View Delta Difference PDF

Delta Dental is a nationwide organization of non-profit dental service plans which underwrite and administer employee group dental programs throughout the nation. With more than 117,000 practicing dentists enrolled in the Delta Dental network (with agreements that help promote quality and moderate fees), the system is a managed-care model that saves group purchasers and individual subscribers more than $4.1 billion annually.

The Dental Expert:
Nearly one in every four Americans with dental benefits relies on the dental expert, Delta Dental, for their coverage. Our programs work because we know Dental. Delta Dental has been underwriting and administering group dental benefits since 1954. Because Delta Dental offers only dental benefit programs, all attention is placed on designing and implementing quality products and providing professional servicing to our clients.

The Cost Management Expert:
Delta Dental participating dentists, who agree to provide Delta Dental subscribers with treatment that meets the dental professionís standards at previously agreed-to fees, are only part of the unique cost-management system known as The Delta Difference. The other parts of Delta Dentalís cost management system are the unique internal processing policies and procedures Delta Dental conducts when processing claims. Combining Delta Dentalís internal features (processing policies and procedures) with its external features (nationwide dental network) enables Delta Dental to provide the type of cost management expertise clients need.

The National Expert:
When you choose Delta Dental, you are choosing the national expert for dental benefits. Delta Dental pioneered the first dental programs more than 50 years ago. Today, the Delta Dental system is a nationwide organization, providing sophisticated systems to administer coverage to purchasers coast to coast. Whether you have employees in two states or all fifty, Delta Dental programs offer:

• Superior cost management systems
• Unparalleled dental expertise
• Uniform benefits and administration
• Uniform professional and utilization review
• Timely, accurate claims processing
• Prompt problem resolution
• Dedicated service centers
• Benefit design flexibility nationwide

 View Advantage of Nonprofit Health Benefits PDF

A new study from the Journal of the American Medical Association finds nonprofit health plans deliver better quality of care. When Delta Dental of Oklahoma was founded, we knew one fact would position us as the dental care leader - being a nonprofit service corporation. It keeps us oriented to what our business partners and customers care about most: extending the reach of affordable, quality dental benefits to as many Americans as possible.

A National Committee for Quality Assurance (NCQA) Report study strengthens our position that nonprofit status gives Delta Dental an advantage. Findings published in the Journal of the American Medical association (JAMA) show a direct correlation between the nonprofit health care business model and higher quality care. The study did not examine dental plans per se, but its findings and subsequent, related articles in the Los Angeles Times, the New York Times and other leading newspapers strongly suggest that the nonprofit business model is superior when it comes to delivering higher quality health care.

Our experience echoes the studyís findings. Some of the most compelling and relevant finds of the JAMA study are:

• Nonprofit health plans consistently achieve higher ratings in each of the 14 quality indicators that are accepted measures of care embraced by the National Committee for the Quality Assurance (NCQA).
• Nonprofit health plans consistently demonstrate higher rates of preventative services for their members.
• While total costs to consumers are roughly equivalent, for-profit health plans spend on administrative on average 48 percent more than their nonprofit counterparts on administrative overhead and spend far less on health services.

Delta Dentalís operations are unaffected by Wall Street volatility, undiluted by shareholder dividends and uncompromised by the demands and requirements of ownership or investment groups. Delta Dentalís consolidated administrative rate of about 9 percent contrasts sharply with the administrative costs typically associated with most for-profit health plans, which generally range between 15 and 30 percent. For Delta Dental clients and enrollees, this means more than 85 cents of every premium dollar go directly toward the delivery of quality dental care. No other dental carrier directs such a high portion of its revenues for care, and so little toward overhead expenses.

Delta Dental invites you to use this information to look beyond just the price of dental benefits and evaluate what factors truly motivate a dental plan to serve you and your groupís members. Is it an uncompromised commitment to quality care and service, or a commitment to the bottom line?

Cost Containment: The Delta Difference is Clear.

 View Cost Containment PDF

At Delta Dental, we view cost management as our primary responsibility. Instead of passing increases on to the client or expecting others to bring cost-savings, we look for ways to reduce costs whenever possible.

Delta Dental is the most experienced cost manager in the group dental benefits market. Our 40-plus years of experience have provided valuable knowledge, which we put to work for our clients on every claim. Annual cost management reports identify eight areas of objectively discernible cost management that save our clients money-in 2005, over $36 million for our Oklahoma clients. Of these eight categories, four stand out as Delta Dental specialties.

Reduction to Maximum Allowable:
More than 85% of Oklahomaís dentists and two-thirds of the nation's dentists have signed agreements with Delta Dental that protect groups and subscribers from unnecessary or unexpected charges. Participating dentists pre-file their fees with Delta Dental and agree that if their fees exceed our allowable charges, the difference will be absorbed by the dentists, not balance-billed to the patients.

In addition, if dentists do balance-bill, intentionally or not, Delta Dental will intercede on the patientís behalf to see to it that only the appropriate charge is billed. Delta Dental also conducts routine in-office visits and contract compliance reviews of participating dentists.

Professional Review:
Delta Dentalís dental consultants, who are licensed practicing dentists, review claims to protect our clients and subscribers from inappropriate charges. Delta Dental has used this form of outcomes management for years to ensure the treatment is appropriate.

Contract Limitations & Exclusions (Non-patient Payable):
Delta Dentalís dental consultants also protect our subscribers and clients from charges deemed non-billable in our agreements with dentists. These savings can come from segmented billing practices for treatment and/or infection control charges.

Coordination of Benefits:
Delta Dental aggressively pursues coordination of benefits (COB). Unlike most multi-line commercial carriers, Delta Dental, as a dental specialist, gathers and records alternate coverage information. That information is used for pro-active measures in COB activity.

Real Cost Management, Not Just Promises:
Delta Dental uses its extensive dental network, utilization database, and ingenuity to design truly cost-effective, managed care dental programs. The many ways we put our cost-management techniques to work for our clients add up to real cost containment, not cost shifting.

Electronic Capabilities - Delta Dental is an Industry Leader:

 View Electronic Capabilities PDF

At DDOK, we are committed to providing leading-edge technology to continually meet the needs of our constituents. Following is a list of on-line services available to our employer groups, as well as recent e-commerce initiatives we have undertaken.

On-Line Services:

• E-Bill - Provides clients with a monthly link notifying you when their billing invoice is ready to be retrieved. Simply visit our website at: https://www.deltadentalok.org/BillingV3/ enter your user name and password (provided by Delta Dental) to retrieve their bill. Clients receive this link on their usual billing day each month. Itís that simple! Prior authorization is required.
• Delta Dentalís Direct Deposit - authorizes Delta Dental of Oklahoma and the financial institution you name to begin deductions of your companyís monthly dental premium from the account you indicate. Premium deductions occur on the 5th of every month.
• Electronic Eligibility - a complimentary service that allows our eligible clients to supply subscriber and dependent information via an electronic format. Once all the employeesí information is entered into your database, a snapshot of the data is exported in the form of a data file and sent using File Transfer Protocol (FTP).
• On-line Eligibility - our On-line Eligibility service allows eligible clients to update enrollee information in ìreal timeî via our web site. Prior authorization is required.

• The Digital Manager - Our award-winning interactive ìDigital Managerî CD-ROM is setting the standard for service in the dental benefits industry. Dental-related forms and documents, group specific documents, and interfaces with Delta Dental of Oklahomaí provide ìreal timeî data in a format that makes your job - and working together - easier than ever before.
• Electronic Documents - DDOK has developed procedures to allow a groupís Summary Plan Description and related documents to be sent electronically. To find out more, contact your Client Services Representative.
• New Web Site - DDOK recently unveiled this completely new design of the Delta Dental of Oklahoma Web Site - now providing a broader scope of up-to-date information for all of our constituents.
• Electronic Surveys - DDOK conducts IT Capability Surveys (on-line) to assure our e-commerce capacities always meet the needs of our employer groups.
• Distance Learning - In conjunction with the University of Oklahoma - College of Dentistry, the DDOK Foundation recently established the Delta Dental Distance Learning Studio - an interactive two-way video conferencing laboratory to facilitate dental-related distance learning across Oklahoma. This will insure that our subscribers always have access to quality dental care.

Get Adobe Acrobat