> ## Documentation Index
> Fetch the complete documentation index at: https://dso.getlemma.com/llms.txt
> Use this file to discover all available pages before exploring further.

# Delta Dental

> Delta Dental profile: the 39-company federation under DDPA, Premier vs PPO network mechanics, per-member-company credentialing, and what that means for a multi-state group.

**Delta Dental** is a federation of **39 independent member companies** coordinated by the **Delta Dental Plans Association (DDPA)**. The federation operates across all 50 states, DC, Puerto Rico, and other US territories.<sup>1</sup> Each member company has its own service area, contracts, and provider-relations process, so a group should identify the relevant company before beginning enrollment or contract review.

Payer portals, forms, IDs, and procedures change frequently. **Timely-filing limits and other participation terms come from the applicable current payer materials and your executed agreement.** Use this page as a starting point, then verify the product, entity, provider, location, and effective date with the payer.

## The federation

|                     |                                                                                                                                                                                                                |
| ------------------- | -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| **Structure**       | 39 independent member companies, each with a defined service area<sup>1</sup>                                                                                                                                  |
| **Entity types**    | Typically state not-for-profit dental service corporations; some multi-state groups (e.g., Delta Dental Insurance Company / "Delta Dental of California and affiliates")                                       |
| **Coordination**    | DDPA administers the brand and national network reciprocity                                                                                                                                                    |
| **Market position** | Delta Dental reports a large national membership across its independent member companies. Published totals vary by date and counting method, and NADP does not publish carrier-level market share.<sup>2</sup> |

Do not assume one participation agreement covers every Delta member company. A multi-state group may need separate applications and contracts, each with its own fee schedules, credentialing process, and terms. See [Enroll with payers, again](/start/second-state/payer-enrollment-again).

## Networks: Premier vs PPO

Every member company offers access to two nationally reciprocal networks:<sup>3</sup>

| Network                  | Character                                                                                                          | Fees                                             |
| ------------------------ | ------------------------------------------------------------------------------------------------------------------ | ------------------------------------------------ |
| **Delta Dental Premier** | Legacy network with the broadest participation (Delta Dental of Massachusetts cites over 95% of in-state dentists) | Higher maximum-allowable fee schedule            |
| **Delta Dental PPO**     | Discounted network; the product employers steer to                                                                 | Lower negotiated fee accepted as payment in full |

A dentist may participate in Premier only, PPO and Premier, or neither network. When a PPO member visits a Premier-only dentist, the applicable member-company rules may process the claim using the Premier arrangement.<sup>3</sup>

Record the exact network and fee schedule rather than only marking the provider "in network with Delta." A decision to change PPO participation should account for the fee difference, member steerage, termination terms, and expected patient volume.

## Enrollment and credentialing

A dentist joins Delta through **the member company for the state where they practice**, signing that company's participation agreement. Credentialing is a DDPA requirement but is administered by each member company, and the platforms differ:<sup>4</sup>

* Delta Dental Insurance Company states use **DDS Enroll**
* Delta Dental of Tennessee runs credentialing through **DentalXChange**
* Michigan, Washington, New Jersey, Colorado, and Arizona each publish their own processes

Start at [deltadental.com's join page](https://www.deltadental.com/dentist/join-our-network/), which routes by state. Recredentialing is generally on a **three-year cycle**.<sup>4</sup>

## Billing notes

* Each member company adjudicates its own claims against its own processing policies; a policy from one Delta does not control another.
* Delta Dental Insurance Company publishes an [837D companion guide](https://www1.deltadentalins.com/content/dam/ddins/en/pdf/dentists/companion-guide-837.pdf) for its states; other member companies publish their own EDI specifications and payer IDs.<sup>5</sup>
* Delta itself has published against leased-network arrangements' fee unpredictability; worth reading before signing any PPO contract with leasing language, Delta's or anyone else's.<sup>6</sup>

## Sources

1. DDPA, [Delta Dental member companies](https://www.deltadental.com/us/en/about-us/delta-dental-member-companies.html).
2. Delta Dental, [about us](https://www.deltadental.com/us/en/about-us.html); NADP carrier-level shares are not published openly.
3. Delta Dental Insurance Company, [how our networks work](https://www1.deltadentalins.com/administrators/word-of-mouth/2022/how-our-networks-work.html); Delta Dental of Washington, [PPO vs Premier](https://www.deltadentalwa.com/dental-benefits-guide/Delta-Dental-PPO-vs-Premier-Whats-the-Difference); Delta Dental of Massachusetts, [understanding networks](https://www.deltadentalma.com/dentists/understanding-networks).
4. [Join our network](https://www.deltadental.com/dentist/join-our-network/); [Delta Dental of Tennessee credentialing](https://deltadentaltn.com/dentists/credentialing-and-recredentialing-for-dentists); [Delta Dental of Michigan credentialing](https://www.deltadentalmi.com/dentists/credentialing); [Delta Dental Ins. Co. join](https://www1.deltadentalins.com/dentists/join.html).
5. Delta Dental Ins. Co., [837D companion guide](https://www1.deltadentalins.com/content/dam/ddins/en/pdf/dentists/companion-guide-837.pdf).
6. Delta Dental Ins. Co., [leased network disadvantages](https://www1.deltadentalins.com/administrators/word-of-mouth/2022/leased-network-disadvantages.html).