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Fee Filing Submission

Weíre Simplifying Reimbursement: No More Filed Fees

You asked, and weíre listening. Based on feedback from our participating dentists, Delta Dental of Arizona is eliminating filed fees as of January 1, 2018.

What does this mean for you?
Starting in 2018, your reimbursement for services rendered will be the lesser of your submitted charges or Delta Dentalís Maximum Reimbursable Amount (MRA). This may result in a higher reimbursement for patients with the Delta Dental Premier® plan. For your patients with the Delta Dental PPOSM plan, you will continue to be reimbursed per Delta Dentalís current PPO fee schedule.

Will this change my reimbursement from all Delta Dental Member Companies?
Yes, this change will affect the way all Delta Dental Member Companies calculate your reimbursement for patients with the Delta Dental Premier plan. Regardless of which Member Company administers your Delta Dental patientís benefits, your reimbursement will be the lesser of your submitted charges or the MRA.

Why is Delta Dental of Arizona eliminating filed fees?
Under the current system, which is sometimes called three-way pricing, Delta Dental approves reimbursement for the lesser of submitted charges, filed fees or the MRA for any given procedure. If your filed fee was lower than your submitted fee or the MRA, you received that lower reimbursement rate.

With the new, two-way pricing system, Delta Dental no longer takes filed fees into consideration. Your reimbursement for Premier patients is only based on the lesser of the submitted charges or the MRA. Just submit your UCR and any outdated filed fees will no longer get in the way of reimbursement; you will receive the lesser of your submitted charges or Delta Dental's MRA.

Questions?
If you have questions, please do not hesitate to reach out to a member of our Professional Relations team at 602.588.3982, option 5 or email us prelations@deltadentalaz.com.

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