General Information
Additional Information about Oral Health.
American Dental Association
Delta Dental Plans Association
Participating Dentists' Network
You'll get the best value from your program when you receive your dental care from one of Northeast Delta Dental's Participating Dentists:
No Balance Billing: Because participating dentists accept Delta Dental's approved amount for service, you may have lower, out of pocket expenses when you visit a participating dentist.
Less Paperwork: Participating dentists will prepare and submit claims for you.
Direct payment: Northeast Delta Dental pays the dentist directly, so you don't have to pay the covered amount up-front and wait for a reimbursement check.
To find out if your dentist is part of the Northeast Delta Dental network, call your dentist or visit our web site at www.nedelta.com. You can also call our Customer Service Department at 800-832-5700 or 603-223-1234.
Claim Submission Process for Participating Dentists
Present your ID card to the dentist at the time of your visit.
The dentist will submit your claim to Northeast Delta Dental.
Northeast Delta Dental will send you a EOB (Explanation of Benefits) detailing what has been processed under your programs coverage. You are responsible to pay any remaining balance directly to the dentist.
Claim Submission Process for Non-Participating Dentists
If you visit a Non–Participating Dentist within the Northeast Delta Dental operating area of Maine, New Hampshire, and Vermont, you may be requested to bring a claim form that is available by calling Northeast Delta Dental or that may be downloaded from www.nedelta.com. Unless otherwise required by State law, payment for services rendered will be made directly to you and will be limited to the lesser of the Dentist's actual submitted charge or the company's allowance for Non–Participating Dentists located in the tri–state region. It will be your responsibility to make full payment to your Dentist.
For Dentists Outside of Maine, New Hampshire and Vermont
If you visit a Dentist outside the operating area of Northeast Delta Dental, you may be required to bring a claim form that is available by calling us or may be downloaded from www.nedelta.com. For benefits provided to a Subscriber or Eligible Dependent by a Dentist outside the Northeast Delta Dental geographic area, benefits will be paid directly to the Dentist if the Dentist is a Participating Dentist with the local Delta Dental member company. If the Dentist does not participate with the local Delta Dental member company, payment will be made to the Subscriber unless the state in which the services are rendered requires that assignment of benefits be honored and Northeast Delta Dental receives written notice of an assignment on the claim form before payment for benefits is made. Payment for treatment by a Non–Participating Dentist will be limited to the lesser of the actually submitted charge or an amount equal to a selected percentile of a nationally recognized database of dental charges for the geographic area in which the services were provided. When there is not sufficient fee information available for a specific dental procedure, Northeast Delta Dental will determine appropriate payment amount.
Predetermination of Benefits
Northeast Delta Dental strongly encourages predetermination of cases involving costly or extensive treatment plans. Although its not required, predetermination helps avoid any potential confusion regarding Delta Dentals payment and your financial obligation to the dentist.
Coordination of Benefits
When a covered individual under this program has additional group dental coverage, the COB (Coordination of Benefits) provision described in your Dental Plan Description booklet will determine the sequence and extent of payment. If you have any questions about COB, please contact our Customer Service department at 800-832-5700 or 603-223-1234.
Identification Card
Two identification cards from Delta Dental will be produced and distributed shortly after your enrollment. Both cards are issued in the subscriber's name, but can be used by everyone covered under the program.
Dental Plan Description Booklet/Outline of Benefits
You will receive a Dental Plan Description booklet containing an Outline of Benefits shortly after your enrollment. This booklet describes the benefits of your program and tells you how to use your plan. Please read it carefully to understand the benefits and provisions of your Northeast Delta Dental program.
Guarantee Of Service ExcellenceSM Program
Northeast Delta Dental is committed to providing extraordinary service to all of its customers. We believe that when our people are inspired to pursue excellence in order to achieve a higher level of customer satisfaction, all of those who share in Northeast Delta Dental will benefit. To emphasize our commitment, we guarantee seven major areas of service to our clients and reinforce them by our comprehensive group refund policy.
Claims Inquiry
If you have further questions, please contact Northeast Delta Dental's Customer Service department at 800-832-5700 or 603-223-1234.