To predetermine treatment, your dentist sends Delta a proposed treatment plan, along with relevant x-rays. Delta then checks to be sure that the services are covered. Some dental work may be limited or excluded by your program, and you will want to know exactly what services are covered before you proceed with treatment. Delta also calculates how any copayments and dollar maximum limits might affect your share of the cost. Your dentist then receives an estimate of the amount Delta will pay for approved services, and the amount you will be responsible for.
Predeterminations usually take about three weeks.
To provide faster turnaround, a predetermination does not take into account any deductibles, so please remember to figure in your deductible, if necessary. Unless the need is urgent, it's worthwhile to find out exactly how much of your treatment is covered, allowing you to plan in advance for your portion of the dentist bill.