Delta Dental Predetermination of Benefits | What Is It and How Does It Work?

What is a Dental Predetermination of Benefits?
Before you agree to treatment, request a Delta Dental predetermination of benefits. Asking for this before you undergo a procedure gives you the power to know the costs before you commit.
Upon receiving your request, your dentist will submit their recommended treatment plan to Delta Dental. Your X-rays may come along for extra information. No need to worry about finding a dental estimate form, either – just ask, and your dental office will submit your information on your behalf.
Once Delta Dental has this information, we will review the documents, the recommended procedures, and your benefits plan.
The Predetermination of how your benefits will be applied to the suggested dental service will then be sent to both you and your dentist office.
When Would I Use A Predetermination of Benefits?
We encourage you to request a predetermination of benefits prior to the start of extensive dental work, especially if your treatment needs could exceed $400. Remember to discuss with your dentist what will happen versus what could happen so your expectations are clear. A Delta Dental predetermination of benefits is most often requested for costly procedures such as crowns, wisdom tooth extractions, bridges, implants, dentures, and oral surgery.
If Benefits Change, Your Predetermination of Benefits Will, Too
The predetermination of benefits that we provide is just an estimate. It is not a guarantee, but rather our best estimation of the costs for which you will be responsible. If your benefits change before the treatment is completed (or starts), the estimate won’t be accurate. The following actions will also render a predetermination of benefits inaccurate:
- Loss of coverage
- Changes in your dentist’s participation with us
- Benefits provided by other medical or dental plans
- Changes to dental codes or treatment made
- Changes in appointment location
- Changes to your dental provider
Don’t forget, if you’re a Delta Dental of Wisconsin member, you can log in to your account to get specific details related to your plan. If you have questions about your pre-treatment estimate, feel free to contact us.
Related stories
-
8 Ways to Drink 8 Glasses of Water
Water is essential. It comprises 70% of the Earth’s surface, and without it, we wouldn’t exist. Every … Read More
-
How Your Practice Can Avoid Non-Intentional Dental Fraud
Fraud not only drives up the cost of dental coverage for your patients, it can directly affect … Read More
-
5 Things That Yellow Teeth
Yellow is usually considered a happy color – sunshine, buttercups, and daffodils are guaranteed to put smiles … Read More
Sign Up Now
Tweets
Most Liked
- 1 Do Expiration Dates on Dental Products Matter? 302 Likes
- 2 Is Activated Charcoal Safe for your Smile? 166 Likes
- 3 Crazy and Cool Fish Teeth Facts 91 Likes
- 4 Delta Dental Protects Your Eyes with DeltaVision® Coverage 69 Likes
- 5 Recipe: Quick Pumpkin Pudding 48 Likes
- 6 The In-between Tooth: Guide to Bicuspids 48 Likes
- 7 Bad Taste After Brushing? Common Explanations 44 Likes
- 8 Own Your Oral Health: Subscribe now for tips to ensure a bright smile 37 Likes
- 9 How COVID-19 Impacts Oral Health 34 Likes
- 10 People with Dental Benefits are Healthier 32 Likes