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Handbook

Listen to the Member Handbook

You can enjoy the Member Handbook in its audio format or download the Member Handbook PDF below.

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Table of Contents

Click one of the links below to jump to a section of the video.

Section 1

1.0- Welcome to Delta Dental of Arkansas :01
1.1- Eligibility 1:05
1.2- If you need us 1:16
1.3- Using this handbook 1:34
1.4- When there are changes 2:08

Section 2

2.1- When should you see a dentist 3:05
2.2- If you are pregnant 3:44
2.3- If you have heart disease 4:25
2.4- If you have diabetes 4:47
2.5- If you have periodontal disease 5:27

Section 3

3.0- Primary Care Dentist 6:02
3.1- What is a primary care dentist 6:07
3.2- Choosing a PDC 6:29
3.3- Using a dentist who is not your PCD 7:06
3.4- Changing your PCD 7:22
3.5- Choosing a dentist who is not your PCD 7:37
3.6- What if my PCD leaves the network 8:00
3.7- Scheduling an appointment 8:13
3.8- What if I need to cancel my dental visit 8:32
3.9- What if I miss an appointment 8:53

Section 4

4.0- ID Cards 9:19
4.1- How to replace a lost ID card 10:40

Section 5

5.0- Non-Emergency Transportation 11:01
5.1- Need a ride to your dentist visit 11:06

Section 6

6.0- Billing Information 13:17
6.1- How much do I pay 13:19
6.2- How to file a claim 14:05
6.3- What if I get a bill 14:20
6.4- Is there a maximum amount Delta Dental will pay each year 14:39
6.5- If you have other dental insurance 14:46
6.6- Other times we may not pay for services 15:07

Section 7

7.1-What is an emergency dental condition 15:36
7.2- What to do in a dental emergency 15:50
7.3- What if I’m out of Arkansas and have a dental emergency 16:46

Section 8

8.0- Covered Services 17:19
8.1- Covered services for adults 17:50
8.2- Covered dental services 18:20
8.3- Lifetime benefits 21:03
8.4- Prior authorizations (approval) 21:20

Section 9

9.0- Services Not Covered 21:55
9.1- Services that are not covered 22:24

Section 10

10.0- Member Rights and Responsibilities 22:40
10.1-Member rights 22:53
10.2- Member responsibilities 27:17
10.3- Use your benefits wisely 28:50

Section 11

11.0- Grievance And Appeal 29:10
11.1- How to file a grievance or ask for an appeal 29:12
11.2- What is a grievance 29:29
11.3- How do I file a grievance 29:38
11.4- Processes and timeframes 30:11
11.5- What is an appeal 31:32
11.6- How do I file an appeal 32:06
11.7- Processes and timeframes 32:30
11.8- State Fair Hearing 34:32
11.9- Continuing your benefits 35:28

Section 12

12.0- Fraud, Waste, Abuse and Overpayments 36:15
12.1- Fraud, waste, abuse and overpayments 36:16
12.2- Definitions 36:45
12.3- Examples of fraud, waste, abuse and overpayments 37:19
12.4- Report of fraud, waste, abuse and overpayments 38:13

Section 13

13.0- Your Privacy 39:33
13.1- Your protected health information 39:49

Appendix

A- Helpful Information 42:29