Frequently Asked Questions
The following are commonly asked questions by our network dentists.
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 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.
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.
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.
NEAwww.nea-fast.com
800 782-5150
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.
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.
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