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If you go to a Non-Participating dentist, Delta dental pays the same percentage for covered services based on the dentist's fee up to the Maximum Allowance. But since we cannot guarantee the dentist's fees, your share of the cost may be significantly higher when visiting a Non-Participating dentist.
When dental services are received from a Non-Participating dentist, reimbursement for the services will be paid directly to you. Non-Participating dentists will bill you for their normal charges, which may be higher than the Allowed Amount for the service. You will need to pay the dentist yourself and then submit a claim to Delta Dental for reimbursement, less your share of the cost. (You may download a claim form here.) Since the DPO Maximum Allowance for services your receive from a Non-Participating dentist may be less than the Non-Participating dentist's charges, your out-of-pocket costs may be significantly higher.
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