Benefits administrator blog from Delta Dental

Tag: dentist networks (Page 2 of 2)

5 dentists your enrollees won’t find in our networks

2‑minute read

At Delta Dental, we don’t lease any of our dental networks. In fact, our Professional Relations department specializes in developing close relationships with our providers to ensure quality care for your enrollees. This Halloween season, we’re showing you what not to expect in our networks — and that dental visits might not be so scary after all.

Mother and daughter carving pumpkin

 

Here are some doctors enrollees won’t find in our networks:

  1. Philip Sherman, Finding Nemo

Okay, so P. Sherman might not be your run-of-the-mill villain, but why would anyone want to visit a man who lets his niece torture adorable sea creatures? Plus, enrollees can find a credentialed network provider easier than getting “just keep swimming” stuck in their heads with our find a dentist tool.

  1. Stuart Price, The Hangover

While Stu seems like a stand-up guy, enrollees probably don’t want to look up from the chair and see a dentist with a missing tooth, a knot on his head and point-blank taser wounds on his neck. Ouch.

  1. Wilbur Wonka, Charlie and the Chocolate Factory

Unlike Willy Wonka’s father Wilbur, we don’t believe that “lollipops ought to be called cavities on a stick.” While our dentists want patients in great oral health, they don’t use scare tactics to achieve wellness. Instead, our dentists encourage regular preventive care and good oral hygiene to combat plaque and decay. (For wellness tips to share with enrollees, check out our SmileWay Wellness Program.)

  1. Orin Scrivello, Little Shop of Horrors

Arguably the most evil dentist character ever played, Orin is the exact opposite of what you’ll find in our networks. In fact, we have a whole team of dental consultants on staff dedicated to reviewing claims and preventing fraud, waste and abuse.

  1. Dr. Mindbender, G.I. Joe 

There’s no mind bending or brain scrambling here — thanks to our enrollee Online Services! Enrollees can log in at deltadentalins.com to view their benefits, check claims status and even look up average submitted fees for common services with our Fee Finder tool.

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May the Fourth (of our PPO network) be with you!

On this fourth day of May, we’d like to remind you of the benefits of PPO network utilization — Star Wars style. May the network force be with you (and with your enrollees)!

First, we interviewed Yoda about the benefits of offering a PPO plan. He says, “To offer your enrollees a PPO plan because they have the freedom to choose any dentist, you probably chose. And with a Delta Dental PPO™ plan, offering secondary access with our Delta Dental Premier® network, you are.”

And he’s right — with Delta Dental PPO, more of your enrollees have an opportunity for moderate savings with a Premier dentist. (But they’ll usually save the most if they go PPO, which is why it’s important for enrollees to understand how to use their plan.)

Need some Jedi wisdom on your dental benefits? Here are some answers to common questions and some things for you (and your enrollees) to consider.

Network (and non-network) dentist visits: A battle scenario

Let’s say your enrollees are young Jedis about to battle skilled Sith warriors. In this scenario, the Sith warriors are the out-of-pocket costs of going to the dentist. So, have your enrollees choose a weapon.

  • No weapon means minimal protection — kind of like visiting a non-Delta Dental dentist. Your enrollees aren’t taking advantage of any of the network savings that your carrier is offering.
  • Using a lightsaber is nice, but your enrollees wouldn’t bring a lightsaber to a blaster fight, would they? This is moderate protection — like visiting a Delta Dental Premier dentist.
  • Finally, using a blaster is usually your enrollees’ most reliable form of protection. Like visiting a Delta Dental PPO dentist, they’re getting the most protection against Siths — er, out-of-pocket costs.

“What if my group has a PPO plus Premier plan design?” We thought you might ask. In that scenario, you’re offering your enrollees more protection against balance billing than you would be with a standard PPO plan, but they (and your group’s overall plan costs) will usually benefit most from going PPO.

Dental networks and finding a dentist

A dental plan is only as valuable as its network. That’s why we’re proud to offer expansive, nationwide PPO access. If you think an army of storm troopers is a crowd, you haven’t seen our provider directory.

And your enrollees don’t have to go to Tatooine to find network savings — tell them to log in to our online services and use our Find a Dentist tool to find a PPO dentist near their home, office or any chosen location.

Encouraging PPO utilization 

You should talk with your employees about the benefits of in-network dentist visits, like more potential savings and more convenience with no claims forms.

In Yoda’s words, pass on what you have learned! Consider attaching this instructional flyer (PDF) to your next group email and encourage them to search only for PPO dentists. And remember — the force is strong with those who go PPO.


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Delta Dental PPO: Is your group part of the in-crowd?

2‑minute read

One of the best parts about choosing a PPO dental plan for your employees is giving them the freedom to choose any licensed provider for their next visit. And, with Delta Dental, you’re offering additional access with our Delta Dental Premier® network. With so many choices, it’s important to weigh the options.

Network utilization is a key aspect of your dental plan — because in-network visits could save you money or help stabilize your group’s plan costs over time. Some things to consider:

What does in-network actually mean?

If you currently offer a Delta Dental PPO™ plan, in-network visits always mean visits to PPO dentists. We’d like to say it’s that simple, but sometimes offering twice the freedom results in twice the questions.

What about Premier visits?

The Delta Dental Premier® network acts as a safety net for out-of-pocket costs, so enrollees usually save more than they would if they visited a non-Delta Dental dentist. However, the Premier network doesn’t offer the deep discounts that PPO can.

What if I offer a PPO plus Premier plan?

If your group offers a Delta Dental PPO plus Premier™ plan, or any plan in which non-PPO dentists are not reimbursed based on contracted PPO fees, enrollees will still save the most when they go PPO. The difference for these plans is how we calculate fees for claims. The plan still offers a safety net for non-PPO claims if enrollees visit a Premier dentist, and you’re offering them more balance billing protection if you choose a fee basis other than the PPO contract allowance for all claims.

How do I encourage PPO utilization?

Talk with your employees about the benefits of in-network dentist visits, like more potential savings and more convenience with no claims forms to fill out. You can also remind them to find a network dentist using our find a dentist tool. Consider attaching this instructional flyer to your next group email and encourage them to search only for PPO dentists.


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