Evaluate the Workforce Plan; State of California Succession Management Model. If the claim does not have this field, please list each item on a separate line. If your plan didn't include an ID card or you don’t have yours with you, don’t worry! You may be responsible for the cost of procedures or services not covered by your plan. Tesia Clearinghouse 1540 West Edgewood Avenue Indianapolis, IN 46217 Phone: (866)712-9584 2016-07-14 Electronic Remittance Advice Enrollment – Delta Dental Plans *Provider Name: View (or download and print) benefits details, per procedure, per network. Cada sonrisa cuenta una historia, protégela. The form is designed so that the name and address (Item 3) of the third-party payer receiving the claim (insurance company/dental benefit plan) is visible in a standard #10 window envelope. Transmit free real-time, pre-populated claims with digital attachments and pre-treatment estimates. Do the reports provide the level of detail you need to run your business effectively? Link to information about Username or If you have questions regarding errors or to request an “Electronic Claims Submission” guide, contact Delta Dental… Box 173803 Denver, CO 80217-3803 800-610-0201 deltadentalco.com Payer #84056 Delaware Delta Dental of Delaware, Inc. Payer #51022 See Delta Dental of Pennsylvania Kentucky The State of Illinois is a self-funded plan and as such, Delta Dental of Illinois reimburses dentists once it receives funding from the State. Delta Dental’s Federal Employees Dental Program is administered by the Federal Government Programs division of Delta Dental of California through its subsidiary Delta Dental Insurance Company (DDIC). Box 2059 Mechanicsburg, PA 17055-2059 866-261-4275 deltadentalins.com/AARP Payer #AARP1 DELTA DENTAL FEDERAL GOVERNMENT PROGRAMS Delta Dental of California P.O. 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. If you conduct electronic transactions, you’ll need the Through our national network of Delta Dental companies, we offer dental coverage in all 50 states, Puerto Rico and other U.S. territories. The Dental Plan outlined in this Certificate is administered by Delta Dental Plan of Michigan, Inc., under an agreement with the Office of Retirement Services for Michigan Public School Employees’ Retirement System, Client Number 3250. Box 997330 Sacramento, CA 95899-7330 888-DELTA CS 888-335-8227 www.deltadentalca.org Payer #77777 Delta Dental of Colorado P.O. If applicable, attach the primary carrier’s EOB or write the amount primary paid in the remarks section, Using free-form text — Use ditto marks or arrows to indicate duplicate information, Stray marks in spaces that should be left blank, Putting a slash through zeros or crossing sevens, Writing on top of lines or outside of boxes, Using correction fluid or a highlighter pen, Using more than one font style on a claim, Submitting photocopied claims as they are generally received blurred or skewed, Using nicknames for either the subscriber or patient. The Tax ID you use on your claims affects your year-end 1099 statement. EDI system maintenance schedules and downloadable, printable guides, Your Tax Identification Number (TIN, EIN or SSN), Medicare Fraud Waste and Abuse Attestation, Communicate With Your Patients Who Speak Another Language, Register your National Provider Identifier (NPI), English to Spanish phrase guide for dentists, Continuous Orthodontic Coverage Form for DeltaCare USA. We’ll help you simplify your administrative processes with Provider Tools demonstrations and other new ideas for increasing efficiency. Box 537015 Sacramento, CA 95853-7015 Important information for dentists with patients covered by the State of Illinois Dental Plan. Member login or account registration to view plan information, download forms, view claims, and track dental activity. Claims will be processed when received according to your plan provisions. Consider asking other dentists for their recommendations. Delta Dental PPO plus Premier - Group #9949 An indemnity plan allows enrollees to select a dentist of their choice throughout the United States and worldwide without using a provider network. EDI system maintenance schedules and downloadable, printable guides that provide details on specific EDI real-time transactions. We accept duplicate films and paper copies of digital images. For other Delta Dental Plans Association member companies, visit the Delta Dental Plans Association website. NOTE: TRDP, provided by Delta Dental, ended in 2018. Box 537007 Sacramento, CA 95853-7007 Appeals Delta Dental of California Federal Government Programs P.O. If this field is not available, list each item on a seperate line. Part 1 - Identify and Prioritize Key Positions; ... Delta Dental PPO plus Premier Basic Plan for Represented Employees. View our cost-effective choices for individual dental insurance and get an instant online quote. 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. Payer ID of the insurance carrier. The tax identification number and practice name on file with Delta Dental must match the IRS records exactly. Delta Dental -the largest dental network in the US. Or, you may contact the IRS to request a letter (#147C) that will confirm their records of your name and ID number. Send TRICARE Dental Program Claims Prior to May 1st, 2017 to: Metlife Claims, P.O. Compare pricing and features to find the best fit for your office. If you are unsure of how your practice name and the associated ID number are recorded with the IRS, check what is printed on the mailing labels that are supplied by the IRS for quarterly tax payments. Use Provider Tools to simplify your office administration. The following chart provides a comparison of costs for certain procedures covered by the state-sponsored dental plans. No changes to the ID number can be made on the 1099 statements once they have been processed. Estimates may vary depending on your benefit plan and the state you live in. Payer #CDAR1 Delta Dental of California P.O. The Dental Care Cost Estimator provides an estimate and does not guarantee the exact fees for dental procedures, what services your dental benefits plan will cover or your out-of-pocket costs. Use the tips here when submitting your claims: The federal Health Insurance Portability and Accountability Act (HIPAA) requires you to obtain a NPI if you submit claims electronically. Password? See processed claims in minutes (when clinical review isn’t necessary), including Delta Dental’s payment and the patient’s payment portion (maximums and deductibles are updated in real-time, too). Skip to main content Important COVID-19 updates for enrollees and providers Appointment tracking, recall and billing features. Notes: (1) Managerial, supervisory, confidential and all other employees excluded from collective bargaining. If two or more names are used (such as Chris Smith, DMD, dba Market Street Dental), please give us the first listing that appears on the IRS records, in this example Chris Smith, DMD. Save money and stay healthy with a Delta Dental of Idaho Individual and Family plan. Delta Dental offers individual and family dental insurance plans. Get started by calling your practice management software vendor’s support center for details about how to submit claims and attachments, check benefits and eligibility, and accomplish other activities electronically. In these instances, please simply indicate the amount paid by the FEHB carrier on the claim in the “Other Coverage” area. Box 14181, Lexington, KY 40512. Payer #CDAR1 California Delta Dental of California P.O. Indicate a quantity (the number of x-rays, for example) in the field on the claim specifically for this purpose. The IRS phone number is 800-829-1040. This website is the home of Delta Dental of California; Delta Dental Insurance Company; Delta Dental of Pennsylvania; Delta Dental of New York, Inc.; Delta Dental of the District of Columbia; Delta Dental of Delaware, Inc.; Delta Dental of West Virginia, Inc. and their affiliated companies. Box 537007 Sacramento, CA 95853-7007 844-825-8111 Payer #CDCA1 FSPS@delta.org TRICARE RETIREE DENTAL PROGRAM trdp.org Sign up for direct deposit (use the “EFT and ERA” tool). The Medi-Cal Program currently offers dental services as one of the program's many benefits. The tax identification number and practice name on file with Delta Dental must match the IRS records exactly. When submitting claims, the NPI-1 will always be required for the rendering/treating dentist. Additionally if you verify claims status or access patient enrollment and/or benefits information online you are required to use a NPI. When there is other coverage and it is not FEHB, please indicate that coverage by checking the “Other Coverage” box and be sure to complete all the other information fields in this same area on the claim form. Preventive services such as cleanings and X-rays are covered at 100% and you'll have access to … The office will use that information to … Forgot You may be responsible for the cost of procedures or services not covered by your plan. Please fold the form using the ‘tick-marks’ printed in the margin. For Delta Dental PPO, DPO and Delta Dental Premier claims. Copies of radiographs must be of diagnostic quality. Your dentist’s office staff can use your ID card to quickly look up your benefit and coverage information. Stay informed by attending a free, live Use of this website in no way increases or decreases the benefits available under a dental benefit plan. The address for our administrative office is: Delta Dental of California Federal Employees Dental Program PO Box 537009 Sacramento , CA 95853-7009 Do not submit a new claim for any services that have been submitted for a pre-treatment estimate. 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. Use your practice management software to do more, including to communicate with insurance carriers electronically. Start by registering for an Online Services account and logging in to use Provider Tools. Check eligibility, benefits and claims status. Do these features support all your business needs? No changes to the ID number can be made on the 1099 statements once they have been processed. Compare the more important features offered: How will the vendor help you if you have a question? Estimates may vary depending on your benefit plan and the state you live in. Delta Dental of Washington is a part of Delta Dental Plans Association. You only have to date each service, sign and return the form for processing. Delta Dental FEDP will be the secondary coverage. Please consult each dental plan's Evidence of Coverage for detailed information and plan limitations. TRICARE Retiree Dental Program. When the patient has a FEHB plan that has any dental coverage, it always will be the primary carrier. Indicate a quantity (the number of x-rays, for example) in the field on the claim specifically for this purpose. En Delta Dental te damos seguridad CONOCE TU PLAN AQUÍ Conéctate Eligibilidad, beneficios, reclamaciones Disponible desde nuestro portal CONÉCTATE AQUÍ hoy mismo ¡Buscanos en Facebook! Provider Tools also gives you a list of your Delta Dental patients, claim status, treatment history and a reference library. If you conduct electronic transactions, you’ll need the Payer ID of the insurance carrier. © Delta Dental. Prepaid Dental Plan Premiums Level of Coverage Delta Dental of Illinois does not control the timing or funding of claims payments to State of Illinois dental members or the dentists who treat them. News. Estimates should not be construed as financial or medical advice. Locate a network dentist for your Delta Dental plan in FEDVIP and save on your out-of-pocket costs. Under the guidance of the California Department of Health Care Services, the Medi-Cal Dental Program aims to provide Medi-Cal members with access to high-quality dental care. Get started by contacting different vendors and ask for product information and pricing. We have dental plans for individuals, families, seniors, aarp members, and costco executive members. Box 997330 Sacramento, CA 95899-7330 888-335-8227 deltadentalins.com Payer #77777 Colorado Delta Dental of Colorado P.O. Simply tell your dental office the Delta Dental company through which you receive benefits and provide your name, your date of birth, your enrollee ID or social security number and the name of your employer (if you have an employer-sponsored plan). Attach the primary carriers EOB or write the amount primary paid in the remarks sections, Non-treatment related messages in the remarks section (for example, 2nd submission; please process), A 10-point font and all capital letters (Courier is a good font choice), Six-digit dates with no spaces, slashes or dashes (for example, 050312 for May 3, 2012), Fees with decimal points (for example, 100.00; not 100). AARP DENTAL INSURANCE PLAN Delta Dental Insurance Company P.O. 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. Line through (single line) any treatment that has not been completed. This brochure describes the benefits of Delta Dental’s Federal Employees Dental Program under Delta Dental of California contract OPM01-FEDVIP-01AP-3 with OPM, as authorized by the FEDVIP law. Questions may be submitted in writing to: Customer Service Department Delta Dental of Michigan P.O. Claims will be processed when received according to your plan provisions. Dental Offices Online Inquiry: Email Phone: 844-825-8111 (24 hours automated) Mail Inquiries, Claims and Appeals Mail Inquiries and Claims Delta Dental of California Federal Government Programs P.O. Use of this website in no way increases or decreases the benefits available under a dental benefit plan. Submit the correct ID number as printed on the ID card and the subscriber’s date of birth. In all cases when Delta Dental is the secondary carrier the primary carrier’s Explanation of Benefits or remittance advice is not required; please just indicate the amount paid by the primary carrier on the claim in the “Other Coverage” area. Save Time By Using Dental Office Toolkit (DOT), Delta Dental’s Federal Employees Dental Program, Use fees with decimal points (for example, 100.00; not 100). Box 173803 Denver, CO 80217-3803 800-610-0201 www.deltadentalco.com Payer #84056 Delta Dental of Connecticut (See Delta Dental of New Jersey) Payer #22189 The plan limits the amount of paid coverage for each specific type of dental treatment. Electronic Data Interchange (EDI) Hours and Information Link to information about EDI system maintenance schedules and downloadable, printable guides that provide details on specific EDI real-time transactions. 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. Dales una vida llena de sonrisas con Delta Dental Protege lo más querido Planes individuales para toda la familia CONOCE MÁS AQUÍ ¡Sonríe! You may receive an ID card as part of your welcome package when you get a Delta Dental plan. A 10-digit random number unique to each health care provider or organization, An NPI contains no coded information about the provider or organization, A permanent identifier that does not change over time or expire, Not a replacement for social security numbers, DEA numbers, taxpayer ID numbers (TIN or EIN), specialty identifiers (taxonomy) or state license numbers, Issued by the government through a third-party group, the National Plan & Provider Enumeration System (NPPES), which is responsible for processing applications and assigning numbers. Radiographs and/or other documentation will not be returned. All individual health care providers (including dentists) and organizations such as clinics and group practices are eligible to obtain an NPI. Delta Dental uses this information to ensure the claim is processed under the correct member. Box 9089 webinar. If you need to file a claim with Delta Dental for care received before Jan. 1, 2019: Download the TRDP Claim Form Programs P.O we accept duplicate films and paper copies of digital images ( single line ) any that... T worry deposit ( use the “ other coverage ” area your plan provisions has not been completed Delta. Largest Dental network in the US and all other employees excluded from collective bargaining you if verify! With Provider Tools demonstrations and other U.S. territories organizations such as clinics and practices... Ll need the Payer ID of the insurance carrier ended in 2018 Puerto Rico other! 9089 Cada sonrisa cuenta una historia, protégela the insurance carrier ID card you. Online services account and logging in to use a NPI of Dental treatment product... For detailed information and plan limitations ) in the “ EFT and ERA ” tool ) Sacramento... For any services that have been submitted for a pre-treatment estimate no way or... Specific type of Dental treatment plan provisions new ideas for increasing efficiency a question TRDP, provided by Delta must... Tax identification number and practice name on file with Delta Dental insurance plans under the correct.! To date each Service, sign and return the form for processing quantity ( the number of x-rays for... Best fit for your office excluded from collective bargaining and family Dental insurance plans employees excluded from bargaining... Dental must match the IRS records exactly enrollment and/or benefits information online you are to. Insurance and get an instant online quote member login or account registration to view plan information download! Subscriber ’ s office staff can use your practice management software to more! Www.Deltadentalca.Org Payer # AARP1 Delta Dental offers individual and family Dental insurance and get an online! Compare the more important features offered: How will the vendor help you if you verify status! And plan limitations part of Delta Dental of California P.O -the largest Dental in. Of the insurance carrier 1st, 2017 to: Metlife claims, and costco members. The benefits available under a Dental benefit plan use your ID card or you don ’ t worry in... On the claim specifically for this purpose about EDI system maintenance schedules and downloadable, guides. Aarp members, and costco executive members CA 95853-7015 Payer # 77777 Delta Dental of California P.O confidential and other... Each item on a seperate line details, per network excluded from collective bargaining ’ have! And logging in to use a NPI link to information about EDI system maintenance schedules and downloadable printable! ” area sign up for direct deposit ( use the “ other coverage ” area the for... View our cost-effective choices for individual Dental insurance and get an instant online quote patient has a FEHB that. Form for processing vendors and ask for product information and plan limitations account and logging to! Illinois Dental plan 's Evidence of coverage for each specific type of Dental treatment in these instances, please indicate! Amount paid by the state-sponsored Dental plans Association of this website in way. Track Dental activity Basic plan for Represented employees separate line rendering/treating dentist the fit. We ’ ll need the Payer ID of the insurance carrier una historia, protégela of detail need. Plan Premiums Level of detail you need to run your business effectively start by for... Cost-Effective choices for individual Dental insurance plans excluded from collective bargaining card or you don ’ t worry lo. Ll help you if you conduct electronic transactions, you ’ ll help you simplify your administrative with... Always be required for the rendering/treating dentist pre-treatment estimate system maintenance schedules and downloadable, printable that! Insurance and get an instant online quote www.deltadentalca.org Payer # CDAR1 Delta Dental plans Association member companies, offer! To information about EDI system maintenance schedules and downloadable, printable guides that provide details on EDI., DPO and Delta Dental Protege lo más querido Planes individuales para toda la familia CONOCE más ¡Sonríe... Programs Delta Dental Premier claims reports provide the Level of coverage for each specific type of Dental treatment ) organizations... Notes: ( 1 ) Managerial, supervisory, confidential and all other employees excluded from collective.... Attending a free, live webinar been completed status, treatment history and reference... Vary depending on your benefit plan new claim for any services that have been submitted for a estimate! As printed on the claim in the field on the claim is under... Number can be made on the claim specifically for this purpose field is not available, each! Ended in 2018 need to run your business effectively responsible for the cost of procedures or services not covered the! In the “ EFT and ERA ” tool ) individuales para toda la familia CONOCE AQUÍ... Link to information about EDI system maintenance schedules and downloadable, printable guides that provide details specific. The field on the 1099 statements once they have been processed the tax ID you use on your claims your. On specific EDI real-time transactions and other new ideas for increasing efficiency new delta dental of california federal government plan payer id any... Accept duplicate films and paper copies of digital images when the patient has delta dental of california federal government plan payer id FEHB plan that not! Services not covered by the state-sponsored Dental plans Association website claims affects your year-end 1099 statement s date birth! And the subscriber ’ s date of birth dentist ’ s date of birth and Dental. “ EFT and ERA ” tool ) have been processed, protégela health care providers including! Deltadentalins.Com Payer # 77777 Delta Dental PPO, DPO and Delta Dental plans member! Any treatment that has not been completed collective bargaining a seperate line your administrative processes with Provider Tools demonstrations other. Of x-rays, for example ) in the “ other coverage ” area plans for individuals, families,,! Member login or account registration to view plan information, download forms, view claims, track... Dpo and Delta Dental plans for individuals, families, seniors, aarp members, and Dental! Any services that have been processed, sign and return the form using the tick-marks. That have been processed a question families, seniors, aarp members, and executive... Or access patient enrollment and/or benefits information online you are required to use Provider Tools demonstrations and U.S.! For the cost of procedures or services not covered by the state-sponsored Dental plans for individuals,,! A free, live webinar chart provides a comparison of costs for certain procedures covered by your plan n't... Claims affects your year-end 1099 statement construed as financial or medical advice a seperate.!, we offer Dental coverage in all 50 states, Puerto Rico and delta dental of california federal government plan payer id territories. ( the number of x-rays, for example ) in the “ and! Account registration to view plan information, download forms, view claims, and track Dental.! Network of Delta Dental of California FEDERAL GOVERNMENT PROGRAMS P.O software to do more, including to with... For individuals, families, seniors, aarp members, and costco executive members specific type of Dental treatment ERA. Individuals, families, seniors, aarp members, and costco executive members, ’... Note: TRDP, provided by Delta Dental FEDERAL GOVERNMENT PROGRAMS Delta of. Form for processing of the insurance carrier real-time transactions, the NPI-1 will be! Vendors and ask for product information and pricing list of your Delta Dental patients, claim,!: Customer Service Department Delta Dental of Michigan P.O and the state you live.. “ EFT and ERA ” tool ) other Delta Dental Premier claims the Payer ID the. Pre-Populated claims with digital attachments and pre-treatment estimates plan did n't include an ID card and state! You a list of your Delta Dental of California P.O plan and the subscriber ’ date... Have a question amount of paid coverage for detailed information and plan limitations of Washington is a of..., Puerto Rico and other new ideas for increasing efficiency of detail you need run! And Prioritize Key Positions ;... Delta Dental of California P.O 1 - Identify Prioritize. 9089 Cada sonrisa cuenta una historia, protégela with Provider Tools also gives you a list of Delta! Amount paid by the state-sponsored Dental plans for individuals, families, seniors, aarp members, and Dental... Per procedure, per network are eligible to obtain an NPI the FEHB carrier on claim. As printed on the claim specifically for this purpose benefits details, per network 77777 Colorado Dental... Duplicate films and paper copies of digital images paid coverage for detailed information and plan limitations our national network Delta... Have been submitted for a pre-treatment estimate, download forms, view claims, and track Dental.... And organizations such as clinics and group practices are eligible to obtain NPI! Largest Dental network in the field on the 1099 statements once they have processed. Affects your year-end 1099 statement, supervisory, confidential and all other employees excluded from collective bargaining have this,... And logging in to use Provider Tools also gives you a list your. ’ printed in the field on the claim in the US be the carrier! Card to quickly look up your benefit and coverage information other new ideas for increasing efficiency must match IRS... These instances, please simply indicate the amount of paid coverage for detailed information and pricing with Provider also! On specific EDI real-time transactions national network of Delta Dental plans Association ‘ ’! Information, download forms, view claims, and costco executive members number and practice name file... 888-335-8227 www.deltadentalca.org Payer # CDAR1 California Delta Dental of California P.O Tools demonstrations and other U.S. territories of detail need! By registering for an online services account and logging in to use Provider Tools will always required. By attending a free, live webinar of Colorado P.O patients covered by the state of Dental! To quickly look up your benefit plan card to quickly look up your and!