What is Delta Dental Premier?
Delta Dental Premier is a standard fee-for-service dental benefits program. Delta Dental reimburses participating dentists directly based on their submitted fees and our maximum approved fee. Members are responsible for their copayment and deductible (if any) and charges for any non-covered services.
What is the difference between Delta Dental and Delta Dental Premier?
Delta Dental PPO is a PPO network where dentists who participate agree to reduced costs as payment in full. Members who use a Delta Dental PPO will have the lowest out-of-pocket costs. Delta Dental Premier is a managed fee-for-service network where dentists agree to a maximum plan allowance as payment in full.
Can you negotiate with Delta Dental?
The reimbursement schedule for your dental services is negotiable. You can go back and forth before settling on the fees and signing a contract. While many dentists face capitation, flat-fee HMOs pay providers to participate. The emerging DHMO plans offer opportunities to negotiate if you are a specialist.
What does Premier dentist mean?
Premier plans: Dental PPO. Dentists who participate in a Preferred Provider Organization (PPO) have agreed to accept a lower payout for patient services. What does this mean for you? Lower out-of-pocket costs.
What is the difference between Premier PPO and Standard PPO?
Since our Premier network is slightly larger than our PPO network, it acts like a “safety net” to ensure you can access in-network care. It’s kind of like a network within a network. If you have a PPO plan and visit a Delta Dental Premier dentist, you will not maximize your out-of-pocket cost savings.
How do I know which Delta Dental Plan I have?
How do I find out which plan type I currently have? For information about your benefit plan, log in to Member Portal or contact our customer service department at 800-524-0149.
How does Delta Dental reimburse?
Payment is made directly to you as a participating dentist but reimbursement is based on PPO out-of-network coverage. Your patient may be billed the balance up to your submitted charge. There may be a $100 out-of-network deductible, regardless of coinsurance level, before out-of-network reimbursement is made.
How do you negotiate dental costs?
Do some haggling. If you don’t have insurance or your policy won’t pay for a particular procedure, ask for a discount. Start by looking at the “fair” prices in your area for your procedure at FAIR Health and Healthcare Bluebook. If your dentist charges more, negotiate.
What is a Premier PPO plan?
One of the most common dental plan designs, Preferred Provider Organizations (PPOs) give members the freedom to go to the provider of their choice! Like every dental carrier, Premier Access has providers that are contracted, or ‘in-network’.