DENTAL FEE SCHEDULE Effective 01/01/2020 Print Date: 05/05/2020 Current Dental Terminology (including procedure codes, nomenclature, descriptors and other data contained therein) Pricing does not include cutbacks, assessment fees, etc. The Deductible does not apply to diagnostic and preventive services, emergency palliative treatment, brush biopsy, X-rays, and sealants. Nothing on this website guarantees eligibility, coverage, or payment, or determines or guarantees the benefits, limitations or exclusions of your coverage. The Dental Care Cost Estimator provides an estimate and does not guarantee the exact fees for dental procedures, what dental benefits your plan will cover, or your out-of-pocket costs. Have a question about coverage or looking for dental insurance? Sign in to get a more accurate range that includes in-network savings. Information regarding the Cost Estimator content. Connect with your Delta Dental to learn more. See schedule o for continuationfor close to six decades, Delta Dental of Kentucky has helped promote healthy smiles for our members by designing and administering innovative, cost-effective Dental benefit programs. Fee-For-Service: A dental plan under which a dentist is paid for each covered service rendered to an eligible enrollee. Our Dental Care Cost Estimator tool provides estimated cost ranges for common dental care needs. Providers m… Connect with your Delta Dental to learn more. Visiting a Delta Dental dentist provides network savings that result in lower out-of-pocket costs. Through our charitable giving programs, Delta Dental of Kentucky is committed to improving the quality of life for of all Kentuckians. The data is based on actual, non-discounted charges that providers have billed. The description of different treatment categories, and the inclusion of particular services in a treatment category, is not advice that any particular treatment category is the right treatment for you or that you should not obtain any particular treatment. Dentists must meet the coverage provisions and requirements of 907 KAR 1:026to provide covered services. The national network of Delta Dental companies protects more smiles than any other insurance company. Refer to your benefit plan to determine whether preventive services are covered for you. For DeltaCare® USA, maximum contract allowances are not applicable. Delta Dental PPO (Standard) Summary of Dental Plan Benefits . Benefit Year – Policy Year. Plan Pays Plan Pays Plan Pays : Waiting Period Type I - Diagnostic & Preventive Services Oral Exams and Cleanings 80% 80% 80% NONE . Delta Dental Premier Provider *Non-Participating Provider : Covered Services . Sample Schedule of Fees. If you're a Non-profit located in Kentucky, you may apply for a grant from the Delta Dental of Kentucky Foundation. Example: If the dentist submits a fee on a claim for $120, ... Delta Dental reviews allowances on an ongoing basis. Almost every person has experienced toothache in his life. Use of this website in no way increases or decreases the benefits available under a dental benefit plan. These updates are required to be filed first for approval by state regulatory agencies in many locales. delta dental fee schedule – this topic people are often interested in, because there are important reasons for this. In 2015, an additional charitable program, Making Smiles Happen, was established to further our not-for-profit mission. All Rights Reserved. The Content on this website is not medical advice. Confidential Filed Fee Schedule (Updated to include CDT 2015 code terminology) Statement of Intent: I agree that each fee submitted to Delta Dental on a claim for dental services I provide to any Delta Dental patient will be these pre-filed fees or the fees actually charged and accepted as payment in full, whichever is less, consistent with the rules and regulations of Delta Dental. Cost estimates are specific to geographic areas, as defined by the first three digits of a ZIP code (e.g., the geo ZIP for 12345 is 123). Cost estimates for services provided by out-of-network dentists (available in the out-of-network estimator) are based upon submitted claims data for out-of-network providers. 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. 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. Once the deductible has been met, the plan participant has a maximum annual dental benefit of $2,500 for all dental services. Have a question about coverage or looking for dental insurance? General information regarding your health care. Health information changes quickly. Delta Dental PPO. Benefit Year: January 1 through December 31 . We now offer exclusive dental options from Delta Dental of Kentucky as well as vision options from DeltaVision in partnership with VSP. AvMed has teamed up with Delta Dental to offer your dental health plan, a plan with extensive coverage and set costs for continued happiness and big smiles. Delta Dental of Kentucky insures nearly 800,000 smiles in the commonwealth of Kentucky through group and individual plans. For more detailed information on your dental care costs, please consult your dentist or your Delta Dental. Delta Dental PPO (Standard) Summary of Dental Plan Benefits . Prophylaxes (cleanings) are payable twice per calendar year. We update them regularly, usually every 6 to 24 months. MHCP Fee Schedule (MHCP Fee Schedule (dental codes begin on page 55 of the PDF) Fraud, Waste, and Abuse: Combating Medicare Parts C and D Fraud, Waste and Abuse Training Web Based Training Course 2020; Fraud, Waste and Abuse Attestation; Fraud, Waste and Abuse Training Log . Refer to your benefit plan to determine whether these requirements apply to you. Benefit Year: January 1. st. through December 31. st. Delta Dental has the largest network of dentists nationwide. Customer service representatives will be available by phone from 8am – 6pm EST, Monday through Friday and automated services will continue to be available 24/7. Contact your company's human resources department. "Delta Dental" refers to the national network of 39 independent Delta Dental companies that provide dental insurance. Let us help more patients find their way to your office. Save or instantly send your ready documents. See schedule o for continuationproviding value to our customersdelta dental is dedicated to members receiving quality dentistry, while also saving groups and members money. The national network of Delta Dental companies protects more smiles than any other insurance company. Our dentist credentialing, cost management policies and fee reduction agreements with dentists help our members receive the best dental outcomes. You should always talk to your health care professionals for information concerning diagnosis and treatment, including information regarding which drugs or treatment may be appropriate for you. Preventive services are included in this tool. Connect with your Delta Dental to learn more. The maximum annual dental benefit for all dental services is $2,000 if an out-of-network provider is utilized. Connect with your Delta Dental company to learn more. Delta Dental's Online Services ; Protect Your Practice from Fraud; Electronic transactions; Running a paperless office; Update your information; Your Tax Identification Number (TIN, EIN or SSN) Medicare Fraud Waste and Abuse Attestation; Webinars and Events; Resources, Tips, Suggestions. DeltaVision utilizes the VSP Choice Network with over 100,000 access points available. For more detailed information on your actual dental care costs, please consult your dentist or your Delta Dental. In order to solve this problem, he always turned to the dentist. Please scroll down and accept to proceed. For more detailed information on your actual dental care costs, please consult your dentist or your Delta Dental. How to use your Dental Medicare Advantage Plan - Choice of Network Dentist . Delta Dental of Kentucky . Find the one that’s right for you. Code Procedure Description Fee; 0120 Oral Evaluation $33; 0274. Therefore, it is always best to confirm information with your health care professionals. If you live outside the U.S., you may see information on this cost estimator about products or services that are not available or authorized in your country. The information provided on this site is for general education purposes only and is not intended as a diagnosis, treatment, or a substitute for professional medical or dental advice, diagnosis, or treatment. Want to know before you set foot in the dentist’s office? Whether you regularly receive your 2 cleanings or have an unexpected dental emergency, investing in a plan with Delta Dental will always save you money. Preventive care coverage varies by plan and by demographic considerations such as age. Show fee discounts on claims; Filing fees for multiple offices; Working with Delta Dental. A Delta Dental Medicare Advantage TM member will be handled the same as any other patient in your practice who has a Delta Dental PPO or Delta Dental Premier plan, and claims will be processed the same as well. No dentist found that matches your criteria, I receive dental insurance through my employer, Please enter a treatment type and/or valid 5-digit ZIP code. Estimates should not be construed as financial or medical advice. Control Plan - Delta Dental of Colorado . Shop Delta Dental of Kentucky's Dental & Vision plans. None of the information on this website represents or warrants that any particular drug or treatment is safe, appropriate or effective for you. For more detailed information on your actual dental care costs, please consult your dentist or your Delta Dental. PPO Provider . For information on becoming a network dentist, enter the state where you practice. Dental coverage for children includes oral exams, emergency visits, x-rays, extractions, and fillings. Payment is not guaranteed. Find a dentist who participates in DeltaCare, our HMO-type program. Listing of a service in an administrative regulation is not a guarantee of payment. When you visit a New Mexico dentist who participates in Delta Dental Patient Direct, you can receive discounts on hundreds of common dental procedures. DeltaVision, a partnership between Delta Dental of Kentucky and VSP Vision Services, provides a comprehensive vision benefit plan to individuals and families. 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. Delta Dental has important information for our members about COVID-19, including what to expect at your next dentist appointment. Delta Dental of Kentucky now offers affordable vision plans that will save you money. DeltaVision utilizes the VSP Choice Network with over 100,000 access points available. You may be responsible for the cost of procedures or services not covered by your plan. Any services performed must fall within the scope of practice for the provider. The version of the Cost Estimator that is available publicly (does not require sign-in credentials) uses aggregated historical cost data for the procedure in question. The national network of Delta Dental companies protects more smiles than any other insurance company. Good oral health is a vital part of good general health, and your Delta Dental program is designed to promote regular dental visits. If you are experiencing a medical or dental emergency, you should seek appropriate emergency medical or dental assistance, such as calling "911." The maximum orthodontia benefit is $1,500 if an out-of-networ… *Not sure where your company is headquartered? How much is it going to cost? Code Code Status PA Description Min Age Max Age Begin Date End Date Max Units Fee D0350 Fee on File 2D … By clicking, you agree that you have read the information below, are accessing this information for purposes of determining treatment cost estimates for dental care services you are considering receiving, and will not use the information in this tool for a commercial or anti-competitive purpose. Please input information for either ZIP code or address but not both, Please enable your browser to allow this site to use your location. © Copyright 2020 Delta Dental Plans Association. *Not sure where your company is headquartered? Our Dental Office Toolkit provides fast online claims processing and easy access to information. This amount may be less than what the Dentist charges or Delta Dental approves and you are responsible for that difference. DeltaVision, a partnership between Delta Dental of Kentucky and VSP Vision Services, provides a comprehensive vision benefit plan to individuals and families. Estimates should not be construed as financial or medical advice. Language Assistance: لعربیة | Ikirundi | 繁體中文 | Français | Deutsch | 日本語 | 한국어 | नेपाली | Oroomiffa | Deitsch | Русский | Srpsko-hrvatski | Español | Tagalog | Tiếng Việt, I receive dental insurance through my employer. Consult your dentist or physician for information or treatment specific to you and your health. Copyright © 2011–2019 Delta Dental of Kentucky. Easily fill out PDF blank, edit, and sign them. Access your benefits online; anytime, anywhere. The costs provided in this tool are estimates only and are not a guarantee of payment or benefits. Delta Dental of Kentucky offers four dental plan options for individuals and families. *Not sure where your company is headquartered? There is also no balance billing when utilizing a PPO dentist. Group Name: Kentucky Conference of the United Methodist Church . Delta Dental of Kentucky Delta Dental PPO plus Premier Summary of Dental Plan Benefits Group Name: ... * When you receive services from a Nonparticipating Dentist, the percentages in this column indicate the portion of Delta Dental's Nonparticipating Dentist Fee that will be paid for those services. The cost estimates provided may be different from your actual costs for several reasons, including but not limited to, your unique dental circumstances and the decisions made by you and your dental professionals as to what services you will receive, deviations between the anticipated scope of services and the services actually provided, and the characteristics of your particular plan. Have a question about coverage? Please contact the Delta Dental company below for more information. Delta Dental PPO in-network providers offer services at a lower negotiated fee schedule, resulting in lower member copays. Please input information for either ZIP code or address but not both, Please enable your browser to allow this site to use your location. Members are responsible for all charges over the scheduled amount and/or the annual maximum benefit. 2021 Client Relations Billing Schedule: Billing Month: Friday - Cutoff Date: December 2020: November 13, 2020: January 2021: December 11, 2020: February 2021 Our plans have the benefits you and your family need at an affordable price. The Delta Dental of Kentucky Foundation was created in 2004 to support projects and nonprofit organizations in Kentucky. Through our national network of Delta Dental companies, we offer dental coverage in all 50 states, Puerto Rico and other U.S. territories. If you are shopping for individual dental insurance, have individual dental insurance or have general questions, enter the state you live in. Want to know before you set foot in the dentist’s office? Estimates may vary depending on your benefit plan and the state you live in. Confidential Filed Fee Schedule (Updated to include CDT 2018 code terminology) Statement of Intent: I agree that each fee submitted to Delta Dental on a claim for dental services I provide to any Delta Dental patient will be these pre-filed fees or the fees actually charged and accepted as payment in full, whichever is less, consistent with the rules and regulations of Delta Dental. This plan pays benefits based on Delta Dental PPO network fees. It shows procedures, date(s) of service, processing policies, Delta Dental's payment and the amount (if any) that the enrollee owes to the dental provider. Here are the benefits of creating an account. General information regarding your dental benefits, General information regarding cost estimates, More information regarding how cost estimates are calculated. Contact your company's human resources department. Contact your company's human resources department. To begin using the Dental Care Cost Estimator tool, click the Agree button below. Access your insurance and the tools to help you use it anytime, anywhere with the Delta Dental mobile app. delta dental of kentucky insures nearly 800,000 smiles in the commonwealth of kentucky through group and individual plans. Find the one that’s right for you. Schedule of Benefits. Group Number: 148230-2001, 2299 . Delta Dental Patient Direct is a discount dental plan designed to help New Mexicans without dental benefits obtain more-affordable dental care services. There is no separate fee schedule for Medicare Advantage plans, as payment is based on the program in which the dentist is participating. We encourage you to take advantage of this program by calling your Dentist today for an appointment. Oral exams (including evaluations by a specialist) are payable twice per calendar year. Delta Dental of Kentucky . Group Name: ST CLAIRE HEALTHCARE . Enter the location where your company is headquartered or the state where your company's insurance-buying decisions are made. Pre-authorizations or referrals are required for certain benefit plans and certain dental care providers. Therefore, the services of a dentist are a necessary and even inevitable thing in our life. How much is it going to cost? It offers online invoice fee facility to all its users and provides several other how one can pay bills. Claims will be processed when received according to your plan provisions. See Delta Dental Premier. This website shows estimates of certain dental care costs. The maximum lifetime benefit for child orthodontia is $2,000 and is subject to course of treatment limitations. 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