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How much is it going to cost? Affordable Care Act. . Rubber Dam | Rubber Dam Clamps | See Related Links below for information about each specific fee schedule. located outside the zip code indicated. Be sure to submit dual coverage information on claims for orthodontic procedures, even if the other insurance does not cover orthodontics. Miscellaneous services. ZIPCODE TO CARRIER LOCALITY FILE (see files 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. Dental Patient Financing | Dental Financing | Send the information to your inbox and check at your convenience. D3310-D3330, D3921. 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. The benefit is based on theapproved fee for conventional orthodontics. Prosthodontics, fixed (bridge abutment crowns), Description of service: 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. None of the information on this website represents or warrants that any particular drug or treatment is safe, appropriate or effective for you. For more details see our privacy policy. An NPI is required by the federal Health Insurance Portability and Accountability Act (HIPAA) for electronic transactions. Please input information for either ZIP code or address but not both, Please enable your browser to allow this site to use your location. The Dental Care Cost Estimator provides an estimate and does not guarantee the exact fees for dental procedures, what dental benefits your plan will cover, or your out-of-pocket costs. The AMA assumes no liability for data contained or not contained herein. 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. Periodontal charting. Copyright 2023 Delta Dental Plans Association. hb```g``Zpj1 X{ y `` U. S. Mail:Delta Dental of Pennsylvania,ATTN: Provider Onboarding, P.O. Claims will be processed when received according to your plan provisions. Enter the NPI of the billing dentist or dental entity, as well as the treating dentists NPI (if they are different). The sample table is a small selection of common procedures discounted by these discount dental plans and programs. 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. 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. Dental Burs & Diamond Burs | If the claim does not have this field, please list each item on a separate line.