Delta Dental

As part of this transition, we will now ask that patients with Delta Dental keep a credit card on file. This is actually a benefit to you—because instead of requiring full payment up front, we are choosing to wait until after you receive your reimbursement check from Delta Dental before collecting any remaining balance. This approach helps reduce your immediate out-of-pocket costs and allows you to receive your insurance payment before any charges are made. It ensures your care continues without delay or financial strain during this transition. Rest assured, your card will not be charged until after Delta Dental has processed your claim and issued a final determination.

Delta Dental is currently the only major dental insurance carrier that does not allow assignment of benefits to dental offices for out-of-network providers. This means that instead of paying us directly for your care, they send the reimbursement check to you, the patient. While most other insurance companies give patients the option to have payments sent to their provider, Delta Dental requires patients to pay the provider directly and then get reimbursed. This unique policy can create some additional steps for you, but we're here to help guide you through the process and make the transition as smooth as possible.

They might, but not always. Once we’re out-of-network, Delta Dental may reimburse you at a different rate than before. That means your outof-pocket costs could change slightly, depending on your plan and the type of procedure. That said, many Delta Dental plans still reimburse preventive care—like cleanings, exams, and X-rays—at or near 100%, even when out-ofnetwork. In those cases, your out-of-pocket cost may not change at all. For other types of treatment, coverage can vary more, and you would be responsible for the difference between what your plan pays and our usual fee. We’re always happy to provide treatment estimates in advance, so you’ll know what to expect and can plan with confidence.

Yes! We will submit your claim to Delta Dental electronically on the day of your visit. Reimbursement will then be sent directly to you.

Most patients receive their reimbursement within 7-14 business days, depending on your Delta Dental plan and whether or not your treatment requires supplemental documentation from us.

We're happy to provide a treatment estimate and can submit a predetermination of benefits to Delta Dental upon request. Please note that reimbursement amounts and timelines are determined solely by your insurance company. However, we find that turnaround times for these estimates are typically very quick.

We completely understand that this is a big change, and we want to make it as easy as possible for you. That's why we're offering a grace period during this initial transition. For your next preventative visit, we will not collect more than the amount you receive from Delta Dental in your reimbursement check — even if that means we don't receive our full fee. We're doing this because we believe in supporting our patients through change, even if it means a financial loss for our office. Our goal is to give you time to adjust, ensure your care stays consistent, and allow you the space to make any decisions about your dental coverage or provider without pressure.

This decision was made so we can continue to provide the level of care our patients deserve. Over time, Delta Dental's reimbursement rates have not kept pace with rising costs of modern dentistry. As an in-network provider, we were required to follow contracted pre-set fees determined by Delta Dental, which often didn’t reflect the time, quality, and materials involved in delivering high-quality care. In our case, Delta Dental has not increased our contracted fees since the day we opened in 2009. Staying in-network would have meant compromising on appointment time, materials, and the personalized attention we value. By stepping away from the Delta Dental network, we're choosing to prioritize your care without being limited by outdated insurance contracts.

No, this change only applies to Delta Dental.

We completely understand — many people feel cautious about storing card information, especially with concerns about fraud and data breaches. Please know that your card is stored securely using encrypted, HIPAA-compliant software designed specifically for dental and medical offices. It may help to know that keeping a card on file is actually very common — just like hotels, car rental companies, airlines, and even restaurants require one to hold a reservation or confirm services. It’s simply a secure and efficient way for us to manage your care without asking for full payment up front. In fact, we’re doing this to make things easier for you. Instead of requiring full payment at the time of your visit, we wait until Delta Dental has finalized your claim and you’ve had time to receive your reimbursement. At that point, you can choose how to pay us, whether that be bringing in your check or authorizing us to charge your card. And of course, you’re still in control. If you prefer to pay using a check, debit card, or another method, you’re absolutely welcome to do so. The card on file is simply a convenient and secure backup to make the process smoother and more flexible for everyone.

Not at all — if you prefer not to leave a card on file, that’s absolutely okay. In that case, the alternative is to pay in full at the time of your visit. We’ll still file your Delta Dental claim for you, and you’ll receive your reimbursement directly once the claim is processed. We offer the card-on-file option simply as a convenience to allow time for your reimbursement to arrive before any balance is collected. But the choice is entirely yours — we’re happy to work with whichever option is most comfortable for you.

We know how frustrating it can be when insurance doesn't cover something you expected - and this is, unfortunately, one of the most difficult parts of working with any dental insurance. While we do our best to help you navigate your benefits and submit all claims correctly, the final decision about what is covered is made by your insurance plan. If Delta Dental denies or partially reimburses your claim, any remaining balance becomes the patient's responsibility. Please know that when a claim is denied, it's not a reflection of how the services were provided — it's a decision made by the insurance company based on their internal policies — which aren't always clearly communicated to patients (or providers). These inconsistencies and lack of transparency are part of the reason we've made the difficult decision to step away from being in-network with Delta Dental. That said, we're still here to help you understand your Explanation of Benefits (EOB), answer questions, and support you however we can.

Here are a couple tips to help ensure you receive your reimbursement smoothly and on time:

• Make sure your contact information is up to date — Log in to your Delta Dental account or call them to confirm that your mailing address, phone number, and email are current. Reimbursement checks are usually mailed, so having the correct address is essential. Please note: by default, checks are sent to the plan subscriber (usually the main policyholder), unless you’ve arranged otherwise with Delta.
• Track your claim status — Use Delta Dental’s online portal or mobile app to keep an eye on your claim. You’ll be able to see when it’s received, processed, and paid. If your check hasn’t arrived within 30 days, it’s a good idea to contact Delta Dental’s customer service for an update.

Delta Dental has sent—or may send—a letter to some patients that encourages them to switch providers. This letter is very confusing and may lead some patients to believe they need to find another dentist. This is NOT true. You can absolutely continue to receive care at Villa Vista Dental. You can still use your Delta Dental benefits in our office. And we will continue to help you receive your insurance policy benefits. Delta Dental may include a list of other providers in their letter, but the choice of where to receive your care is entirely up to you. We are here to support you, answer your questions, and continue providing the highquality care you know and trust.

That’s entirely up to you—we can’t recommend specific plans, as everyone’s needs and preferences are different. But we can help you understand how different types of plans might affect your experience at our office. We’ve actually always been out-of-network with other dental insurance carriers, and in nearly all cases, patients have still been able to use their benefits with ease. That’s because most PPO plans allow assignment of benefits, meaning they send payment directly to our office, and you’re only responsible for your estimated portion at the time of your visit. Delta Dental is the only major carrier that handles things differently. Once we’re out-of-network, they won’t send payment to us at all—they reimburse you directly instead. This is the main reason the change with Delta feels different than it does with other plans. Unfortunately, this policy is designed to make the decision to leave their network more difficult for both patients and providers. If you’d prefer to return to the more familiar process—where we handle the claims, your insurance pays us directly, and you just pay your portion —then selecting a non-Delta PPO plan during open enrollment may be worth considering. That said, we’re not here to steer you away from Delta or any other carrier—only to help you make an informed decision based on what works best for you. If you’d like help understanding how a specific plan might work with our office, feel free to contact us or bring the details to your next appointment. We’re happy to help.