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Delta Dental Smiles:


Thank you for choosing Delta Dental Smiles!

As a Delta Dental Smiles member you have access to

  • Excellent dental benefits and customer service
    • Call us at (866) 864-2499, Monday - Friday, 7 am to 7 pm Central Time.
  • A Primary Care Dentist (PCD) to visit regularly

Member Rights

As part of being with Delta Dental Smiles, you have these rights:

  1. You have the right to be treated with respect, dignity, and privacy.
  2. You have the right to receive care no matter how you identify your race, color, nationality, disability, sex, religion, or age.
  3. You have the right to get correct, easy-to-understand information to help you make healthy choices.
  4. You have the right to file a complaint or grievance about us, a dentist, or the care you receive. This includes any abuse, neglect, or exploitation. For complaints, please call 1-800-482-8988, or refer to the contact information in Appendix A.
  5. You have the right to file an appeal about an action or decision we make.
  6. You have the right to know:
    • a. Why Delta Dental decides to cover or not cover a service.
    • b. Why Delta Dental decides if a service is medically necessary.
    • c. Who in Delta Dental’s office decides these things.
  7. You have the right to know the names of Delta Dental Smiles Network dentists.
  8. You have the right to pick from a list of dentists to get the right kind of care for you.
  9. You have the right to take part in all your dental care decisions. This may include refusing treatment.
  10. You have the right to get a second opinion, at no cost, from another Delta Dental Smiles Network dentist about what kind of treatment you need.
    • a. To request a second opinion, please call us at 1-866-864-2499.
    • b. You must request your second opinion within 90 days of your original treatment plan.
  11. You have the right to fair treatment from us, Delta Dental Smiles Network dentists, and other dentists.
  12. You have the right to:
    • a. Talk to a dentist in private.
    • b. Have dental records kept private.
    • c. Request a copy of dental records.
    • d. Ask for changes to those records.
  13. You have the right to know dentists who can inform you about:
    • a. Health status.
    • b. Dental care.
    • c. Treatment.
  14. You have the right to know you are not responsible for paying for covered services. Delta Dental Smiles Network dentists can’t require you to pay for your covered services.
  15. You have the right to receive all information, including, but not limited to, informational materials, instructional materials, available treatment options, and alternatives in a manner and format that you can easily understand. Please contact us toll-free at 1-866-864-2499.
  16. You have the right to get a spoken translation at no cost for all non-English languages, not just those identified as prevalent.
  17. You have the right to recommend changes in policies and services under Delta Dental Smiles. Write us or call toll-free at 1-866-864-2499.
  18. You have the right to get detailed information about emergency and after-hours coverage. This includes, but is not limited to, information about:
    • a. What counts as an emergency medical condition, emergency services, and services after you are stabilized.
    • b. Emergency services don’t require prior approval.
    • c. The process and procedures for obtaining emergency services.
    • d. The locations of any providers and hospitals who provide emergency services and services after you are stabilized covered under the contract.
    • e. Your right to use any hospital or other setting for emergency care and services after you are stabilized care services.
  19. You have the right to request and receive a copy of your medical records and to ask that they be amended or corrected. You get one free of charge.
  20. You have the right to have your privacy protected following the privacy requirements in federal law to the extent that they apply.
  21. You have the right to exercise these rights without changing the way Delta Dental, providers, or DHS treats you.
  22. You have the right to be free from any form of restraint or seclusion used as a means of coercion, discipline, convenience, or retaliation as specified in the federal regulations on the use of restraints and seclusion.
  23. You have the right to make recommendations about these rights and responsibilities.
  24. You have the right to obtain services from an out-of-network provider at no cost only if there is not a Delta Dental Smiles Network provider that can offer services.

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