Verify eligibility, look up claims, and more.
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Everything you need to know about our federal programs’ benefits, policies, and procedures.
“We see our dentists as trusted partners working toward the same goal: bringing health to our communities. We want to contribute to the provider’s success as a businessperson, as a healer, as a community member.”
― Dr. Daniel Croley
Vice President of Network Development
Verify eligibility and benefits electronically through:
We’ve established a single, dedicated toll-free number exclusively for dental offices. Whenever you need to call Federal Government Programs, simply dial: 844-825-8111.
Use our redesigned interactive voice response (IVR) system to hear automated verification of eligibility and benefits. With the IVR, you can also select the option to have a copy faxed to your office to place in the patient’s chart for future reference.
To file a claim online, log into your Dental Office Toolkit account.
If you cannot file the claim online, you can complete a claim form and send to the following address:
General Correspondence & Claims
Delta Dental of California
Federal Government Programs
PO Box 537007
Sacramento, CA 95853-7007
Use these tips to complete your manual claims and they will be processed more timely and accurately.
The following may cause delays, inaccurate processing and possible denials:
If you have submitted a pre-treatment estimate, once services are provided use the notification of pre-treatment estimate form. You only have to date each service, sign and return the form for processing. Line through (single line) any treatment that has not been completed. Do not submit a new claim for any services that have been submitted for a pre-treatment estimate.
The tax identification number you use on your claims affects your year-end 1099 statement. Any changes to this ID number during the year should be verified through your local Delta Dental Member Company no later than the end of each year. No changes to the ID number can be made on the 1099 statements once they have been processed.
The tax identification number and practice name on file with Delta Dental must match the IRS records exactly. If they do not, the IRS requires Delta Dental to withhold 28 percent of the dollars owed to you from future payments until the matter is resolved. Use the tips here when submitting your claims:
The federal Health Insurance Portability and Accountability Act (HIPAA) requires you to obtain an NPI if you submit claims electronically. Additionally if you verify claims status or access patient enrollment and/or benefits information online you are required to use an NPI. All individual health care providers (including dentists) and organizations such as clinics and group practices are eligible to obtain an NPI.
There are two types of NPIs: Type 1 for individual health care providers, such as dentists and hygienists, and Type 2 for incorporated businesses, such as group practices and clinics. When submitting claims, the NPI-1 will always be required for the rendering/treating dentist.
There are various dental programs for the Federal Government, including Federal Employees and Retirees, Veterans Affairs, Office of the Comptroller of the Currency, and the Federal Housing Finance Agency.
Coverage is offered worldwide, with the Delta Dental PPO and Premier dentist networks offered to those residing in the 50 United States, the District of Columbia, Puerto Rico, Guam and the U.S. Virgin Islands. With worldwide coverage, members in the programs are able to enjoy access to their dental care regardless of where they live or travel.