*Note: Additional forms, including claim forms, are in Benefits Connection, your online "patient portal." Click here to register for a Benefits Connection account.
*Note: Delta Dental of New Jersey will accept diagnostic quality photographs in lieu of stone models for prior authorization of medically necessary orthodontic treatment plans for children covered under Affordable Care Act plans in New Jersey and Connecticut. Diagnostic quality photographs should be consistent with the photographic requirements of the American Board of Orthodontics and include three facial photographs (profile, frontal, and smiling), and five intraoral photographs (frontal, right lateral, left lateral, and maxillary and mandibular occlusal). Photographs should be of sufficient quality to support the determination of medical necessity.
*These forms are located in Benefits Connection.
The Participating Handbook is in Benefits Connection.
Update your Office Information
Please contact us immediately of any changes to the following: