You recently received a correspondence from our office regarding our contractual status with your insurance carrier. We are striving to provide as much education and transparency for the changes made to our contract to your dental plan.   It is important to know that on average, Delta reimburses the patient within 2 weeks.  We take care of all claim submissions and if there is requested documentation necessary.  

We know this change is difficult for all of us.  The decision to have patients pay for their services is not ours but a rule your dental insurance has, further making it difficult for members like yourself.  All other insurance companies we are not contracted with accept our fee as reasonable and customary and those plans pay us directly.  We would not intentionally choose this difficult administrative change for you or your family. 

If we do not have your email address please provide it so we can attach your plan benefits available from Delta Dental.  On this document, you will see information pertaining to the subscriber/patient of the plan and the breakdown for all 3 tiers within Delta Dental.  Premier, PPO, and non-participating.  If your plan changes from one network to the next, you will see these divided in different columns.

We are not in a direct contract or participating in any other dental plan available.  Delta Dental is the only dental insurance we are aware of that has separate plan provisions or “tiers” as we refer to them as.  We are delighted to review that as with any other plan we help utilize benefits for, there is little to no change for most of our patients.

Many of our patients are requesting code use and our standard fees to be well prepared for their upcoming preventative appointments.  Please find below our practice preventative care policy we will continue to provide for all patients.

D0120: Periodic Exam.  This exam is completed 2 times per 12 months.  This exam is necessary for complete review and diagnosis from radiographs, oral cancer screenings, periodontal evaluations and measuring, home health discussions and concerns with the patient.

D1110/D1120:  Adult Prophy/Child Prophy.  These codes are your preventative procedures often referred to as “cleanings”.  This is completed 2 times per 12 months on average, however, some patients require additional prophylaxis annually.

D0272/D0274:  Bitewing x-rays.  This is completed 1 time per 12 months.  These required x-rays are also considered our cavity and decay detecting images.  In addition to that, it allows our team to view the bone health as part of the exam, see pathologies not visible to the eye and much more.

D4910:  Periodontal Maintenance.  This code is used instead of the D1110 code when a patient has periodontal disease (bone loss) and the prevention of progression of the patient’s disease may require 2, 3 or 4 visits per year to maintain the patient’s oral health.

Please be aware that the codes provided are our most common preventative visit codes used.  Our providers have always customized the care specific to the patient’s unique needs and this may change because of your overall health, diet and other considerations necessary to provide the best care we can.

Please let us know if you have any further questions!  Otherwise, we are grateful for your loyalty and trust with our providers, and we will continue to provide as much support during this change.