Handbook

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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 :59
1.2- If you need us 1:12
1.3- Using this handbook 1:24
1.4- When there are changes 2:57

Section 2

2.1- When should you see a dentist 3:10
2.2- If you are pregnant 3:48
2.3- If you have heart disease 4:25
2.4- If you have diabetes 4:46
2.5- If you have periodontal disease 5:24

Section 3

3.0- Primary Care Dentist 6:02
3.1- What is a primary care dentist 6:07
3.2- Choosing a PDC 6:30
3.3- Using a dentist who is not your PCD 7:07
3.4- Changing your PCD 7:21
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 8:14
3.8- What if I need to cancel my dental visit 8:32
3.9- What if I miss an appointment 8:48

Section 4

4.0- ID Cards 9:15
4.1- How to replace a lost ID card 10:38

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 13:32
6.1- How much do I pay 13:36
6.2- How to file a claim 14:18
6.3- What of I get a bill 14:35
6.4- Is there a maximum amount Delta Dental will pay each year 14:55
6.5- If you have other dental insurance 15:05
6.6- Other times we may not pay for services 15:28

Section 7

7.1-What is an emergency dental condition 15:57
7.2- What to do in a dental emergency 16:15
7.3- What if I’m out of Arkansas and have a dental emergency 17:11

Section 8

8.0- Covered Services 17:47
8.1- Covered services for adults 18:20
8.2- Covered dental services 18:52
8.3- Lifetime benefits 21:32
8.4- Prior authorizations (approval) 21:50

Section 9

9.0- Services Not Covered 22:45
9.1- Services that are not covered 22:54

Section 10

10.0- Member Rights And Responsibilities 23:10
10.1-Member rights 23:24
10.2- Member responsiblities 28:24
10.3- Use your benefits wisely 29:50

Section 11

11.0- Grievance And Appeal 30:10
11.1- How to file a grievance or ask for an appeal 30:14
11.2- What is a grievance 30:31
11.3- How do I file a grievance 30:44
11.4- Processes and timeframes 31:30
11.5- What is an appeal 32:42
11.6- How do I file an appeal 33:09
11.7- Processes and timeframes 34:16
11.8- State Fair Hearing 37:56
11.9- Continuing your benefits 39:23

Section 12

12.0- Fraud, Waste, Abuse and Overpayments 40:58
12.1- Fraud, waste, abuse and overpayments 41:03
12.2- Definitions 41:37
12.3- Examples of fraud, waste, abuse and overpayments 42:12
12.4- Report of fraud, waste, abuse and overpayments 43:02

Section 13

13.0- Your Privacy 44:26
13.1- Your protected health information 44:43

Appendix

A- Helpful Information 47:32
B- Taglines and Non-Discrimination Disclosures 48:50