Delta Dental of Tennessee - Constant Contactfiles.constantcontact.com › dd5d7555401 ›...
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Delta Dental of Tennessee Dental Benefit Highlights for July 20, 2015 6085-00001, 12511, 31351, etc Delta Dental PPO (Standard) Coverage effective June 1, 2015 Delta Dental PPO Dentist Delta Dental Premier Dentist Non- participating Dentist Plan Pays Plan Pays* Plan Pays* Diagnostic & Preventive Diagnostic and Preventive Services - exams, cleanings, fluoride, and space maintainers 100% 100% 100% Brush Biopsy - to detect oral cancer 100% 100% 100% Radiographs - X-rays 100% 100% 100% Periodontal Maintenance - cleanings following periodontal therapy 100% 100% 100% Basic Services Emergency Palliative Treatment - to temporarily relieve pain 80% 80% 80% Sealants - to prevent decay of permanent teeth 80% 80% 80% Minor Restorative Services - fillings 80% 80% 80% Simple Extractions - non-surgical removal of teeth 80% 80% 80% Other Basic Services - misc. services 80% 80% 80% Adjustments and Repairs - to bridges and dentures 80% 80% 80% Major Services Crown Repair - to individual crowns 50% 50% 50% Endodontic Services - root canals 50% 50% 50% Periodontic Services - to treat gum disease 50% 50% 50% Other Oral Surgery - dental surgery 50% 50% 50% Major Restorative Services - crowns 50% 50% 50% Relines and Rebase - to dentures 50% 50% 50% Implant Repair - implant maintenance, repair, and removal 50% 50% 50% Prosthodontic Services - bridges, implants, and dentures 50% 50% 50% * When services are received from a Premier or Nonparticipating Dentist, the percentages in this column indicate the portion of Delta Dental's PPO Dentist Schedule (or the Nonparticipating Dentist Fee) that will be paid for those services. This amount may be less than what the dentist charges or Delta Dental approves and you are responsible for that difference. Maximum Payment – $1,000 per person total per Benefit Year on all services. Deductible – $50 Deductible per person total per Benefit Year limited to a maximum Deductible of $150 per family per Benefit Year. The Deductible does not apply to oral exams, prophylaxes (cleanings), fluoride, X-rays, periodontal maintenance, and full mouth debridement. Rates Employee Only $23.50 Employee + Spouse $47.07 Employee + Child(ren) $53.58 Employee + Family $84.96 Note - This document is only intended to provide a brief description of your benefits. Please refer to your Certificate and summary for a complete description of benefits, exclusions, and limitations. Welcome to Tennessee's largest dental benefits family! As a member of Delta Dental of Tennessee, you have access to the nation's largest dental networks: Delta Dental PPO and Delta Dental Premier. It's easy to find a dentist! Four out of five dentists nationwide participate in our network. You have superior access to care and fee savings because of our agreements with participating dentists. Our dentists cannot balance bill you, which means more money in your pocket! No troublesome paperwork! Network dentists will fill out and file your claims. Pay only your copayments and/or deductibles when you receive care from PPO dentists -- there are no hidden fees. Because payment is based on the PPO Dentist Schedule, you may have to pay more for services from our Premier Dentists (up to our Maximum Approved Fee). You can still visit nonparticipating dentists, but you may be billed the full amount at the time of service and then have to wait to be reimbursed. Quality Dental Program With our quick and accurate claims processing, we pay more than 90% of claims in 10 days or less. Delta Dental also offers world-class customer service from our dedicated call center. Online Access Our online Consumer Toolkit lets you access your dental plan securely over the Internet. You can find a dentist, check benefits, select paperless notices, review claims and amounts used toward maximums, print ID cards, and more -- all at your own convenience. A Healthy Smile Keep your smile healthy with dental benefits from Delta Dental. Your smile is a good indicator of your health. Did you know that your dentist can detect up to 120 different diseases, including diabetes and heart disease? Early detection is one of the best ways to prevent further complications. Questions? If you have questions, please call our Customer Service team at (800) 223-3104 or look online at www.DeltaDentalTN.com. INVO PEO - PEO #6085 PPO Network
Transcript of Delta Dental of Tennessee - Constant Contactfiles.constantcontact.com › dd5d7555401 ›...
Delta Dental of Tennessee Dental Benefit Highlights for
July 20, 2015 6085-00001, 12511, 31351, etc
Delta Dental PPO (Standard) Coverage effective June 1, 2015
Delta Dental PPO Dentist
Delta Dental Premier Dentist
Non-participating
Dentist Plan Pays Plan Pays* Plan Pays*
Diagnostic & Preventive Diagnostic and Preventive Services - exams, cleanings, fluoride, and space maintainers
100% 100% 100%
Brush Biopsy - to detect oral cancer 100% 100% 100% Radiographs - X-rays 100% 100% 100% Periodontal Maintenance - cleanings following periodontal therapy
100% 100% 100%
Basic Services Emergency Palliative Treatment - to temporarily relieve pain
80% 80% 80%
Sealants - to prevent decay of permanent teeth 80% 80% 80% Minor Restorative Services - fillings 80% 80% 80% Simple Extractions - non-surgical removal of teeth
80% 80% 80%
Other Basic Services - misc. services 80% 80% 80% Adjustments and Repairs - to bridges and dentures
80% 80% 80%
Major Services Crown Repair - to individual crowns 50% 50% 50% Endodontic Services - root canals 50% 50% 50% Periodontic Services - to treat gum disease 50% 50% 50% Other Oral Surgery - dental surgery 50% 50% 50% Major Restorative Services - crowns 50% 50% 50% Relines and Rebase - to dentures 50% 50% 50% Implant Repair - implant maintenance, repair, and removal
50% 50% 50%
Prosthodontic Services - bridges, implants, and dentures
50% 50% 50%
* When services are received from a Premier or Nonparticipating Dentist, the percentages in this column indicate the portion of Delta Dental's PPO Dentist Schedule (or the Nonparticipating Dentist Fee) that will be paid for those services. This amount may be less than what the dentist charges or Delta Dental approves and you are responsible for that difference. Maximum Payment – $1,000 per person total per Benefit Year on all services. Deductible – $50 Deductible per person total per Benefit Year limited to a maximum Deductible of $150 per family per Benefit Year. The Deductible does not apply to oral exams, prophylaxes (cleanings), fluoride, X-rays, periodontal maintenance, and full mouth debridement. Rates Employee Only $23.50 Employee + Spouse $47.07 Employee + Child(ren) $53.58 Employee + Family $84.96 Note - This document is only intended to provide a brief description of your benefits. Please refer to your Certificate and summary for a complete description of benefits, exclusions, and limitations.
Welcome to Tennessee's largest dental benefits family!
As a member of Delta Dental of Tennessee, you have access to the nation's largest dental networks: Delta Dental PPO and Delta Dental Premier.
It's easy to find a dentist! Four out of five dentists nationwide participate in our network.
You have superior access to care and fee savings because of our agreements with participating dentists.
Our dentists cannot balance bill you, which means more money in your pocket!
No troublesome paperwork! Network dentists will fill out and file your claims.
Pay only your copayments and/or deductibles when you receive care from PPO dentists -- there are no hidden fees.
Because payment is based on the PPO Dentist Schedule, you may have to pay more for services from our Premier Dentists (up to our Maximum Approved Fee).
You can still visit nonparticipating dentists, but you may be billed the full amount at the time of service and then have to wait to be reimbursed.
Quality Dental Program
With our quick and accurate claims processing, we pay more than 90% of claims in 10 days or less. Delta Dental also offers world-class customer service from our dedicated call center.
Online Access
Our online Consumer Toolkit lets you access your dental plan securely over the Internet. You can find a dentist, check benefits, select paperless notices, review claims and amounts used toward maximums, print ID cards, and more -- all at your own convenience.
A Healthy Smile
Keep your smile healthy with dental benefits from Delta Dental. Your smile is a good indicator of your health. Did you know that your dentist can detect up to 120 different diseases, including diabetes and heart disease? Early detection is one of the best ways to prevent further complications.
Questions?
If you have questions, please call our Customer Service team at (800) 223-3104 or look online at www.DeltaDentalTN.com.
INVO PEO - PEO #6085 PPO Network
The Delta Dental Mobile App is available for Apple
iOS or Android users. Visit the App Store (Apple) or
Google Play (Android) and search for ‘Delta Dental.’
Or, scan this QR code to download the app.^
Your Delta Dental benefits, at your fingertips The new Delta Dental Mobile App helps you get the most out of your dental benefits anytime, anywhere. Use the dentist search or toothbrush timer without logging in, or enter your username and password* to securely access your personal benefit information.
» Dentist SearchFind a dentist in your plan/network, narrow the list with criteria like ‘language spoken’ and ‘specialty’, and even find a dentist nearby using your current location. After you pick a dentist you can save the contact information and get directions.
» Mobile ID CardNo more paper! Provide your dentist with the information he or she needs by accessing your ID card right on your phone.
» View Coverage & Review ClaimsSee your plan type, benefit levels, deductibles, maximums, and more. Check the status of recent dental claims for you and your dependents. To keep this information secure, you’ll have to log in each time. No personal information is ever stored in the app.
» Toothbrush TimerMake sure you brush for the recommended two minutes with this handy timer that can use a song from your phone or a pre-loaded tune to keep you going.
To register, go to
www.DeltaDental.com
Scan QR code to download or visit:
http://delivr.com/2c9vx_qr
* To register, go to www.DeltaDental.com and sign up for an account that will also work in the mobile app.
^ To scan the code, you must have a QR code reader on your smartphone.
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Dental made simple :)Delta Dental of Tennessee
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