Delta Dental of North Carolina

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Frequently Asked Questions (FAQs)

At Delta Dental of North Carolina we strive to provide superior Customer Service. It is important to us to answer every inquiry quickly, professionally, and accurately. Below, find answers to many of our most commonly asked questions. If your question is not answered here, please contact us.

 

I did not receive an Explanation of Benefits (EOB) statement for a recent dental office visit. How can I view/print my Explanation of Benefits (EOB) statements?

Do you offer individual coverage?

How do I find out which plan type I currently have?

Can I view information for my adult dependents online?

How do I get a new ID card?

Does my plan offer "two free cleanings a year?"

My current dentist is not a provider. Will Delta Dental of North Carolina pay anything on my claim?

How do I submit a claim for reimbursement?

I have never used my plan before, how does it work?

How does a current subscriber change the way he/she is enrolled?

Does my plan cover braces?

What is my User ID number? 

 
I did not receive an Explanation of Benefits (EOB) statement for a recent dental office visit. How can I view/print my Explanation of Benefits (EOB) statements?
 
Delta Dental of North Carolina does not mail EOB statements for services covered at 100% and for which the patient owes nothing. These statements are available to view and print on our secure Consumer Toolkit. Once you have logged into the Consumer Toolkit, click on Claim Info. Enter the date of service in the Start Date field, or enter a date range using Start Date and End Date. Click on the Claim Number for the EOB you wish to view. You also can click on the Procedure Code number for a definition of the service provided. To print EOB statements, click on the printer icon in your browser toolbar or select File then Print.
 
Do you offer individual coverage?
 
Yes, we offer an Individual Plan. For more information, visit the Individual Plan page or call (800) 971-4108.
 
How do I find out which plan type I currently have?
 
For information about your benefit plan, log in to the Consumer Toolkit or contact our Customer Service department at (800) 662-8856.
 
Can I view information for my adult dependents online?
 
Information for dependents 17 and older must be obtained via phone.
 
How do I get a new ID card?
 
You may print an ID card using our Consumer Toolkit or you may request an ID card via phone by calling (800) 662-8856 and pressing 4.
 
Does my plan offer "two free cleanings a year?"
 
To get information about your specific benefit plan, log in to the Consumer Toolkit or call us at (800) 662-8856.
 
My current dentist is not a provider. Will Delta Dental of North Carolina pay anything on my claim?
 
Delta Dental has an extensive list of participating providers. Visiting a participating provider may help to reduce your out-of-pocket expenses. However if you choose to see a dentist who is not a participating provider with Delta Dental, you still may be eligible for partial reimbursement. Contact a Customer Service Representative at (800) 662-8856 for more information.
 
How do I submit a claim for reimbursement?
 
When visiting a participating Delta Dental provider, your claims will be filed for you. If your dentist is a non-participating provider, you may need to submit the claim yourself. Claim forms are available online. Either you or your dentist may complete the form and attach a copy of your bill. Completed forms may be submitted via mail to: Delta Dental of North Carolina, PO Box 9085, Farmington Hills, MI 48333-9085.
 
I have never used my plan before, how does it work?
 
Using your Delta Dental benefits is easy. Schedule an appointment with a Delta Dental provider or your preferred dentist. When visiting Delta dental participating dentists, they will file the claims for you. We welcome the opportunity to help you learn what your benefit options are as well as help you locate a participating provider in your area. You can register for the Consumer Toolkit to learn more about your specific benefit plan. If you need help finding a dentist, visit our Dentist Search. You can also contact our Customer Service Department for further assistance at (800) 662-8856.
 
How does a current subscriber change the way he/she is enrolled?
 
To request changes to the way a subscriber is enrolled, an employee should first contact their employer’s Plan Administrator or Human Resources Department. Depending on the employer’s plan requirements, some changes may only be made during an open enrollment period. Some changes, called qualifying events, enable an employee to make changes prior to open enrollment if the change is requested within 31 days of the event. The birth of a child and the marriage or divorce of an enrolled subscriber are examples of a qualifying event.
 
Does my plan cover braces?
 
Orthodontic coverage varies from plan to plan. Please sign in to the Consumer Toolkit to view your benefits, or contact us to determine eligibility requirements.
 
What is my User ID number?
 
Your User ID number is a randomly generated alternate ID number. This alternate ID number can be found on your ID card or it can looked up in the Consumer Toolkit. Please note: members enrolled in a Delta Dental plan prior to September 2011 have been issued new alternate ID numbers. Please confirm your ID number through the Consumer Toolkit or the new ID card issued in September 2011 prior to visiting the dentist or filing a claim.
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

 

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