Delta Dental - Dentists - Orthodontic Processing


GROUP NUMBER	GROUP NAME AND PAYMENT PROCESS DETAILS
6318 & 4357	Boston Teacher's Union Paid off a specific table-$2,000 lifetime orthodontic maximum paid in two payments, six months apart. Do not usually meet their maximum-$57 for each month of treatment plus $381 for records and banding. Please note: Non-par is paid at a reduced fee. $45.60 for each month. $304.80 for records and banding.
6563	Interstate Electrical $1,500 lifetime orthodontic maximum-paid out in one payment.
7525	The New England Carpenters (formerly Massachusetts State Carpenters) $2,000 lifetime orthodontic maximum-paid out in one payment.
7850	The TJX Companies $1,000 lifetime orthodontic maximum with a $500 calendar year maximum. Receive one lump payment of $500 for the first year. Must resubmit the second year for the remaining $500 paid out in monthly installments.
4309	NSTAR Only Sublocations 7430-7432 & 9997 that have a $1501 lifetime maximum that is paid out as follows: Four payments that are each six months apart. First payment is $760, six months later a payment of $285, six months later $228, and the final payment six months later of $228. Please note: There are some NSTAR sub-locations that have an $1800 maximum. These are paid monthly but must be submitted each month.
3615	Tweeter Home Entertainment $1500 lifetime orthodontic maximum with a $750.00 calendar year maximum. Receive $750 for the first year in monthly installments. Must resubmit the second year for the remaining $750 paid out in monthly installments.
2397	Massachusetts Bricklayers $2600 orthodontic lifetime maximum with a cap of $1300 paid per fiscal year. The fiscal year runs from July 1st through June 30th. Two orthodontic payments are made 6 months apart as long as the second payment is in a different fiscal year. If the second payment would fall in the same fiscal year, wait until the following July to submit for the second payment.
7007	Massachusetts Public Employees Quarterly payments are based on length of treatment. Please submit a copy of the pre-estimate with date of service at the specified payment intervals to receive payment of orthodontic benefits.
DeltaCare	All groups that have the DeltaCare product Please submit a claim with the initial date of banding or date appliance is placed. Six months later please submit claim with date of service for remaining orthodontic benefits.