Change Healthcare announced a breach of HIPAA privacy and is reaching out to individuals whose personal information may have been compromised. Although this incident does not involve Delta Dental of New Jersey or Connecticut, Change Healthcare is a vendor we used and we are providing this information to help our members who might be affected.
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Excellent benefits, low out-of-pocket costs. In-network dentists have agreed to pre-established fees for services. On average, patients save 43% on the fee typically submitted for a claim. Delta Dental PPO dentists’ rates are usually the best value, often better than other network rates. |
No more billing surprises. Delta Dental PPO network dentists won’t “balance bill” patients. That means they can’t charge you the difference between their usual fee and the amount they’ve agreed to charge patients covered by Delta Dental. |
When you see an out-of-network dentist | When you see a Delta Dental PPO dentist | ||
They can bill you the full $1,438 | $1,500 | PPO dentist’s maximum allowed fee | $960 |
Delta Dental’s maximum allowed fee: | - $960 | Delta Dental covers 50% of the maximum allowed fee | x 50% |
The difference between the dentist’s charge and the maximum allowed fee is the balance billed amount | $540 | Your cost, assuming you already met your deductible for the year | $480 |
Delta Dental covers 50% of the maximum allowed fee | $480 |
Total savings with the Delta Dental PPO network = $540! |
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You’ll pay the other half of the maximum allowed fee plus the balance billed amount from above | $480 + $540 |
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Your cost | $1,020 |