Commonly Asked Questions
Q. Does Delta Dental sell individual policies?
Q. Do I have to go to a particular dentist?
Q. Can my dentist join the network?
Q. What does my plan cover?
Q. How do I check to see if I've met my deductible?
Q. Do I need a referral to have a procedure done by a specialist?
Q. When should I ask for a pre-treatment estimate?
Q. Do I need to submit a claim form?
Q. If I have to send a claim form, where do I send it?
Q. What do I do if I've lost my ID card?
Q. Does Delta Dental sell individual policies?
A. Delta Dental sells group programs to Rhode Island-based businesses. Members of certain other organizations, such as a Chamber of Commerce or AAA Southern New England, can also purchase dental coverage with us. Companies with fewer than five employees can contact their local Chamber of Commerce for more information. Members of AAA Southern New England who live in Rhode Island can click here for details about their new dental program.
Q. Do I have to go to a particular dentist?
A. You always have the freedom to choose any dentist, however your out-of-pocket costs will probably be higher at a non-participating dentist. In Rhode Island, nine out of ten dentists participate with Delta Dental. And, three out of four dentists nationwide participate. As a member of Delta Dental, you enjoy distinct advantages when you visit a participating dentist. The dentist agrees to accept our payment as payment in full - minus any applicable deductibles or co-insurances - and you are protected against being billed for any remaining balance. A participating dentist will also file your claims directly with us and handle all paperwork.
Q. Can my dentist join the network?
A. If you'd like us to invite your dentist to join Delta Dental's network, email our Professional Relations department with the dentist's name and address. We'll get in touch with the dentist. If he or she decides to participate and meets Delta Dental's credentialling and geographical selection criteria, we'll enroll him or her in the network.
Q. What does my plan cover?
A. One of the benefits of Delta Dental is our total flexibility in plan design, so there is no one answer to this question. For a detailed breakdown of your personal benefits, check out BenefitCheck - our online benefits and eligibility feature. You can also refer to the benefit literature available through your company, or call InfoLine, our automated phone system, at 401-752-6100 or 800-843-3582.
Q. How do I check to see if I've met my deductible?
A. For a year-to-date status of how many benefit dollars have been used or to find out how much has been applied to your deductible, visit BenefitCheck - our online benefits and eligibility feature. Available 24 hours a day, 7 days a week, BenefitCheck provides you with a detailed description of your specific benefit information in an easy to read format. You may also call our automated information system, InfoLine, at 401-752-6100 or 800-843-3582.
Q. Do I need a referral to have a procedure done by a specialist?
A. You do not need a referral but we strongly encourage you to use a participating dentist to maximize your benefits. You may also want to have the specialist submit a pre-treatment estimate to determine any potential out-of-pocket costs.
Exams and consultations by specialists may not be covered by your plan so check your benefits.
Q. When should I ask for a pre-treatment estimate?
A. Whenever you and your dentist discuss a treatment plan that is expected to cost $300 or more, we recommend that the dentist file a pre-treatment estimate with us prior to commencing treatment. We will review the treatment plan and let you and the participating dentist know, in advance, how much we will cover. For services that your dental plan does not cover at 100%, having a pre-treatment estimate lets you know what your out-of-pocket costs will be.
Q. Do I need to submit a claim form?
A. Participating dentists will take care of filing claims for you. Some non-participating dentists may submit them on your behalf. Call the dentist's office before you visit to make sure, and if you need one, you may download one here.
Q. If I have to send a claim form, where do I send it?
A. Delta Dental of Rhode Island
PO Box 1517
Providence, RI 02901-1517
Q. What do I do if I've lost my ID card?
A. Email us or call Customer Service (401-752-6100 or 800-843-3582) and we will mail a replacement card to you within two weeks. Once enrolled, members can also print a copy of their ID card through the Members Online feature of our website. |
