Dentist Guide

Become a Delta Dental Premier Participating Dentist
Participating Dentist Responsibilities
Predeterminations

All New Mexico licensed dentists are eligible to apply for membership provided they:

Sign the Delta Dental Premier Participating Dentist Agreement and any additional Network addenda.
Provide all required credentialing documents:

Delta Dental's payment is made directly to the dentist.
Delta Dental's payment is based on the dentist's actual fee charged or Delta Dental's Maximum Approved Amount.
The patient is responsible for their deductible, co-payments, and any services not covered by their benefit contracts at the time of service.

Accept assignment of benefits from Delta Dental, charging the patient only their deductible and co-payments.
File insurance claim form on behalf of the patient.
ADA approved claim forms may be obtained from Delta Dental. Please contact us at 505.883.4777 in Albuquerque or toll-free at 800.999.0963. You may also download claim forms from our website here

Although predeterminations are not required, many patients prefer an insurance estimate before beginning major treatment. Participating dentists are required to provide this service if the patient requests it.
Use an ADA claim form for a predetermination. Provide all information as stated in filing for payment except "Date Service Performed".
Instead of sending back the original claim form used to submit a predetermination, Delta Dental will send the dentist's office a predetermination voucher. Please review this voucher with your patient before commencing with treatment. In order for the dentist to receive payment, the patient needs to sign the voucher. (The patient's signature will safeguard the dentist as well as Delta Dental.) When services are completed, record the date(s) in the "Date Service Completed".