FAQs

How do I register for an online account?

If you already have an online provider account with your Delta Dental member company, you can use your log in credentials to sign in here.

If you don’t already have an online provider account, you will need to register through your local Delta Dental.

Once you set up your online provider account, you can return to DeltaDentalCoversMe.com to access information on Individual & Family plan members.

Download instructions for accessing your online account and viewing member plan information

How do I manage my account information?

Contact your local Delta Dental to make changes to your account information.

Find your Delta Dental member company

Where can I access a patient's benefits?

You have two options to access patient benefits:

1. The new provider portal has a robust view of patient benefits.
• Search for a patient by name and date of birth or Subscriber ID.
• Further narrow down benefits by searching against specific procedure codes.
• Search treatment history for a tooth number, arch or quadrant (when available).
• Sign in to the provider portal to access these tools.
2. IVR FaxBack will remain available for offices who want to receive benefit information.

Delta Dental PPO or Delta Dental Premier providers may submit a claim directly to Delta Dental on behalf of a patient.

To submit a claim, fill out the Dental Plan Claim Form and attach an Attending Dentist Statement.

• Mail the form directly to:
  Delta Dental
  PO Box 103
  Stevens Point, WI 54481-0103
  Electronic Claims Payer ID: WDENC

What could cause an error when submitting claims?

Please refer to the error code received when submitting the claim electronically. Some of the most common reasons for claim rejection include:

“Invalid Subscriber” means the policy was not found with the information provided.

• Make sure claim is submitted to the correct insurance company. Claims for the individually purchased plans we service go to the address listed above.
• Make sure claim has the valid 11-digit subscriber ID number for the dental plan (not a Social Security number).
• Make sure subscriber and patient information (first name, last name, date of birth) match the way they appear in Provider Portal when accessing patient benefits or on the IVR FaxBack

“Provider Match Not Found” means the provider information doesn’t match what is listed with your local Delta Dental in the dentist directory.

• Make sure treating dentist name is listed in first name, last name format (not “signature on file”)
• Make sure the doctor’s valid NPI1 and Tax ID are listed on the claim.
• Make sure billing and treating address are listed on the claim the same way they appear in the Delta Dental dentist directory.

“Invalid Procedure” or “Too Many Teeth” means something with the procedures listed on the claim can’t be validated.

• Make sure each procedure code listed is a valid CDT Code for the date of service. The CDT Code manual is updated each year. Outdated/invalid codes cannot be processed.
• Make sure each procedure has a submitted fee. $0 claims cannot be processed.
• If a claim has orthodontic treatment (D7282, D7283, D8080, D8703, etc.) make sure to complete the section of claim asking “Is Treatment For Orthodontics” as yes with required information.
• Make sure tooth numbers are included only for procedure codes that are tooth specific (e.g., fillings are tooth specific and should include both the tooth number and surfaces, denture codes are specific to the arch so no tooth numbers should be listed).

What results will the procedure code lookup tool return?

The tool will show benefit information for the selected member as of the date the tool is used. To see benefits for other members on the policy click "Return to Search", click "Submit", and select the desired member from the list given. 

Why did I receive an error that says "The procedure code is invalid" after entering a valid procedure code?

Please check to see if this member is enrolled in one of our fixed patient copay plans (e.g. the Clear Plan). These plans are currently not supported by our procedure code lookup tool. We plan to expand functionality to include these types of plans in the future.