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The Delta Dental Plans Association, also known as simply Delta Dental, is an American network of dental insurance companies composed of 39 independent Delta Dental members operating in all 50 states, the District of Columbia and Puerto Rico. These member companies provide coverage to 85 million people, enrolled in over 157,000 groups.
A medical biller then takes the coded information, combined with the patient's insurance details, and forms a claim that is submitted to the payors. [2] Payors evaluate claims by verifying the patient's insurance details, medical necessity of the recommended medical management plan, and adherence to insurance policy guidelines. [4]
With indemnity dental plans, the insurance company generally pays the dentist a percentage of the cost of services. Restrictions may include the co-payment requirements, waiting period, stated deductible, annual limitations, graduated percentage scales based on the type of procedure, and the length of time that the policy has been owned.
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File a complaint and a claim: Murray recommends that people file a complaint with Delta, as well as filing for reimbursement. See the Help Center on Delta.com to file complaints. See the Help ...
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In January 2018, a class action lawsuit accused Centene's Ambetter marketplace healthcare plans of misleading enrollees about plan benefits. [37] [38] According to the lawsuit, people who bought Centene's plans had difficulty finding medical providers that accepted patients covered under Centene's policies. [39]
With 13 million children and adults enrolled, Denti-Cal is the largest state-sponsored dental insurance program; Private contractor that administers Denti-Cal is Delta Dental. In 2016, the State of California awarded Delta Dental a new contract to provide administrative services for the Denti-Cal program, continuing the 42-year relationship [7]