FAQ

At Delta Dental of Tennessee we strive to provide superior Customer Service. It is important to us to answer every inquiry quickly, professionally, and accurately. Below, find answers to many of our most commonly asked questions. If your question is not answered here, please contact us.

I have never used my plan before, how does it work?

Using your Delta Dental benefits is easy. Schedule an appointment with a Delta Dental provider or your preferred dentist. When visiting Delta Dental participating dentists, they will file the claims for you. We welcome the opportunity to help you learn what your benefit options are as well as help you locate a participating provider in your area.

You can register for the Member Portal to learn more about your specific benefit plan. If you need help finding a dentist, visit our Dentist Search. You can also contact our Customer Service Department for further assistance at (800) 223-3104.

 

What is the difference between the Delta Dental PPO network and Delta Dental Premier?

Delta Dental Premier® - Access to more than 2,800 dentists in 2,132 locations across Tennessee. More than 157,000 participating dentists in 115,069 locations nationwide. Dentists have agreed to reduced fees for dental care services.
Delta Dental PPO^SM - Access to more than 2,200 dentists in 1,767 locations across Tennessee. Access to more than 115,000+ dentists in 86,396 locations nationwide. Provides the deepest discounts.

 

I did not receive an Explanation of Benefits (EOB) statement for a recent dental office visit. How can I view/print my Explanation of Benefits (EOB) statements?

Delta Dental of Tennessee does not mail EOB statements for services covered at 100% and for which the patient owes nothing. These statements, however, are available to view and print on our secure Member Portal. Once you have logged into the Member Portal, click on Claim Info. Enter the date of service in the Start Date field, or enter a date range using Start Date and End Date. Click on the Claim Number for the EOB you wish to view. You also can click on the Procedure Code number for a definition of the service provided. To print EOB statements, click on the printer icon in your browser toolbar or select File then Print.

 

Do you offer individual coverage?

Yes, we do offer an Individual Plan for Tennessee residents. For more information, visit the Individual Plan page or call (855) 844-0445.

 

How do I find out which plan type I currently have?

For information about your benefit plan, log in to the Member Portal or contact our Customer Service department at (800) 223-3104.

 

Can I view information for my adult dependents online?

Information for dependents 18 and older must be obtained via phone.

 

How do I get a new ID card?

You may print an ID card using our Member Portal or you may request an ID card via phone by calling (800) 223-3104. You can also access your ID card using the Delta Dental mobile app. You do not necessarily have to have an ID card to see a dentist as the cards are not a guarantee of coverage.  The dental office can order a fax of benefits at the above number as long as they have the subscriber’s ID number and date of birth and the patient’s name and date of birth, or they can get the benefit information verbally through DASI which is our automated system.

 

Does my plan offer "two free cleanings a year?"

To get information about your specific benefit plan, log in to the Member Portal or call us at (800) 223-3104. We don’t refer to them as “free” as different plans have different stipulations.

 

My current dentist is not a provider. Will Delta Dental of Tennessee pay anything on my claim?

Delta Dental has an extensive list of participating providers. Visiting a participating provider may help to reduce your out-of-pocket expenses. However, if you choose to see a dentist who is not a participating provider with Delta Dental, you still may be eligible for partial reimbursement. Contact a Customer Service Representative for more information.

 

How do I submit a claim for reimbursement?

When visiting a participating Delta Dental provider, your claims will be filed for you. If your dentist is a non-participating provider, you may need to submit the claim yourself. Download a claim form here. Either you or your dentist may complete the form and attach a copy of your bill.  Make certain that you have the dentist’s information such as Tax ID#, treating dentist’s license or NPI number.  The bill they provide you may have that information on it.  Also, make certain that the CDT codes for each procedure are on the bill as well. Completed forms may be faxed to (615) 244-8108 or submitted via mail to:

Delta Dental of Tennessee
P.O. Box 24810
901 Broadway
Nashville, TN 37202

 

How does a current subscriber change the way he/she is enrolled?

To request changes to the way you are enrolled, you should first contact your employer’s Plan Administrator or Human Resources Department. Depending on your employer’s plan requirements, some changes may only be made during an open enrollment period. Some changes, called qualifying events, enable an employee to make changes outside of open enrollment if the change is requested within 31 days of the event. The birth of a child and the marriage or divorce of an enrolled subscriber are examples of a qualifying event.

 

Does my plan cover braces?

Orthodontic coverage varies from plan to plan. Please log in to the Member Portal to view your benefits, or contact us to determine eligibility requirements. You would need to see a licensed orthodontist with periodic visits in office.  Mail order companies are not covered by Delta Dental of TN.

 

What is my Member ID number?

Your Member ID number is usually your social security number. Some groups use randomly assigned alternate ID numbers instead of social security numbers. If your group uses alternate ID numbers, your number will be printed on your ID card. If you employer uses alternate ID cards, the subscriber ID will be on the card.  If there is not a subscriber ID number, the subscriber ID will be the employee’s social security number for all members of the family.   The Customer Service Representatives are not allowed to give these numbers over the phone.

 

What if I am outside of the U.S.?

With Passport Dental, you can receive expert dental care when they are outside of the United States through the AXA Assistance worldwide network of dentists and dental clinics. Learn More.