FYI

If you’re new to treating Delta Dental patients, congratulations! We’re proud to partner with you in delivering exceptional care and supporting your patients' oral health.

As you get started, don’t let paperwork delay your first payment. It may take some time to enter your information into our system and establish an accurate dentist directory listing, but that shouldn't stop you from seeing Delta Dental members. To ensure you receive payments quickly and effortlessly, please submit a  taxpayer identification number (TIN) form with your first claim.
 

What is the TIN form?

The taxpayer identification number form provides us with the information we need for contracting, claims processing and IRS income reporting purposes. This includes your taxpayer identification number, practice information, business mailing address and other relevant information.
 

Why do I need to submit a TIN form?

The IRS requires us to file an information return and to use your TIN to report any income paid to you. Filing this return with your correct TIN and appropriate certifications prevents your payments from being subject to backup withholding.
 

What happens if I don’t submit a TIN form?

As a new Delta Dental provider or an office considering joining our network, failing to submit a TIN form may lead to claims denials or slower claims processing. This form is essential for creating your record in our system, which is necessary for processing your first claim. Without this record, your claims may be denied due to missing provider information.

Even for out-of-network dentists, submitting a TIN form is crucial for processing claims, although your office will not be added to our dentist directory. Be sure to submit your first claims with a TIN form to avoid any disruptions. Once submitted, you’ll be placed in the Dentist Directory, and you won't need to resubmit the TIN form.