Delta Dental FAQs
After much deliberation, Sausalito Dentistry has decided to end our preferred provider status with Delta Dental effective May 31, 2022. We understand that dental insurance can be confusing, so we provide below the answers to some frequently asked questions (FAQs) to help our patients understand the reason for this change and how it may affect them.
Why are you ending your preferred status with Delta Dental?
At Sausalito Dentistry, we have been partners with Delta Dental in providing quality dental care for over 30 years. However, it has become clear to us that we cannot continue to be a preferred provider with Delta and maintain the high quality, personalized care that we have always prided ourselves on. Over the years Delta has added increasing restrictions on what they will allow for their subscribers, influencing healthcare decisions that should be between doctor and patient. These restrictions are motivated by Delta’s bottom line and consequently, many of them run counter to your optimal health by disallowing the treatments you and Dr. Lee have deemed best for you.
Delta’s preferred provider fees have also not kept pace with inflation, and, for some procedures, have actually been lowered. Some offices can make these lower fees work by using cheaper materials and overseas labs, cutting appointment times and staff hours, and using outdated technology. Not us! Since we are not willing to partner with any entity that may compromise optimal patient care, we have decided to end our preferred status—the highest compensatory level available to Legacy Delta providers--so that we can continue to provide the same level of care that our patients expect and deserve.
Does this mean that you don’t accept my Delta insurance anymore?
Don’t worry, you can still utilize your Delta insurance benefits at our office. We will continue to process your claims as we always have, and Delta will pay your benefits at your plan’s non-preferred rate. This rate will be different for each group depending on the fee schedule negotiated by your benefits administrator. Some patients may not see a difference in reimbursement; however, most will notice some increase in their copays. If you have concerns about your out-of-pocket costs, we are happy to send Delta a pre-treatment estimate prior to your appointment.
Will I have to pay for my appointment upfront? Unique to non contracted Delta providers, yes. No other dental insurance provider requires such an arrangement after termination of a contract. Delta has devised this policy to discourage providers from leaving their network, with decreasing effectiveness. For the reasons outlined above, Delta’s contracted private care providers--many of whom, like us, have been Delta providers for decades--are leaving in droves. The biggest change our patients will see is that Delta will no longer assign patient benefits directly to our office. This means that all Delta patients are required by Delta to pay the balance of their appointment up front. After we process and submit a claim on the day of the appointment, Delta will send reimbursement directly to the subscriber’s address on file, usually in 2-3 weeks.
What are my options if I don’t want to pay upfront or my copays have increased too much? If your employer offers any other insurance options, you can always switch carriers during open enrollment. Almost all other carriers offer a “PPO” plan that will allow benefits to be paid directly to our office. Many insurance carriers also offer plans with comparable preferred/non-preferred benefits, so if your current Delta plan has poor non-preferred benefits, you may find a better option with a new carrier.
We are also introducing an in-office Membership Plan to help keep our quality dental care affordable for all our patients. This plan allows our Delta patients to continue to maximize benefits available from their plan, without restrictions, after we terminate our contract with Delta. For a set yearly rate, the membership plan will include all of your routine preventative care and a discount on any additional treatments or services. The net result? The same high quality care you have come to expect, but with more choices specific to your needs, less wait, less uncertainty, and minimal net changes in costs to you!
Additional questions? If you have additional questions about the Delta transition, please don’t hesitate to call or email them to our office manager Jessica at 415-331-5656 or info@sausalitodentistry.com. You can also refer to our website, Sausalitodentistry.com, for more information about our transition to less restrictive, highly affordable, high quality dental care for you and your family.