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Your Benefits - Three Options All of the benefits provided under the Basic Plus option plus the availability to use ANY de...
Delta  Networks   Basic and Basic Plus members use the PPO network exclusively while Flex Option members can choose Premie...
Delta Dental PPO Network <ul><li>No balance billing </li></ul><ul><li>Dentist submits claim paperwork </li></ul><ul><li>Mi...
Your Benefits – Basic Option $750 Annual Maximum Not covered Orthodontics Not covered Major Services  such as bridges, den...
Your Benefits – Basic Plus Option $1000 Annual Maximum 50% $1000 lifetime maximum Orthodontics for Children (under age 19)...
Your Benefits – Basic & Basic Plus Options $750 Not covered Not covered 70% 100% $25 per person $75 per family Delta Denta...
Your Benefits – Flex Option $1000 50%; $1000  lifetime maximum 60% 90% 100% $50 per person $150 per family Delta Dental PP...
<ul><li>Claims finalized in 3.3 days (average) </li></ul><ul><li>99.9% accuracy </li></ul>Outstanding Speed and Accuracy
<ul><li>Example: a  Delta Dental PPO   dentist installs a two surface amalgam filling on a patient. Patient has 70% covera...
<ul><li>Example: a  Delta Dental PPO   dentist installs a two surface amalgam filling on a patient. Patient has 90% covera...
<ul><li>Example: a  Delta Dental Premier   dentist installs a two surface amalgam filling on a patient. Patient has 80% co...
<ul><li>Example: a  nonparticipating   dentist installs a two surface amalgam filling on a patient. Patient has 80% covera...
$6.50 $58.50 $65.00 $136.00 Delta PPO (Flex Option) $16.00 $136.00 $136.00 Submitted  Amount $33.60 $102.40 $128.00 Out of...
<ul><li>99.8% - solutions on first call </li></ul><ul><li>Over 98% of customers satisfied with service </li></ul><ul><li>A...
<ul><li>24/7 access to benefit and claims information: </li></ul><ul><ul><li>Benefit24 online at   www.deltadentalmo.com <...
<ul><li>For members and dentists: </li></ul><ul><ul><li>Participating dentists </li></ul></ul><ul><ul><li>Claims status an...
Find a Dentist . . .
$40.72 $52.98 $84.24 Family $22.76 $31.15 $49.21 Employee + 1 $11.63 $16.41 $25.14 Employee Rates: Not Covered $1000 Child...
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Your Benefits - Three Options All of the benefits provided ...

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  • Delta’s national networks are comprised of a dual level of protection for our partners. The DeltaPreferred Network is a preferred provider panel which provides deep discounts in exchange for plan steerage. In addition, outside the preferred panel, DeltaPremier provides savings on a second level which encompasses over 70% of practicing dentists nationally. Approximately 30% of practicing providers would be out of either network.
  • Amazing customer service
  • Employees/members have access to benefit and claims information 24 hours a day.
  • Our web site is constantly being upgraded in response to input from members, administrators and our employees.
  • Transcript of "Your Benefits - Three Options All of the benefits provided ..."

    1. 2. Your Benefits - Three Options All of the benefits provided under the Basic Plus option plus the availability to use ANY dentist. The Flex Option also includes a higher level of benefits on many services and adult orthodontic benefits. All of the benefits provided under the Basic Option plus major services including bridges, dentures, crowns, periodontics, endodontics and orthodontics for children (up to age 19 only). Preventive and basic care including cleanings, x-rays, fluoride treatments, sealants, fillings and extractions. What services are covered? Delta Dental PPO Dentists or any other dentist you choose Delta Dental PPO Dentists Delta Dental PPO Dentists Who provides services? Flex Basic Plus Basic
    2. 3. Delta Networks Basic and Basic Plus members use the PPO network exclusively while Flex Option members can choose Premier and non-participating dentists as well. <ul><li>Local PPO dental offices </li></ul>1700 Local Premier dental offices
    3. 4. Delta Dental PPO Network <ul><li>No balance billing </li></ul><ul><li>Dentist submits claim paperwork </li></ul><ul><li>Minimal out of pocket expenses </li></ul><ul><li>Over 600 general dentists to choose from in the St. Louis area </li></ul>
    4. 5. Your Benefits – Basic Option $750 Annual Maximum Not covered Orthodontics Not covered Major Services such as bridges, dentures, crowns, oral surgery, periodontics & endodontics 70% Basic Services including x-rays (bite-wings, full mouth and periapical), fillings (amalgam, synthetic porcelain and plastic), simple extractions and sealants. 100% Preventive Care including routine exams, cleanings, fluoride treatment, space maintainers and emergency treatment for pain. $25 per person $75 per family Calendar Year Deductible (does not apply to preventive care) Delta Dental PPO Network
    5. 6. Your Benefits – Basic Plus Option $1000 Annual Maximum 50% $1000 lifetime maximum Orthodontics for Children (under age 19) 35% Major Services such as bridges, dentures, crowns, oral surgery, periodontics & endodontics 70% Basic Services including x-rays (bite-wings, full mouth and periapical), fillings (amalgam, synthetic porcelain and plastic), simple extractions and sealants. 100% Preventive Care including routine exams, cleanings, fluoride treatment, space maintainers and emergency treatment for pain. $25 per person $75 per family Calendar Year Deductible (does not apply to preventive care) Delta Dental PPO Network
    6. 7. Your Benefits – Basic & Basic Plus Options $750 Not covered Not covered 70% 100% $25 per person $75 per family Delta Dental PPO Basic Option $1000 Annual Maximum 50% $1000 lifetime maximum Orthodontics for Children (under age 19) 35% Major Services such as bridges, dentures, crowns, oral surgery, periodontics & endodontics 70% Basic Services including x-rays (bite-wings, full mouth and periapical), fillings (amalgam, synthetic porcelain and plastic), simple extractions and sealants. 100% Preventive Care including routine exams, cleanings, fluoride treatment, space maintainers and emergency treatment for pain. $25 per person $75 per family Calendar Year Deductible (does not apply to preventive care) Delta Dental PPO Basic Plus Option Network
    7. 8. Your Benefits – Flex Option $1000 50%; $1000 lifetime maximum 60% 90% 100% $50 per person $150 per family Delta Dental PPO $1000 Annual Maximum 50%; $1000 lifetime maximum Orthodontics for Adults and Children 50% Major Services such as bridges, dentures, and crowns. 80% Basic Services including , fillings, sealants, simple and surgical extractions, oral surgery, periodontics and endodontics. 100% Preventive Care including routine exams, x-rays, cleanings, fluoride treatment, space maintainers and emergency treatment for pain. $50 per person $150 per family Calendar Year Deductible (does not apply to preventive care) Out of PPO network dentists (including Delta Premier dentists) Network
    8. 9. <ul><li>Claims finalized in 3.3 days (average) </li></ul><ul><li>99.9% accuracy </li></ul>Outstanding Speed and Accuracy
    9. 10. <ul><li>Example: a Delta Dental PPO dentist installs a two surface amalgam filling on a patient. Patient has 70% coverage for basic services. </li></ul>Delta Dental PPO Network – Basic Options Procedure code 2150 – two surface amalgam filling Submitted DPO scheduled Delta Dental pays Patient pays amount amount (70% of $65) (30% of $65) $136.00 $65.00 $45.50 $19.50 This calculation is for illustration purposes only, it does not reflect actual fees.
    10. 11. <ul><li>Example: a Delta Dental PPO dentist installs a two surface amalgam filling on a patient. Patient has 90% coverage for basic services. </li></ul>Delta Dental PPO Network – Flex Option Procedure code 2150 – two surface amalgam filling Submitted DPO scheduled Delta Dental pays Patient pays amount amount (90% of $65) (10% of $65) $136.00 $65.00 $58.50 $6.50 This calculation is for illustration purposes only, it does not reflect actual fees.
    11. 12. <ul><li>Example: a Delta Dental Premier dentist installs a two surface amalgam filling on a patient. Patient has 80% coverage for basic services. </li></ul>Delta Dental Premier Network – Flex Option Only Procedure code 2150 – two surface amalgam filling Submitted Approved Delta Dental pays Patient pays amount amount (80% of $125) (20% of $125) $136 $125 $100 $25 Members in Basic and Basic Plus Options have no benefits for Premier or non-participating providers. This calculation is for illustration purposes only, it does not reflect actual fees.
    12. 13. <ul><li>Example: a nonparticipating dentist installs a two surface amalgam filling on a patient. Patient has 80% coverage for basic services. </li></ul>Delta Dental Nonparticipating – Flex Option Only Procedure code 2150 – two surface amalgam filling Submitted Approved Delta Dental pays Patient pays amount amount (80% of $128) * $136 $128 $102.40 $33.60 * 20% of $128 ($25.60) - plus the difference between the approved amount and the dentist’s charges ($8) Members in Basic and Basic Plus Options have no benefits for Premier or non-participating providers. This calculation is for illustration purposes only, it does not reflect actual fees.
    13. 14. $6.50 $58.50 $65.00 $136.00 Delta PPO (Flex Option) $16.00 $136.00 $136.00 Submitted Amount $33.60 $102.40 $128.00 Out of Network (Flex Option Only) $25.00 $100.00 $125.00 Delta Premier (Flex Option Only) $19.50 $45.50 $65.00 Delta PPO (Basic Options) You Pay Delta Pays Approved Amount Filling
    14. 15. <ul><li>99.8% - solutions on first call </li></ul><ul><li>Over 98% of customers satisfied with service </li></ul><ul><li>Average speed of answer: 8 seconds </li></ul><ul><li>96% answered in 30 seconds </li></ul><ul><li>Abandon rate: 0.6% </li></ul><ul><li>Average 14 years experience </li></ul><ul><li>Minimal turnover </li></ul>Unrivaled Customer Service 1-800-335-8266
    15. 16. <ul><li>24/7 access to benefit and claims information: </li></ul><ul><ul><li>Benefit24 online at www.deltadentalmo.com </li></ul></ul><ul><ul><li>Benefit24 VRU </li></ul></ul><ul><ul><ul><li>Faxback – summary of benefits </li></ul></ul></ul>Ease and Convenience
    16. 17. <ul><li>For members and dentists: </li></ul><ul><ul><li>Participating dentists </li></ul></ul><ul><ul><li>Claims status and history </li></ul></ul><ul><ul><li>Copy of EOB </li></ul></ul><ul><ul><li>Benefit design </li></ul></ul><ul><ul><li>Track use of maximums </li></ul></ul><ul><ul><li>Print ID cards </li></ul></ul>State-of-the-art Web-based Service
    17. 18. Find a Dentist . . .
    18. 19. $40.72 $52.98 $84.24 Family $22.76 $31.15 $49.21 Employee + 1 $11.63 $16.41 $25.14 Employee Rates: Not Covered $1000 Child Only $1000 Adult & Child $1000 Adult & Child Lifetime Orthodontia Maximum $750 $1000 $1000 $1000 Annual Maximum Per Person $75 $75 $150 $150 Per Family $25 $25 $50 $50 Per Person B Services B & C Services B & C Services B & C Services Applies to: Deductible Not Covered 50% 50% 50% Type D: Orthodontics Not Covered 35% 50% 60% Type C: Major Restorative Services 70% 70% 80% 90% Type B: Basic Restorative Services 100% 100% 100% 100% Type A: Preventive Care Co-Insurance (Plan Pays) In Delta Dental PPO Network Only In Delta Dental PPO Network Only Out of PPO Network (Delta Premier Network or Non- participating providers) In PPO Network Network Considerations Delta Dental PPO (with no out of network benefit) Delta Dental PPO (with no out of network benefit) Delta Dental PPO Type of Plan OPTION 3 Basic Option OPTION 2 Basic Plus Option OPTION 1 Flex Option Benefits
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