Important Changes to Delta Dental Partnership

To our valued patients,

After many years of deliberation, we have made the difficult decision to end our participating relationship with Delta Dental. This important change will become effective October 1^st, 2025.

What is a dental insurance partnership and how does it work?

When a dental office decides to become a contracted in-network provider with an insurance company, it agrees to discount its fees for all patients who have that particular dental insurance. For example, if the office usually charges $200 for a routine teeth cleaning, the insurance company may require that cost to be discounted to $100 for all of its members. In exchange, the insurance company will list the office in their directory.

Do these discounted fee schedules change over time?

We partner with most major dental insurance companies and most of them do routinely adjust the fees to help match inflation and the economic environment in the region. This allows providers to continue providing high-quality dentistry without compromising. The provider can continue to use high quality materials, keep manufacturing and lab work in the United States, keep highly trained staff members, and spend sufficient time with patients to ensure the best possible outcomes. But while most other insurance companies are willing to negotiate fees to help their patients get better care, Delta Dental has been doing the exact opposite.

Why are we leaving the Delta Dental network? Over the past few years, Delta Dental has been using their large market share in the industry to bully providers in to accepting lower and lower reimbursements. While other insurance companies were giving modest raises in reimbursements each year, Delta actually REDUCED them. This may not be a problem for large corporate dental chains, but it puts a huge strain on private offices like ours. While corporate offices can simply increase their patient volume by shortening appointment times and double/triple booking patients, this is not something that we are willing to do.

Rather than lowering the high standards that we have maintained since we have opened, we have chosen to terminate our relationship with Delta Dental.

What will happen once The Smile Company leaves the network?

Shortly after we notify Delta Dental of our intent to leave the network, they will send all patients a letter stating that The Smile Company is now an “out-of-network provider”. The letter is meant to encourage you in to finding an in-network provider to “save money” on treatment costs and to get the best “quality” care. Ultimately, it is your decision on whether to find another provider in their network or to stay with us. But we hope you will choose us and not allow Delta Dental to dictate your oral health. 

Can I continue to come to The Smile Company with my Delta Dental insurance?
Yes! Most Delta Dental plans have out-of-network benefits that allow you to visit any office. We will still bill the insurance for you at the time of service as a courtesy, just as we have always done. We will continue to help you maximize the use of your insurance plans.

Will my insurance benefits be different now?
This really depends on your company’s plan under Delta Dental. Some plans will have very similar benefits, regardless of the office’s network status. However, some plans may have a reduced annual maximum for out-of-network offices or they might cover items at different percentages. For example, your plan may give you $2500 in annual maximum benefits for in-network providers but only $2000 in maximum benefits for out-of-network providers. Another example is that they may cover your cleanings at only 80% instead of 100%.

To fully understand your specific dental plan’s benefits and reimbursements, we encourage you to reach out to your human resources department for details. We are here to help you in whatever capacity we can, but Delta Dental does not share out-of-network plan benefits with us. We will have to manually submit pre-authorizations for all visits to better understand coverages and copays. 

What other things should I expect if I choose to stay with The Smile Company?
Before, we would bill your insurance after each service date and they would mail us the check directly within a few weeks. Once we leave the network, Delta Dental will no longer mail the checks to our office but to the patient directly. The processing time may be longer as well.

In order to navigate around this new absurd obstacle, we will require payment up front for all services rendered. We will then bill the services to the insurance like before and the insurance will send payment directly to you. In some cases, we may also ask you to either mail or drop off all checks and documents to our office when you receive them.

We hope that the care you have received from us and the partnership that we have built as advocates for your oral health will encourage you to continue with our practice. However, if you choose to seek care from a new dentist, please let us know and we will help with the transition. 

If you have any questions or concerns, please do not hesitate to reach out to our practice.