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Posted by / 27-Sep-2017 17:14

If you must send the original and need it returned to you, please clearly indicate your wishes on the x-ray and claim form.Q: Am I required to submit a predetermination of benefits before beginning treatment on a patient?Q: Do I have to take a write-off on a procedure that isn’t covered by the patient’s dental plan?

Q: Can I bill the patient the difference between my fee and your allowance?

A: When you participate with Delta Dental, if your fee for a service exceeds Delta Dental's maximum plan allowance, participating dentists agree to write-off any difference and not charge the remaining balance to the patient. A: We recommend that you apply your normal billing procedures to all patients - "bill all on prep date or bill all on delivery.” (Excludes partials or dentures, which must be billed on seat date).

While third-party claim submission policy offers dentists some latitude as to whether claims may be submitted at the commencement of procedures or at their conclusion, no ethical principle allows a dentist to bill and retain money for work that is not performed (ADA Ethics).

Submitting a monthly claim for orthodontics is not necessary.

Normally, the claim is filed for the entire treatment, and Delta Dental automatically makes a payment each month until the treatment is completed, terminated, or the patient is no longer eligible.

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Predeterminations allow your patient the opportunity to make proper financial arrangements for their portion of the treatment cost before actual work begins.