Please use this page for a handy reference to frequently asked questions.
Benefits and Eligibility
Claims
Membership
Fees
General Questions
Benefits and Eligibility
How can we obtain benefit information for our patients without waiting on the phone?
You have several easy-to-use options:
Washington Dental Services interactive voice response (IVR) system allows you to use your touch tone phone to obtain eligibility and benefit information, as well as claim status. This option includes a speak back feature.
Our IVR system also includes a fax-back capability. You can request a fax of eligibility and benefit information, claim status for a specific claim or the status of unpaid claims received within the past 30-60 days.
You can also go to secured Check Your Benefits section on the WDS website to get current information on each of your Washington Dental Service patients, including totals of the deductibles satisfied and benefits used. Just click the Check Patient Benefits at the top of the page.
Another option available to your office is your practice management software. Click here for more information.
My benefits page is not printing correctly, how do I get everything on the page to display when printing?
You will need to change the settings in the Print function. Below are the steps to change your settings to landscape so the entire page displays when printed.
- Go to ‘File” in top tool bar, choose Print
- Click on Preferences in upper right hand of the gray box
- Click on Basics in top nav of the gray box
- Click on Landscape found in lower left of the gray box
- Click “ok"
- Click “ok” again – this will print page correctly.
Is there a missing tooth clause?
No, WDS does not have a missing tooth clause.
Can all four quadrants be done on the same day for procedure codes D4341/D4342?
Yes, all four quadrants can be done on the same day.
Claims
What is the correct address for mailing claims to Washington Dental Service?
The correct address for mailing your claims to Washington Dental Service is:
Washington Dental Service
P.O. Box 75983
Seattle, WA 98175-0983
Does Washington Dental Service require periodontal charting for D4341, periodontal scaling and root planing?
Click here for our current documentation requirements.
What if there is additional information I feel is pertinent to processing a specific claim?
If you believe there is additional information that should have been considered in the processing of a claim or predetermination, you may place one of the following “key words” along with the additional information in the comment field of the claim form. These “key words” will stop a claim for review of additional information.
- Accident
- Appeal
- Assessment Code
- Corrected
- Reconsider
- Reevaluate
- Reprocess
- Resubmission
- Review
- Seat
Does Washington Dental Service pay on the prep or seat date for a crown?
Washington Dental Service pays on the completion, or seat, date for all multiple appointment procedures.
When do we need to submit x-rays?
Click here for our current documentation requirements. Washington Dental Serivce does not return x-rays. Please keep this in mind when determining how to submit x-rays to us.
What is the process of submitting Orthodontia claims?
When submitting a full case set-up, it is not necessary to submit claims for monthly or quarterly payments. In fact, it is important that you do NOT send continuation claims for the remainder of treatment. Washington Dental Service will set those up automatically and pay them on schedule. If you are not receiving payments, call WDS Customer Service at (206) 522-2300 or 1-800-554-1907. When submitting your full case set-up claim, please be sure to include:
The bandling date
The total treatment fee
The down payment
The estimated number of treatment months (not payment months)
The monthly fee
Where can I periodically review information about the Clinical Review process at Washington Dental Service?
There is a "Clinical Review Updates" link in the resource center on the WDS website where current information about the Clinical Review process can be accessed.
If I submitted incorrect information on a claim, what is the best way to submit a corrected claim so I don’t have to call customer service?
If you need to submit a corrected claim, please make sure you clearly indicate on the claim that it is a corrected claim and include a narrative with the corrected information. (For example: Claim #123456789123456 submitted with tooth #15 in error. Please reprocess claim using tooth #16.)
If my patient has Dual WDS Coverage do I need to submit two claim forms?
No, only one claim needs to be submitted as long as all the Secondary Coverage information is filled out under the other coverage section of the claim form.
Should I highlight important on claim forms before sending them in?
Highlighting data on the claim forms causes that information to be unreadable when the claims are scanned. Please do not highlight any information on them prior to submitting them.
How long should I wait to receive payment or denial on a claim before I resubmit the claim or contact customer service?
Washington Dental Service has 30 days to process claims. For claims that have not received a payment or denial, please wait 30 days before resubmitting them or calling customer service to inquire about their status. Resubmitting the claims causes additional claim volumes and can delay the payment or denial of the claims.
Are there any restrictions to sealants?
Sealants are covered on permanent molars with no restorations or decay on the occlusal surface.
Should I include the primary carrier’s explanation of benefits (EOB) when submitting a claim to Washington Dental Service if WDS is the secondary carrier?
Yes. You should always include the primary carrier’s EOB when submitting your patients’ claims to Washington Dental Service if WDS is secondary. This will reduce requests for additional information and help ensure that your claims are processed quickly and accurately.
Membership
If I am a Washington Dental Service member dentist, which networks do I belong to?
When you become a member dentist with Washington Dental Service, you are automatically a member of the Delta Dental Premier® network. You must apply separately for any other network(s) you would like to join. If you're not sure which networks you have joined, you can use the "Find a Dentist" capability on our Web site to double check. Click the Find A Dentist link on the Dentist Home page and search for yourself; the results will display every network you currently belong to.
I am a member at one dental office. Does that mean I'm automatically a member at all of my offices?
No. Washington Dental service membership, and membership in any provider network, is per location. If you want to be a member dentist in any or all of our networks at multiple locations, you must apply separately for each location.
Do dental associates working under my Tax ID Number need to be members?
No. Your employees do not need to be member dentists, but this could result in their claims paying as non-member claims, using non-member fees. This is especially true for claims processed in states other than Washington. Also, most Delta plans pay non-member claims directly to the patient instead of to the dentist.
Can I access membership applications online?
Yes. You can access the Delta Dental Premier® application online. All the forms you need have been conveniently placed in a single location. Click here
After completing your applicaiton, you can fax it to (800) 460-3159 for fastest processing. If you don't wish to fax your documents you can mail them to:
Washington Dental Service
P.O. Box 75688
Seattle, WA 98175-0983
You cannot access the PPO application online. Please contact Provider Services by e-mail at techserv@deltadentalwa.com or call (800) 238-3439.
I am changing or have changed my Tax ID Number. What's next?
Please complete a Tax ID change notification form, W-9 cover sheet, and W-9 and fax them to Provider Services at (800) 460-3189. Click here to access the forms.
Fees
Can a Customer Service representative give me my filed fees?
No. Our Customer Service representatives can only verify a filed fee if they are researching a fee for a procedure your office has submitted to verify whether the correct fee was applied by our computer information system. If you are a Washington Dental Service participating dentist and would like a complete listing of your filed fees, you can contact our Provider maintenance team at 1-800-238-3439 or 206-528-7394.
What is a Maximum Allowable Fee?
A maximum allowable fee is the amount WDS will pay on a procedure that a dentist does not have a filed fee for.
Can you tell me Washington Dental Service's Maximum Allowable Fees over the phone?
Provider Services can tell you the maximum allowable fee for procedures you cannot file fees for. You can get the maximum allowable fee for up to three procedures over the phone. Our Provider Services representatives can help you determine where to go on our Web site for future reference.
There are several dentists in our office with the same fees. Can we update all of their fees at the same time?
You cannot update the fees for multiple providers at one time. The fees must be updated for each provider individually. If you get any kind of error when doing so, please call Provider Services at 1-800-238-3439.
General Questions
How can I get my question answered if I don't have time to hold on the phone?
If you need the answer to a simple question and you don't see it in these FAQ's, you can e-mail us at techserv@deltadentalwa.com and we'll respond to your question within one business day.
What is the Washington Dental Service Payer ID?
91062
Where can I review the Washington Dental Service processing policies?
There is a processing policy manual on the WDS website that can be accessed in the Resource Center under Policies, Manuals, Contracts. In the Member Dentist Manual it's titled "WDS Processing Policy Manual."