What is a predetermination?
A predetermination is a written estimate of the benefits that may be available to you under your dental plan. This estimate is requested by your dentist for a proposed treatment and is provided to you by Delta Dental before you receive the treatment.
When should I request a predetermination from my dentist?
You can request a predetermination at any time; however, specific instances when you may want to request one include:
- If your dentist is recommending extensive treatment
- If you need information on benefit coverage and plan limitations
- If you would like an estimate of how much you may have to pay
How long does it normally take to receive a predetermination?
If all information is received with the initial request for predetermination, please allow 10 – 14 business days for processing. To receive a predetermination even faster, have your dentist submit the request online.
A predetermination is informational only, and is not required for you to receive dental care. It is not a claim for benefits or a preauthorization, precertification, or other reservation of benefits. It also is not a guarantee of available benefits or costs. The benefits you have available when a predetermination is requested may be different from the benefits available at the time of treatment. You will receive the same benefits under your plan whether or not a predetermination is requested.