Delta Dental of New Mexico FAQs

Delta Dental of New Mexico does not mail EOB statements for services covered at 100% and for which the patient owes nothing. These statements, however, are available to view and print on our secure Member Portal.

Once you have logged into the Member Portal, click on Claim Info. Enter the date of service in the Start Date field, or enter a date range using Start Date and End Date. Click on the Claim Number for the EOB you wish to view. You also can click on the Procedure Code number for a definition of the service provided. To print EOB statements, click on the printer icon in your browser toolbar or select File then Print. 

For information about your benefit plan, log in to the Member Portal, or contact our Customer Service Department at (877) 395-9420, Monday through Friday, 8:00 a.m. to 4:30 p.m. MST.

Information for dependents 17 and older must be obtained via phone. Please call our Customer Service Department at (877) 395-9420, Monday through Friday, 8:00 a.m. to 4:30 p.m. MST.

You may print an ID card using our Member Portal or you may request an ID card via phone by calling our Customer Service Department at (877) 395-9420, Monday through Friday, 8:00 a.m. to 4:30 p.m. MST.

To get information about your specific benefit plan, log in to the Member Portal or call our Customer Service Department at (877) 395-9420, Monday through Friday, 8:00 a.m. to 4:30 p.m. MST.

Delta Dental has an extensive list of participating providers. Visiting a participating provider may help to reduce your out-of-pocket expenses.

However, if you choose to see a dentist who is not a participating provider with Delta Dental, you still may be eligible for partial reimbursement. Please call our Customer Service Department at (877) 395-9420, Monday through Friday, 8:00 a.m. to 4:30 p.m. MST for more information.

When visiting a participating Delta Dental provider, your claims will be filed for you. If your dentist is a non-participating provider, you may need to submit the claim yourself. To access a dental claim form, please log into the Member Portal. 

You can also call Customer Service Departmentt at (877) 395-9420, Monday through Friday, 8:00 a.m. to 4:30 p.m. MST,  or send an email to customerservice@deltadentalnm.com to request a dental claim form.

Either you or your dentist may complete the form and attach a copy of your bill. Completed forms may be mailed to:

Delta Dental of New Mexico
100 Sun Avenue NE, Suite 400
Albuquerque, NM 87109

Schedule an appointment with a Delta Dental provider or your preferred dentist. When visiting Delta Dental participating dentists, they will file the claims for you. We welcome the opportunity to help you learn what your benefit options are as well as help you locate a participating provider in your area. 

You can register on the Member Portal to learn more about your specific benefit plan. Need help finding a dentist? Use our Find a Dental Provider tool. You can also contact our Customer Service Department at (877) 395-9420, Monday through Friday, 8:00 a.m. to 4:30 p.m. MST.

To request changes to the way a subscriber is enrolled, an employee should first contact their employer’s Plan Administrator or Human Resources Department. 

Depending on the employer’s plan requirements, some changes may only be made during an open enrollment period. Some changes, called qualifying events, enable an employee to make changes prior to open enrollment if the change is requested within 31 days of the event. The birth of a child and the marriage or divorce of an enrolled subscriber are examples of a qualifying event.

Orthodontic coverage varies from plan to plan. Please sign in to the Member Portal to view your benefits, or contact our Customer Service Department at (877) 395-9420, Monday through Friday, 8:00 a.m. to 4:30 p.m. MST, to determine eligibility requirements.

Your User ID number is usually your social security number. Some groups use randomly assigned alternate ID numbers instead of social security numbers. If your group uses alternate ID numbers, your number will be printed on your ID card. 

To download the latest version of the Delta Dental mobile app, visit Google Play or the iTunes App Store.

Once you’ve downloaded the app, you can access the Dentist Search and Toothbrush Timer from the home screen without signing in.

You will need to sign in to access the app's full set of features, including benefits and eligibility, mobile ID card, claims status and Cost Estimator (availability may vary by geographical area).

• If you are a registered user of deltadental.com, sign in to access your account using your existing username and password.
  
  
• If you're not a registered user, use the link to register. You must be a Delta Dental member to register.

Use the Delta Dental app to:     

• Quickly find a dentist in your area.
• Search by your current location or enter an address.
• Filter and sort your results to find a dentist that suits your specific needs.
• Use our Cost Estimator to find the typical cost for popular dental treatments and procedures. Select procedure, provider and your ZIP code, and we'll provide a cost estimate for the treatment when seeing a Delta Dental dentist or an out-of-network dentist (not available in all geographic areas).
• Schedule an appointment or navigate directly to their office with the touch of your finger (availability may vary by individual dentist participation).
• Access your mobile ID card at your fingertips. You can email your ID card to your dentist or a dependent right from the app (sign in required). You can also save your ID card to your device and access it at any time via the Delta Dental app home page.
• Get claims and coverage information on the go.
• See your plan type, benefit levels, deductibles and maximums for both you and your dependents.
• Find contact information for your Delta Dental.
• Check the status of your most recent dental claims, for both you and your dependents.
• Use our toothbrush timer to make brushing fun and help you stick with it for the recommended two minutes.

If you're having any issues using our mobile app, please call 630-574-7001 or email support@deltadental.com. 

If you are not the primary member on the account, you cannot sign in. We currently support only primary member accounts.

If you are the primary member and are still having issues signing in, please try registering for the mobile app with new sign-in credentials.  In some cases, the credentials you use to sign into your Delta Dental company website cannot be used on the mobile app.

If you continue to have issues signing in, contact us at support@deltadental.com.

Delta Dental uses our internal data to calculate a fee or range of fees for each procedure within a three-digit ZIP code (the group of ZIP codes that have the same first three digits and are typically located nearby), both for dentists in our network and out of our network. Dentists in our network agree to accept discounted fees for various procedures, so the in-network estimates are typically lower than out-of-network estimates.

Currently, the Dental Care Cost Estimator only provides a range of costs that reflects what the dentists in the ZIP code provided charge for a procedure. Your benefits may pay a portion of that cost, and you may be required to pay a portion of the cost yourself. Cost estimates should not be viewed as a guarantee of coverage or cost. Please review the Terms of Use within the Dental Care Cost Estimator tool for more details.

The Delta Dental mobile app uses the latest security technology to protect your personal health information. You must enter your username and password each time you access the secure portion of the app. No personal health information is ever stored on your device. For more details on security, view our Privacy Policy on the app homepage.

Currently, our app is available for iOS and Android devices, both smartphones and tablets. Visit the App Store or Google Play to download and install the app on your device.

The Delta Dental mobile app is designed to provide real-time information, so you will need internet access in order to make full use of the features. You can access the Toothbrush Timer when you are offline, as well as your ID card, if you saved it to your device.

Benefits and eligibility, as well as claims status and details are updated in real time. Our dentist directory is updated daily.

No. Our Dentist Search and Toothbrush Timer features are available for anyone to use. You must be a member to access certain features of the app.

Currently, Delta Dental only supports accounts for members on our website and app. 

When providers register for the Dental Office Toolkit® they will be prompted for their license number; however, the toolkit does not accept alpha characters in front of the license number. Please see the following example:

• DD2222 is not acceptable (note alpha characters in front of license number)
• 2222 is acceptable

You will use the same link you currently use (https://dentalofficetoolkit.com) to access the new Toolkit.

The first time you log in, you will be prompted to create new security questions and/or confirm the name, phone number and email address for your account.

This is likely because you have visited the correct URL but are working in an unsupported web browser. Please try accessing https://dentalofficetoolkit.com using Google Chrome.

If you are not sure what browser you’re working in, navigate to https://www.whatsmybrowser.org. If you see the message “You’re using Chrome 63” or any number higher than that, you’re good to go! 

If you received a different message, please use this tutorial to download and install Google Chrome on your computer. We recommend you do this on all computers that will be accessing the new Dental Office Toolkit®.

1. If you are an existing user of the Dental Office Toolkit®, you do not need to re-register.

2. If you are a new user, to register for the Dental Office Toolkit®, ensure that you have the following information:

• Provider’s license number
• State in which provider is licensed
• Provider’s Tax Identification Number (TIN)
• Service office ZIP code
• Phone number or email address associated with the service office

3. What if I have more than one service office associated to a TIN?

• You will only have to register for one service office. The system will be able to link all service offices associated with that TIN.

4. Do I have to re-register for multiple providers? (ex. one office (one TIN), with multiple licenses)?

• If you have multiple providers associated with one TIN, you will not have to re-register for each provider.
  
  

Note: If you do not know the phone number or email address associated with the service office, please contact the Delta Dental provider records department for your state.

You will only have to register for one service office. The system will be able to link all service offices associated to that TIN.

If you have multiple providers associated with one TIN, you will not have to re-register for each provider.

Note: If you do not know the phone number or email address associated with the service office, please contact the Delta Dental provider records department for your state.

To register additional users, please view the following video: How to set up User Management.

No, your existing DOT username and password will continue to work with the new Toolkit.

We encourage offices to use a separate account for each user. With DOT’s new user management functionality, offices may manage the roles and permissions of other users in their office.

You will need to re-register for the new toolkit. Click here to watch a tutorial video on the quick and easy registration process!

Note: When you re-register for the Toolkit, ensure the first name and last name combination you have provided is unique from the previous first and last name combination you were entering. For example: If the first name and last name combination was previously John Smith, please add a number after either the first or last name to make it unique (ex: John Smith1)

• Routed: A claim that requires manual review prior to processing. You may be required to submit information for this claim to complete processing (Information Request).
• Estimated: A pre-treatment estimate that has completed processing and can be submitted in for payment.
• Paid: A claim that has completed processing and been paid.
• Denied: A claim that has completed processing and has been denied and/or is not billable to the patient. Please check the processing policies on the claim in question for the reason the claim was denied.

A no pay processed claim is any claim that is a $0 cost to the business. This includes any claims that have been denied, declined or that have a $0 payment.

It is possible your browser's pop-up blocker is blocking this functionality. Ensure your browser's pop-up blocker is disabled. Click here to view a tutorial on disabling your pop-up blocker.

The Dental Office Toolkit® (DOT) can be utilized to view information and submit claims for the following Delta Dental entities:

• Delta Dental of Michigan
• Delta Dental of Ohio
• Delta Dental of Indiana
• Delta Dental of North Carolina
• Delta Dental of Arkansas
• Delta Dental of Kentucky
• Delta Dental of Nebraska
• Delta Dental of New Mexico
• Delta Dental of Minnesota (Individual ONLY)
• Delta Dental of Tennessee
• Delta Dental of Wisconsin (CMS ONLY)

The recommended browser for the Dental Office Toolkit® is Google Chrome. If you are not sure what browser you’re working in, navigate to https://www.whatsmybrowser.org. If you see the message “You’re using Chrome 63” or any number higher than that, you’re good to go!

 If you received a different message, please use this tutorial to download and install Google Chrome on your computer. We recommend you do this on all computers that will be accessing the new Dental Office Toolkit®.

If you are unable to pass the incomplete profile page, you are most likely trying to register under a first and last name combination that already exists for your business (TIN). To overcome this, please include a number at the end of either your first or last name to make it unique (John Smith turns to John Smith1).

The FGP toolkit will remain as-is until a later date. For now, you can access it here.

To request changes to the way a subscriber is enrolled, an employee should first contact their employer’s Plan Administrator or Human Resources Department. 

Depending on the employer’s plan requirements, some changes may only be made during an open enrollment period. Some changes, called qualifying events, enable an employee to make changes prior to open enrollment if the change is requested within 31 days of the event. The birth of a child and the marriage or divorce of an enrolled subscriber are examples of a qualifying event.

If your patient is covered by both Delta Dental of New Mexico and another dental carrier or a medical plan that offers dental coverage, Delta Dental coordinates benefits with the other carrier. Generally, if the patient is covered as an employee and also as a dependent of an employee at another company, the coverage through the patient’s employer is primary. Children covered by parents who work for different employers are usually primary under the plan of the parent whose birthday occurs first in a calendar year (not necessarily the oldest parent). Total payments from both carriers cannot exceed 100% of the approved fee for the service. Some groups have specified a “carve-out” clause in their dental programs that might limit a secondary carrier’s payment. If you have questions about Coordination of Benefits, please contact our Customer Service team.

You can easily and quickly view your patient’s benefits/eligibility through your online account. Log in to your account by clicking here. Once logged in, select the New Mexico Provider Toolkit, and then select Patient Benefits or Benefit Rundown.

If the group has selected an option that limits access based on the dentist’s participation level, indication is made on the top right-hand corner of the dental insurance card — “Must see a PPO provider for benefits.” With these particular plans, if the patient chooses to see a provider outside his/her network, no benefits will be paid and full payment is the responsibility of the patient. For a patient’s specific plan details, visit your online account or contact our Customer Service team.

• View the how-to video tutorials that guide you through key activities like viewing coverage, searching for a claim and finding a provider.

• Yes, the new Member Portal is specifically designed for use on mobile devices. You can access all the information you need via mobile menus and screens that have been designed with the user experience as a priority.

When providers register for the Dental Office Toolkit® they will be prompted for their license number; however, the toolkit does not accept alpha characters in front of the license number. Please see the following example:

• DD2222 is not acceptable (note alpha characters in front of license number)
• 2222 is acceptable

A Client Administrator is a representative from your company who manages all of the company’s Benefit Manager Toolkit (BMT) accounts. The Client Administrator will set up accounts for new BMT users, plus manage current user accounts, including resetting passwords, updating user contact information and setting access levels (ex: read-only).

By having a Client Administrator, your organization will have much more control over the Benefit Manager Toolkit experience. Since you will no longer have to wait for Delta Dental to set up users or reset a forgotten password, you and your staff get immediate access to the Toolkit and its eligibility management features.

No. Management of all Benefit Manager Toolkit user accounts is transitioning to the group.

Setting up a Client Administrator is easy.

1. First, tell us who your Client Administrator will be. You can send your Delta Dental representative an email with the Client Administrators contact information, or download this form and fax it to (505) 883-7444.
2. Next, the Client Administrator will receive an email with a security code and a link to register. The Client Administrator has 30 days from the date the email was sent to register before the code expires.
3. Follow the instructions on the website to complete the registration.

The Client Administrator may begin managing Benefit Manager Toolkit accounts as soon as registration is complete.

Yes. Current Benefit Manager Toolkit user accounts will be deactivated after the Client Administrator is set up.

Yes. The Client Administrator will choose their username and password during the registration process.

The Client Administrator will go to the Client Admin section and choose “Create User”. The Client Administrator will then input the user’s name and information, and set a username and password.

Depending on the speed of your internet connection, either function should take no more than three to four minutes.

Yes. The Client Administrator will be able to reissue passwords for Benefit Manager Toolkit users.

You may have one Client Administrator per organization. 

Yes. The Client Administrator may grant read-only access to a Benefit Manager Toolkit user, or restrict the user’s access to select subgroups. The Client Administrator may also grant access to Client Knowledge or billing reports (if applicable).

Client Administrators can see a Benefit Manager Toolkit user’s username, but not their current password. Client Administrators have the ability to reset passwords.

The Client Administrator will set up the Benefit Manager Toolkit user’s username and initial password. Toolkit users are encouraged to reset their password.

Once a Client Administrator is active, access to all current Benefit Manager Toolkit accounts will be revoked and the Client Administrator will set up new user accounts. This will cleanse the system of any out-of-date accounts and ensure all users have the correct access. Client Administrators will have 30 days to set up the new accounts before access to the old accounts are revoked.

If the Client Administrator leaves, please notify your Delta Dental representative. Delta Dental will disable the Client Administrator’s access and add a new Client Administrator.

Yes, as long as the Client Administrator can correctly answer the secret question provided during registration.

Contact us to get set up! Your Client Administrator will register first through the process outlined above, and they can then begin creating Benefit Manager Toolkit accounts for other users. You can always contact your Delta Dental representative with any questions. 

No, your existing BMT username and password will continue to work with the new BMT.

Delta Dental Virtual Visits delivered by TeleDentistry.com provides 24/7 access to a dentist, 365 days a year, to Delta Dental of New Mexico members whose plans include coverage for oral exams.

In a dental emergency, it’s best to start with your regular dentist. Most dentists will have an emergency number or after business hours instructions. If your dentist is not available or you are traveling and cannot find a dentist, sign into the Delta Dental Virtual Visits patient portal or call (866) 693-5430 to get started with a virtual visit.

Delta Dental Virtual Visits are meant to supplement your current dental plan and should be used after business hours, on holidays and weekends, or when experiencing a dental emergency and your regular dentist is not available.

Delta Dental Virtual Visits supplement your current plan coverage and should be used after business hours, holidays and weekends, or when your regular dentist is not available. Schedule a virtual visit when you:

• Have a dental emergency and do not have a regular dentist
• Need access to a dentist after hours and cannot get a hold of your dentist
• Needs to consult with a dentist while traveling

Using your smartphone, computer or phone, the TeleDentistry.com dentist will provide an initial consultation and can write prescriptions when appropriate. If additional dental care is needed and contact information is provided, your regular dentist will receive notes on the consultation with TeleDentistry.com. If you do not have a dentist, TeleDentistry.com can help you find a Delta Dental network dentist for definitive diagnosis and treatment.

To get started with a virtual visit, go to sign into the Delta Dental Virtual Visits patient portal or call (866) 693-5430. Then just follow the steps below:

1. Fill out your e-documents.
2. Take photos of the problem area, if necessary.
3. Connect with a TeleDentistry.com dentist and begin.

Emergency dentists are available 24/7. The average wait time to meet with a TeleDentistry.com dentist is 3 minutes.

No. The fastest way to start your virtual visit is to sign into the Delta Dental Virtual Visits patient portal and fill out the required online forms. Then you'll be connected to a live dentist to begin your consultation. 

The TeleDentistry.com dentist will share any consultation notes with your regular dentist if further treatment is needed and you provide your regular dentist's phone number and email address. If you do not have a regular dentist, TeleDentistry.com can help you find a Delta Dental network dentist for definitive diagnosis and treatment.

Depending on the recommended treatment, the TeleDentistry.com dentist can provide a prescription to prevent infection or reduce pain. The TeleDentistry.com dentist cannot prescribe controlled substances or write international prescriptions.

No. A virtual visit delivered by TeleDentistry.com is counted as a problem-focused examination under your dental plan and does not count toward your regular preventive oral exam.

Yes. TeleDentistry.com only works with licensed dentists and has strict credentialing processes that meets the industry standards set by the National Committee for Quality Assurance (NCQA).

A virtual visit delivered by TeleDentistry.com is considered an in-network service for Delta Dental of New Mexico members.

Teledentistry is already a covered benefit in Delta Dental of New Mexico’s dental plans. However, a virtual visit delivered by TeleDentistry.com is counted as a problem-focused examination under the dental plan and does not count toward your regular preventive oral exam. A teledentistry visit delivered by your regular dentist may be counted as a regular exam under your plan.

Both types of teledentistry visits are covered services under Delta Dental of New Mexico's plans. However, a virtual visit delivered by TeleDentistry.com is counted as a problem-focused examination under your dental plan and does not count toward your regular preventive oral exam frequency. A teledentistry visit delivered by your regular dentist may be counted as a regular exam under your plan.

No. The Teledentistry.com Fluoride Varnish Kit pays/coordinates like a fluoride treatment in a dental office. This type of treatment can be useful for patients in rural areas with limited access to dental care.