Delta Open Enrollment PPT

Your Benefits - Three Options: 

Your Benefits - Three Options

Slide3: 

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.

Delta Dental PPO Network : 

Delta Dental PPO Network No balance billing Dentist submits claim paperwork Minimal out of pocket expenses Over 600 general dentists to choose from in the St. Louis area

Your Benefits – Basic Option: 

Your Benefits – Basic Option

Your Benefits – Basic Plus Option: 

Your Benefits – Basic Plus Option

Your Benefits – Basic & Basic Plus Options: 

Your Benefits – Basic & Basic Plus Options

Your Benefits – Flex Option: 

Your Benefits – Flex Option

Slide9: 

Claims finalized in 3.3 days (average) 99.9% accuracy Outstanding Speed and Accuracy

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 Example: a Delta Dental PPO dentist installs a two surface amalgam filling on a patient. Patient has 70% coverage for basic services. Delta Dental PPO Network – Basic Options This calculation is for illustration purposes only, it does not reflect actual fees.

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 Example: a Delta Dental PPO dentist installs a two surface amalgam filling on a patient. Patient has 90% coverage for basic services. Delta Dental PPO Network – Flex Option This calculation is for illustration purposes only, it does not reflect actual fees.

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 Example: a Delta Dental Premier dentist installs a two surface amalgam filling on a patient. Patient has 80% coverage for basic services. 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. Delta Dental Premier Network – Flex Option Only

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) Example: a nonparticipating dentist installs a two surface amalgam filling on a patient. Patient has 80% coverage for basic services. 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. Delta Dental Nonparticipating – Flex Option Only

Slide15: 

99.8% - solutions on first call Over 98% of customers satisfied with service Average speed of answer: 8 seconds 96% answered in 30 seconds Abandon rate: 0.6% Average 14 years experience Minimal turnover Unrivaled Customer Service 1-800-335-8266

Slide16: 

24/7 access to benefit and claims information: Benefit24 online at www.deltadentalmo.com Benefit24 VRU Faxback – summary of benefits Ease and Convenience

Slide17: 

For members and dentists: Participating dentists Claims status and history Copy of EOB Benefit design Track use of maximums Print ID cards State-of-the-art Web-based Service

Find a Dentist . . .: 

Find a Dentist . . .

Questions?: 

Questions?