Frequently Asked Questions

The following are commonly asked questions by our network dentists.

Yes, if you are an Arkansas dentist. In order for us to maintain accurate records, you are required to notify our Professional Relations Department, in writing, of any changes to your practice. Click here to view the available forms. 

Changes are not automatically made when claims are submitted. Failure to notify us of these changes may result in payment delays or payments being sent to the patient.

If you are a dentist outside of Arkansas, you should submit any of the above changes to your local Delta Dental member company.
Delta Dental of Arkansas does not send payments to non-participating dentists; a non-participating dentist would not receive the IRS Form 1099 from Delta Dental of Arkansas.
Yes, Delta Dental of Arkansas accepts electronic attachments through National Electronic Attachments (NEA) and Rdental.com. Please note that the attachment must be sent with an electronic claim. If you receive a "Request for Additional Information" from Delta Dental of Arkansas, you may submit an electronic attachment without a claim if you submit the claim number with the attachment. Please do not send an electronic attachment without the claim or claim number as we will not be able to match the attachment with the claim.
Yes, electronic claims can be filed on the Dental Office Toolkit at no cost. Simply click on “Dentists”from the main menu on the home page and select “Dental Office Toolkit” from the dropdown list. Register for an account if you do not already have one. Once you have an account, log in to the site and select “Patient Info/Enter Claims” on the left side of the screen and enter the patient's member identification number. Select “Add Claim” under “Member Information.”

Delta Dental of Arkansas also accepts claims through Envoy, CPS, and Healtheon/WebMD (formerly MedeAmerica). Our payer ID # for Delta Dental Premier, PPO and Delta Dental Smiles is CDAR1. Our payer ID # for Delta Dental Medicare Advantage is ARCMS. We accept electronic claims for payment, pre-determination, coordination of benefits, and orthodontia.

For more information, please contact the Delta Dental of Arkansas Professional Relations department at 501-992-1710. It would be our pleasure to provide you and/or your staff with training on submitting claims through our website. You may also contact your software vendor.
Non-participating dentists must collect their fee directly from the patient. Arkansas law and ERISA law do not require Delta Dental of Arkansas to honor assignment of benefits.

Delta Dental of Arkansas no longer requires dentists to update their filed fees. The Delta Dental of Arkansas participating dentists' maximum reimbursement, including deductibles, co-payments and/or co-insurance established by Delta Dental of Arkansas, for covered services rendered, shall be the Maximum Plan Allowance (MPA) as set by Delta Dental of Arkansas.

The Delta Dental of Arkansas Maximum Plan Allowance is determined by actuarial analysis of submitted charges, utilization, competition in the marketplace, and other data as determined by Delta Dental of Arkansas. The Maximum Plan Allowance is usually adjusted annually at the discretion of Delta Dental of Arkansas.

Dentists located outside of Arkansas will be paid based on the allowed fees as set by their local Delta Dental member company.

Participating dentists can receive payment within 24 hours of claim processing. Simply complete the Direct Deposit Form and return a copy of a voided check to the Professional Relations Department at:

Delta Dental of Arkansas
Attn: Professional Relations
P O Box 15965
Little Rock, AR 72231

Please contact the Professional Relations department at 501-992-1710 or profrelations@deltadentalar.com. We are more than happy to assist you.

Dentists located outside of Arkansas must contact their local Delta Dental member company to become a participating Delta Dental dentist.

You can access your patients' Delta Dental Premier, PPO and Delta Dental Smiles benefits in the following ways:

1. Participating dentists may access patient benefits and eligibility by clicking on “Dentists”from the main menu on the home page and selecting “Dental Office Toolkit” from the dropdown list. Simply register for an account if you do not already have one. Once you have an account, log in to the site and select “Patient Info/Enter Claims” on the left side of the screen and enter the patient's member identification number.

2. You can also use the Fax Back system to verify eligibility or claim status.
Dial 1-877-942-6858 or 501-834-3400.
Press "1", and enter the dentist's Tax ID.
Choose "1" for Eligibility and Claim Status or "2" for Claims.
Enter the patient's Member ID and Date of Birth.
Press "1" for a Fax Back.

3. Our Benefit Services Representatives are also available Monday – Friday from 7:00 a.m – 7:00 p.m. at 800-462-5410 or 501-834-3400 to assist you and your staff.

You can access your patients' Delta Dental Medicare Advantage benefits in the following ways:

1. Participating dentists may access patient benefits and eligibility by clicking on “Dentists”from the main menu on the home page and selecting “Dental Office Toolkit” from the dropdown list. Simply register for an account if you do not already have one. Once you have an account, log in to the site and select “Patient Info/Enter Claims” on the left side of the screen and enter the patient's member identification number.

2. Dial 1-855-253-4706.

For patients covered by other Delta Dental member companies, please contact the respective Delta Dental member company to verify patient benefits and eligibility. For contact information for other Delta Dental member companies, click here

In order to submit electronic attachments, you will need equipment that produces an electronic copy of a document or image. The type of equipment and other requirements depends on which vendor you choose to support this capability. A notable vendor is NEA, which is a separate entity from Delta Dental.

NEA
www.nea-fast.com 
800 782-5150

There a several ways to view status of a claim for a Delta Dental Premier, PPO or Delta Dental Smiles member.

  • You may view claim status by clicking on “Dentists”from the main menu on the home page and selecting “Dental Office Toolkit” from the dropdown list. Register for an account if you do not already have one. Once you have an account, log in to the site and select “Search” on the left side of the screen. Enter the criteria for your desired results and click the search button.
  • You can also use the Fax Back system to verify eligibility or claim status.
    Dial 1-877-942-6858 or 501-834-3400.
    Press "1", and enter the dentist's Tax ID.
    Choose "1" for Eligibility and Claim Status or "2" for Claims.
    Enter the patient's member ID and date of birth.
    Press "1" for a Fax Back.

    3. Our Benefit Services Representatives are available Monday – Friday from 7:00 a.m. – 7:00 p.m. at 1-877-942-6858 to assist you and your staff with claim status questions.

To check claim status of a claim for a Delta Dental Medicare Advantage member:

  • You may view claim status by clicking on “Dentists”from the main menu on the home page and selecting “Dental Office Toolkit” from the dropdown list. Register for an account if you do not already have one. Once you have an account, log in to the site and select “Search” on the left side of the screen. Enter the criteria for your desired results and click the searchbutton.
  • Dial 1-855-253-4706.

For patients covered by other Delta Dental member companies, please contact the respective Delta Dental member company to verify claim status. For contact information for other Delta Dental member companies, click here.

By signing a Delta Dental of Arkansas Participating Provider Agreement for our Delta Dental Premier and PPO networks, your participation is honored throughout the national Delta Dental system. Please keep in mind that if your patient is covered under a Delta Dental National Coverage plan, claims must be submitted to the appropriate Delta Dental member company for processing. You are still guaranteed direct payment and Arkansas Maximum Plan Allowances (MPA) for these claims.

This does not apply to our Delta Dental Smiles and Delta Dental Medicare Advantage networks.

If you are a dentist outside of Arkansas, the same policy applies except that you are paid at the allowance determined by your local Delta Dental member company.

No, please do not send duplicate claims. This will only slow down the process.
No, sending a paper copy or duplicate electronic claim will delay the process. Please feel free to contact our Benefit Services department to confirm receipt of your electronic claim. Your software vendor should also be able to assist you with questions on the transmission of your claims.

In order to reduce costs for our participating dentists and increase administrative efficiency while maintaining program quality, Delta Dental of Arkansas no longer requests radiographs for all claims. Instead, Delta Dental of Arkansas periodically selects claims for review and will request additional information if necessary for proper benefit determination.

Radiographs submitted to Delta Dental of Arkansas will not be returned unless a self-addressed, stamped envelope is provided.

Participating Delta Dental Premier dentists are guaranteed direct payment for services rendered to Delta Dental Premier patients. This will save a significant amount of time as well as reduce billing costs. Your name is also published as a participating Delta Dental Premier dentist in directories sent to our groups, as well as on our website. Delta Dental Premier members generally have reduced out-of-pocket expenses when they visit participating Delta Dental Premier dentists.
The clearinghouse you use will forward us a paper claim for processing. We plan to accept electronic claims from all clearinghouses in the very near future.
Many patients know they are covered by Delta Dental, however, it is important to ask under which program they are covered. Determining this in advance will enable the patient to know if you participate in their program, which will help avoid any misunderstandings.

Delta Dental Premier or Delta Dental Premier National Coverage is our traditional fee-for-service program. Participating dentists are guaranteed direct payment. Arkansas dentists will be paid based on the lesser of their submitted fee or the Delta Dental of Arkansas Maximum Plan Allowance, regardless of which Delta Dental member company processes their claim. Subscribers with Delta Dental Premier coverage have financial incentive to seek services from a participating Delta Dental Premier dentist. Participating dentists outside of Arkansas will be paid based on the allowance set by their local Delta Dental member company.

Delta Dental PPO and Delta Dental PPO National Coverage is our reduced fee-for-service program commonly referred to as a PPO. Arkansas Delta Dental PPO dentists agree to accept payment based on the lesser of their submitted fee or the Delta Dental of Arkansas PPO Maximum Plan Allowance. Just as in Delta Dental Premier, dentists file claims and receive direct payment, regardless of which Delta Dental member company processes the claim, but will be paid based on the Delta Dental of Arkansas Maximum Plan Allowance. There is a financial incentive for Delta Dental PPO patients to choose a participating Delta Dental PPO dentist. Unless the group contract specifies otherwise, Delta Dental PPO patients may choose to incur higher out-of-pocket expenses and seek services from a Delta Dental Premier only dentist. Arkansas Participating Delta Dental Premier dentists agree to file claims, accept Arkansas Maximum Plan Allowances, and receive direct payment for Delta Dental PPO patients, just as they do for Delta Dental Premier patients.

Be sure to include the member's name and identification number on all claim forms.

Paper claims for Delta Dental Premier, PPO or Delta Dental Smiles members should be mailed to:

Delta Dental of Arkansas

PO Box 15965
Little Rock, AR 72231

Paper claims for Delta Dental Medicare Advantage members should be mailed to:

Delta Dental Medicare Advantage

PO Box 9230
Farmington Hills, MI 48333

Paper claims for Individual or Family ACA plans should be mailed to:

Delta Dental Smiles

PO Box 6247
Little Rock, AR 72124

 

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