Smiles for Children (SFC) is Virginia's Medicaid and FAMIS dental program for adults and children. Get started here. Include all patient information on claims. Indication if this is an initial claim or a transfer case. There is no need to resubmit the claim. Looking to cover yourself or your family? For more information about electronic encounter form submission, please email ourEncounters department. Duplicate radiographs or radiographic image copies of diagnostic quality, including paper copies of digitized images, are acceptable. Medicaid members can now access more dental services. Dental Forceps & Extraction Tools | Zip Note: Fees must be filed with Delta Dental 30 days prior to their effective date to ensure proper payment of DentalPlans detailed profile of Roshanak Rastegar , DDS - Dentist in 20152. Tubing Suction Connect | Mailing addresses for your Delta Dental Premier and Delta Dental PPO claims. App features may vary by geographic area and individual dentist participation. This brochure describes the benefits of Delta Dental's Federal Employees Dental Program under Delta Dental of California contract OPM02-FEDVIP-02AP-05 with OPM, as authorized by the FEDVIP law. your dental service provider's fees and is for informational purposes only. 0 Enter city and state to see all the ZIP Codes for that city. Compare your fees to the 40th 95th percentile, Up to date UCR fees for all U.S based dental practices. No. Delta Dental network dentists are paid directly when they treat Delta Dental members, and our quick, accurate claims processing - ensures you'll be paid promptly and easily. Nothing on this website guarantees eligibility, coverage, or payment, or determines or guarantees the benefits, limitations or exclusions of your coverage. Latex Free Exam Gloves | Complete the application and follow instructions to submit either online or by mail. Download Supporting Materials (Free for ADA members) 2022 Survey of Dental Fees When children are covered through remarriages/domestic partnerships, coverage is determined in this order: In the case of coverage through stepparents only: The stepparent the child lives with provides primary coverage. The Dental Care Cost Estimator sometimes groups together, into "treatment categories," services that are often delivered together to address a particular dental problem. Implant supported prosthetics, Description of service: Dental Practice Marketing & Office Supplies | Properly balance your fee schedule to a given percentile to ensure your practice remains competitive in an everchanging dental marketplace. Checking the patients Evidence of Coverage for both plans will help you determine when a medical plan is primary. Minneapolis, MN 55440-9304 . For example, if a retiree is employed, the active coverage is primary; the coverage resulting from retirement is secondary. Refer to your benefit plan to determine whether these requirements apply to you. National Plan and Provider Enumeration System, D4210-D4212, D4240-D4245, D4260-D4285, D4341-D4342, D4381, Periodontics (including scaling and root planing), D6055-D6077, D6082-D6088, D6094, D6097-D6099, D6110-D6123, D6194-D6195, Prosthodontics, fixed (bridge abutment crowns), D7260, D7490D7521, D7530, D7540, D7610-D7780, D7910-D7912, D7980-D7983, D7998, Oral surgery (surgical incision/excision). to California residents or on Fully Insured Plans. Complete the claim information, select Continue, then Submit Claim. Please refer to the specific procedure code below for more details regarding the description of procedures. Mechanicsburg, PA 17055. In such cases, its important to understand that a recommended treatment may be perfectly appropriate. Please input information for either ZIP code or address but not both, Please enable your browser to allow this site to use your location. Estimated fees for Zip Code The procedure fee displayed can differ if your dental service providers office is located outside the zip code indicated. An NPI is required by the federal Health Insurance Portability and Accountability Act (HIPAA) for electronic transactions. We encourage you to check with your participating provider prior Simplylog in to Provider Toolsand select "My claims." Every 12 months you may submit separate Delta Dental Premierfee updates for each practice location, specialty and TIN. Start quoting dental + vision plans for small business. All Rights Reserved. A spouse or domestic partners plan is secondary. If it is not, include a written narrative so that the dental consultant will understand the purpose of the crown. Connect with your Delta Dental company to learn more. For example, if both the primary and secondary carrier pay for the service at 80% level but the primary allows $100 and the secondary carrier normally allows $80 for the same treatment, the secondary carrier would not make any additional payment. Orthodontics Supplies & Tools | Our procedure fee tool provides participants of dental plans insured or administered If the claim does not have this field, please list each item on a separate line. "Delta Dental" refers to the national network of 39 independent Delta Dental companies that provide dental insurance. . Estimates should not be construed as financial or medical advice. Estimates may vary depending on your benefit plan and the state you live in. Daniel Ribeiro , Dentist has not yet indicated the hospitals that he is affiliated with. Please contact the Delta Dental company below for more information. For joint custody, the plan that has covered either stepparent longest provides primary coverage. Doctor.com powers the first vertical network that connects patients and healthcare providers across the web. Check out Virtual Consult, Check out our new DeltaVision plans Is keeping employees healthy and productive one of your priorities? Preventive Products: GC MI Paste Plus, Colgate PreviDent, PreviDent | A current spouse and an ex-spouse: The current spouses coverage is primary (unless a court order makes the ex-spouses plan primary). However, contracted Delta Dental dentists may not charge their Delta Dental patients more than the amount determined by Delta Dental to be the patients portion. The NPI replaces other identifying numbers used in electronic transactions, such as: The NPI willnotreplace these numbers, which are used for purposes other than general identification: NPIs are issued by the National Plan & Provider Enumeration System (NPPES). AED Units and Defibrillator Products | *Not sure where your company is headquartered? Daniel Ribeiro , Dentist has not yet specified details about his residency. The patient should refer to his/her Federal Employees Dental Program . Have a question about coverage or looking for dental insurance? Do not avoid getting dental care based on the cost information provided on this website. Daniel Ribeiro , Dentist has not yet specified details about his education and training. None of the information on this website represents or warrants that any particular drug or treatment is safe, appropriate or effective for you. Generally, Delta Dental allows one reevaluation per claim. However, if the primary carrier only pays 50% of the dentists allowed fee, then the secondary carrier would reduce its payment by the amount paid by the primary plan and pay the difference. Balance your fees before negotiating your PPO reimbursement contracts. National Dental Supply and Dental Products Manufacturers | For DeltaCare USA, maximum contract allowances are not applicable. Your knowledge and expertise about dentistry will likely come across clearly if you remember that your audience is a dentist just like you. The information provided here is for educational purposes only and should not be interpreted as legal advice. Call and make sure that your provider accepts Medicaid coverage so you can receive quality services at no cost. The sample table is a small selection of common procedures discounted by these discount dental plans and programs. (This might require you to upgrade your software. Find health-related articles, product discounts and wellness benefits, Connect remotely with your patients using Simply submit a separate Confidential Fee Filing Form for each update. When premiums increase, groups may consider dropping dental benefits altogether. (1) Network Fee: This fee represents what most dental service providers This will lead you to the claim adjustment form, where you can indicate the issue(s) that needs to be addressed with your claim, provide necessary details and upload supporting documentation. For more detailed information on your dental care costs, please consult your dentist or your Delta Dental. The costs provided in this tool are estimates only and are not a guarantee of payment or benefits. Help the dental consultant review your claim. Please register your NPI with Delta Dental by providing us with a copy of the confirmation containing your NPI that you receive from the National Plan & Provider Enumeration System (NPPES). The dental provider listings on DentalPlans.com are provided directly from each dental network or discount dental plan, which are responsible for their accuracy and completeness. Consult with your provider prior to beginning any treatment. To check that your provider participates, visit our website or call us. Fax: 717-774-1770 Here are the benefits of creating an account. Please Note: The information displayed below is not a guarantee of coverage, and If there is any conflict or discrepancy between the Content on this website and your coverage documents, your coverage documents will control. DentalPlans detailed profile of Daniel Ribeiro , DDS - Dentist in 20152. Endodontics. Please call or write to our Contact Center (and be sure to include all relevant information). On a standard ADA Dental Claim Form (#J400), the treating dentists NPI is entered in field 54 and the billing entitys NPI is entered in field 49. Health information changes quickly. Here are some suggestions to speed up claim payments. 23219For Medicaid EnrollmentWeb: www.coverva.orgTel: 1-833-5CALLVATDD: 1-888-221-1590. If any data related to your NPI changes (name, address, etc. Latex Exam Gloves | Dental Lab Coats | Copyright 2023 Delta Dental Plans Association. Dental Office Supplies & Essentials | The address for our administrative office is: Delta Dental of California . Smiles For Children (SFC) pregnant individuals enrolled in Medicaid and FAMIS MOMS who are 21 years of age and older 600 East Broad StreetRichmondVirginia. The Henry Schein Fee Analysis provides dentists and dental professionals with the latest UCR (Usual, Customary, and Reasonable) fees for the zip code of your choice. Delta Dental Premierand Delta Dental PPO Claims. The NPI contains no embedded intelligence no coding that would identify the dentists state or license number, for example. %PDF-1.6 % To begin using the Dental Care Cost Estimator tool, click the Agree button below. During clinical review of claims and pre-treatment estimates, Delta Dental reserves the right to request radiographic images and/or documentation for procedures that otherwise may be identified as not requiring the submission of documentation. Highlighted fees represent the lowest available discounted fee for each procedure, based on the plans available in the ZIP code entered. Everything you need to know about submitting Delta Dental claims. All CDT codes not listed are discounted 20% off the usual fee. Customers can upgrade any fee analysis to a complete Henry Schein Practice Analysis for an additional $99 per zip code. DeltaCare USA's payer identification number for encounter forms is DDCA3. Like most dental benefit plans, MetLife's dental plans Locate your processed claims by entering your claim number and selecting "Search.". Delta Dental has the largest network of dentists nationwide. Please re-enter. However, we do suggest that you refer your patients to a Delta Dental Premier participating specialist to minimize your patients' out-of-pocket costs. dental entity's Type 2 NPI (if different) to npi@delta.org Please also include the dentist's name, practice name, address and license number. When Delta Dental of California is the secondary carrier and is subject to the provisions of the California Health and Safety Code 1374.19, we pay the lesser of: (1) the amount we would have paid in the absence of any other dental benefit coverage; or (2) the member's out-of-pocket cost payable under the primary plan for benefits that are covered by the secondary plan. Dental Curing Lights - LED Curing Lights | The information and content (collectively, "Content") on this website is for your general educational information only. These listings are updated on a regular basis, and every effort has been made to ensure that only participating active providers are listed. 4. Use these tips for clear, complete paper claims that will move smoothly through our system. D6055-D6077, D6082-D6088, D6094, D6097-D6099, D6110-D6123, D6194-D6195, Description of service: Every health care provider transmitting health information in connection with a standard transaction in electronic form must obtain an NPI. The data is based on actual, non-discounted charges that providers have billed. By submitting your information, you are agreeing to receive communications from DentalPlans.com. The secure version (available only after you sign in) uses procedure costs or cost ranges as reflected in provider fee schedules and aggregated historical cost data. Maximize your oral health and make the most of your dental benefits right from your mobile device by downloading the Delta Dental Mobile App. Delta Dental and its affiliate companies use MetaVance Benefit Administration Software as the claims editing software product to provide timely and efficient adjudication for dental claims. How much is it going to cost? The patient is responsible for their coinsurance/copayment portion only. Depending on the state, maximum contract allowances are derived from a variety of factors, including data from fees on claims, fee filings submitted by dentists (not applicable for Delta Dental of Pennsylvania), current economic factors and/or other data. The data is based on actual, non-discounted charges that providers have billed. only. Protect my smile Dental procedures When do you need a root canal? Ditto marks or arrows to indicate duplicate information. offers available in all markets. hb```g``Zpj1 X{ y `` If you dont conduct any electronic transactions governed by HIPAA, you arent required to obtain an NPI. You will receive by mail a pre-treatment estimate showing the amount Delta Dental is estimated to pay and the amount of the patients responsibility. A nationwide analysis of consumer opinions and behaviors relating to oral health. Oral health habits Be sure to submit dual coverage information on claims for orthodontic procedures, even if the other insurance does not cover orthodontics. The AMA does not directly or indirectly practice medicine or dispense medical services. Disposable Dental Supplies - Single Use Products | actual fees that your dental service provider may charge may be higher or lower a vendor. Also, this will help ensure that Delta Dentals calculation of the patients portion takes into account all available benefit information. Dual coverage with the same Delta Dental company, California rule for coordination of benefits, How to request a real-time pre-treatment estimate, What to include on an orthodontics treatment claim. Estimates should not be construed as financial or medical advice. The national network of Delta Dental companies protects more smiles than any other insurance company. Select the patient, then select the Submit Claim icon in the Actions menu. AARP Dental Insurance Plan c/o Delta Dental Insurance Company 2018 MetLife Services and Solutions, LLC. D7410D7415, D7440D7461, D7465, Description of service: P.O. U. S. Mail:Delta Dental Insurance Company,ATTN: Provider Onboarding, P.O. App features may vary by geographic area and individual dentist participation. They have fee schedules "approved" at Delta and Blue Cross, but they do not participate in managed care. Retired or planning to soon? Fees with decimal points (for example, 100.00; not 100). Compare your fees to the 40th - 95th . We have dental insurance that empowers you to protect the oral health of you and your loved ones. For more detailed information on your actual dental care costs, please consult your dentist or your Delta Dental. Prosthodontic Instruments & Supplies | Daniel Ribeiro is A General Dentist practicing in Chantilly, VA.This provider has not yet shared a personalized biography. Dental Diagnostic Equipment | Maximum contract allowances will differ by 5-digit ZIP code. Survey of Dental Fees This exclusive survey provides you with an analysis of self-reported fees by procedure from a nationwide, random sample of dentists. This cost estimator is intended for use in the 50 states, Puerto Rico and other U.S. territories. DELTA DENTAL PATIENT DIRECT GENERAL DENTIST FEE SCHEDULE ALL PROCEDURES Effective from 06/01/2022 D2712 Crown - Resin-Based Composite (Indirect) $305 D2720 Crown - Resin With High Noble Metal $648 D2721 Crown - Resin With Predominantly Base Metal $561 D2722 Crown - Resin With Noble Metal $625 D2740 Crown - Porcelain/Ceramic $725 Want to know before you set foot in the dentists office? Save time and money while helping the environment by electronically submitting your encounter forms to DeltaCare USA. Use of this website in no way increases or decreases the benefits available under a dental benefit plan. 2Fee schedules and savings may vary by ZIP code and by Provider within a ZIP code. *Not sure where your company is headquartered? We offer vision coverage through DeltaVision in 15 states and the District of Columbia. (2) Out of Network Range: This range is intended to assist you in understanding ZIPCODE TO CARRIER LOCALITY FILE (see files below) Patients may change their coverage, usually in the fall or spring, during their open enrollment periods. Narratives must also be maintained as part of the patient treatment record. Send it to your local Delta Dental by e-mail, fax or U.S. mail: E-mail:dentist_services@delta.org Enter your patients name and choose Existing (or enter a new patients information). a patients eligibility and benefits will only be determined at the time of a claim You may be responsible for the cost of procedures or services not covered by your plan. Special promotions including, but not limited to, additional months free are not available Pediatric Dental Supplies & Instruments | Dental Patient Education | Dental Patient Communications | The benefit is based on theapproved fee for conventional orthodontics. hbbd```b``z"g E,r D2`i`v X.X1X$ LNH`Xed_@d:H=D bg`ig ^ Better yet, send the documentation on a separate attachment (8.5 x 11 inch paper) or transmit it digitally(submit digitized attachments free with Provider Tools; use the Submit Claim or My Patients tool). Daniel Ribeiro , Dentist has not uploaded any photos. Delta Dentals allowance for orthodontic procedures includes all appliances, adjustments, insertion, removal and post-treatment stabilization (retention). E-mail:customerservice@npienumerator.com, Telephone:800-465-3203 / 800-692-2326 (NPI TTY), Mail:NPI Enumerator The description of different treatment categories, and the inclusion of particular services in a treatmentcategory,is not advice that any particular treatment category is the right treatment for you or that you should not obtain any particular treatment. fees when you pay. Claims will be processed when received according to your plan provisions. Faxes are not accepted. You no longer need to send us paper claims just because you need to send an attachment. Please input information for either ZIP code or address but not both, Please enable your browser to allow this site to use your location. Online Dental Supply Company | Dental Supply Store | Dental Companies | On claims, the Type 2 NPI identifies the payee, and may be submitted in conjunction with a Type 1 NPI to identify the dentist who provided the treatment. Sacramento, CA 95853-7007 Also, medical coverage would be primary if the group dental plan contract indicates that specific oral procedures are covered (such as a biopsy, oral surgery provided by a physician or dental treatment provided in a hospital).

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