National Coverage is the arrangement under which Delta Dental member companies from around the country work together to offer the advantages of a local Delta Dental network to organizations that have subscribers in more than one state. There are 39 independent Delta Dental member companies operating in all 50 states, the District of Columbia and Puerto Rico. National Coverage functions as a national umbrella program with three products and networks: Delta Dental Premier, Delta Dental PPO, and DeltaCare.
When you sign a participating dentist agreement or a participating group practice agreement for a particular Delta Dental of Massachusetts network, you also agree to participate in the corresponding National Coverage plan. For example, when you participate in the Massachusetts Delta Dental Premier program, you automatically participate in the Delta Dental Premier with National Coverage program too. As explained below, the same fee schedules apply to both programs.
Being a participating provider in a Delta Dental network offers great advantages to you. Delta Dental members in Massachusetts who receive benefits covered by Delta Dental in another state seek out local participating dentists for care. This can mean more business for your practice.
Claims for your National Coverage patients are processed by the regional control plan based on the location of the group’s corporate headquarters. The control plan for the patient’s group is identified on his or her ID card (click here for a listing of National Coverage plans and their addresses). Treating dental offices complete Delta Dental claim forms and submit them to the control plan handling the group account under which the patient is covered. The amount you are paid is based upon the Delta Dental of Massachusetts fees. As a participating dentist you agree to abide by the National Delta Dental Plans Association processing policies. National Coverage patients are responsible for any applicable co-payments, deductibles, services not covered, and amounts exceeding their annual plan maximum.