How Are Dental Claims Handled?

If you visit a Delta Dental network dentist, you won’t have to submit any paperwork – your dentist will submit a claim directly to Delta Dental of Wisconsin on your behalf after your dental appointment.

On the other hand, if you visit an out-of-network dentist, you may have to submit your own dental claim to us. In this case, you can download a claim form and find more information about how to submit a claim by logging into your account on our Member Connection. If you don’t have an account, you can also register for one. Usually, claims can be emailed, faxed, mailed, and in some cases, submitted online.

After your claim is received, we will review the paperwork to verify if:

• you are eligible for coverage;
• the services you received are covered by your dental plan;
• your dentist is in-network or out-of-network; and
• all necessary documentation is included to process the claim (e.g., X-rays).

Once the claim is reviewed, we will notify you or your dentist if further information is needed. If not, claims are typically processed within five business days, depending on your specific plan. After the claim is processed, we will pay in-network dentists directly. If you submitted the claim, you will be reimbursed and will pay your dentist.

You can check the status of a claim and find information about past claims for up to 18 months by logging into your member account.

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