Delta Dental PPO frequently asked questions
- What is the difference between a Delta Dental PPO dentist and one who is not a Delta Dental PPO?
- What dentist can I see?
- Can I see a specialist with my plan?
- How can I find out what my remaining benefits are for this current benefit year?
- What are the benefits and covered services under my dental plan?
- What if I have a dental emergency and I'm out of town?
- How long are my children covered under my dental plan?
- My former employer is allowing me to pay for continued insurance coverage on my own. How long will my COBRA plan be effective?
- What does the term "least costly" mean?
- What is the address for filing a claim?
What is the difference between a Delta Dental PPO dentist and one who is not a Delta Dental PPO?
Delta Dental PPO dentists are contracted with ODS to provide dental care to you and your covered dependents. If you receive care from a dentist who is not a Delta Dental PPO dentist, out-of-network coverage applies. Delta Dental PPO dentists also have agreed to submit any necessary claims to ODS.
What dentist can I see?
For in-network benefits, you must receive care from a dentist from the Delta Dental PPO Directory. For a list of participating Delta Dental PPO dentists, view our find care directory.
Can I see a specialist with my plan?
Specialist services are a covered benefit under most plans. For a list of participating Delta Dental PPO specialists, view our find care directory. If you receive care from a specialist who is not a Delta Dental PPO dentist, out-of-network coverage applies. You may want to have the specialist submit a preauthorization to determine how much of a benefit you can expect to receive.
How can I find out what my remaining benefits are for this current benefit year?
You can view your remaining benefits as well as other health information on myODS, your personalized member website. You also can contact ODS Customer Service, and we will review your claims history to determine your remaining benefits.
What are the benefits and covered services under my dental plan?
To view your benefits and covered services, please log on to myODS, your personalized member website. You also can refer to your Member Handbook, which you received in the mail after enrollment, or you can view your Member Handbook on myODS. If you have further questions about a specific service, contact Customer Service.
What if I have a dental emergency and I'm out of town?
Most of our plans allow you to see any licensed dentist. Refer to your Member Handbook for any specific limitations. You can access your Member Handbook online anytime by logging in to your myODS account.
How long are my children covered under my dental plan?
Please refer to your Member Handbook for the specific age limits under your plan. You can access your Member Handbook online by logging in to your myODS account.
My former employer is allowing me to pay for continued insurance coverage on my own. How long will my COBRA plan be effective?
The length of time COBRA is offered may vary. You may contact your employer or the third-party administrator that handles the plan.
What does the term "least costly" mean?
If a tooth can be restored with a procedure that is less expensive than the procedure your provider is using, benefits paid will be based on the procedure that costs less.
What is the address for filing a claim?
Send claims to:
ODS
601 S.W. 2nd Ave.
Portland, OR 97204
Please include the following information:
- Patient's name, identification number and group ID number
- Date of treatment
- Diagnosis
- An itemized description of services and charges
If the treatment is for an accidental injury, include a statement with the date, time, place and circumstances of the accident when you send us the physician or professional provider's bill.
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