IQVIA Benefits Handbook
OTHER PLAN FEATURES
Pre-treatment Estimate for Benefits
Pre-treatment estimate requests are not required; however, your provider may file a claim form before beginning treatment, showing the services to be provided to you. Delta Dental will estimate the amount of benefits payable under the contract for the listed services. By asking your provider for an estimate from Delta Dental before you agree to receive any prescribed treatment, you will have an estimate up front of what Delta Dental will pay and the difference you will need to pay. The benefits will be processed according to the terms of the contract when the treatment is actually performed.
Suitable Plan of Treatment
If more than one covered service will treat a dental condition, payment is limited to the least costly service provided it is a professionally accepted, necessary and appropriate treatment. If you request or accept a more costly covered service, you are responsible for expenses that exceed the amount covered for the least costly service.
If You Are Out of Town
Delta Dental's network is national and available in all 50 states, Puerto Rico, and the District of Columbia. If you are out of town and need dental work, call Delta Dental at 800-932-0783 for a list of network dentists in the area or go to www.deltadentalins.com.
If You Need Emergency Dental Treatment
The plan pays the same amount for emergency service charges made by an in- or out-of-network provider. Dental emergency services are required immediately to either alleviate pain or to treat the sudden onset of an acute dental condition. These are usually minor procedures performed in response to serious symptoms, which temporarily relieve significant pain, but do not effect a definitive cure, and which, if not rendered, will likely result in a more serious dental or medical complication.