Orthodontic Processing
Most orthodontic claims will be paid using a monthly payment method, with payments not to exceed twelve installments.
This process allows us to use CDT codes in order to be compliant with the HIPAA code transaction requirements. It also makes good business sense for our accounts in that it will help ensure that patients are still eligible for benefits before payment is rendered.
To begin the payment process, your office will submit an initial claim for orthodontic treatment. You will receive a pre-estimate that will explain line-by-line how much your office will receive each month for that patient's care. You will then receive an automatic payment of a determined amount (based on the total case fee) by the final check run each month-until the patient's orthodontic benefits are satisfied. The monthly payment will appear on your CEOB. You may bill the patient balance up to your submitted charge excluding any Delta discounts in whatever manner you choose.
Using the navigation links to the left, you will find the following items that are meant to help explain the new payment process:
- How to Report Orthodontic Services
- Frequently Asked Questions
- Listing of groups that have unique orthodontic benefits (not adhering to the automated monthly payment method)
- Sample CEOB and Pre-Estimate forms
- The Processing Policies and Procedures contain an updated orthodontic section
Thank you for your continued participation with Delta Dental of Massachusetts. If you have any questions, please contact our Customer Service department at (800) 872-0500.
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