Broker blog from Delta Dental

Tag: dentist networks

Why leased networks don’t deliver

When it comes to dental coverage, having a large, dependable dentist network is crucial for quality dental care and reliable, cost-saving in-network access.

One of the unique advantages your clients enjoy with Delta Dental is network size. Our proprietary dentist networks are the nation’s largest. How large? Our combined Delta Dental PPO™ and Delta Dental Premier® networks feature more than 155,000 unique dentists, as of September 2021, according to Zelis Network360.

And to ensure quality care, we contract directly with each of our dentists and, most importantly, never lease our networks. That’s not the case with most other carriers, which lease dentist networks from other carriers to boost their numbers.

Of course, you might say to yourself, numbers are numbers ― if the network is large and my clients and their employees can visit a dentist, why does the type of network matter?

Because with leased networks, these numbers can be deceiving. What’s more, leased networks come with serious disadvantages for members.

To help understand some of these disadvantages, let’s first take a look at what leased networks are and how they work.

How leased networks work

A leased network arrangement is when one carrier agrees to share its dentist network, or a portion of it, with another carrier. A carrier can add one or many leased networks to their proprietary network.

A carrier can also share its network with a third-party insurance administrator, also known as an aggregator. Aggregators don’t own the insurance plans or pay claims. Instead, as the name suggests, aggregators lease networks from several carriers and offer participation to dentists for a fee.

Carriers profit from these arrangements by charging access fees for using their network. They may also profit from shared claim savings, which is an agreed-upon amount paid by an aggregator or carrier to the carrier whose dentist was visited to provide a service.

Leasing networks offers carriers several benefits. It allows them to expand into areas where they don’t have a network presence. It enables them to claim that they’ve increased their network size, which they can use to gain an advantage in the marketplace. And they stand to profit from access fees and shared saving.

However, these advantages for the carrier can mean disadvantages for your clients.

The downside of leased networks

Access fees

While carriers may benefit from access fees, your clients won’t. Carriers who lease networks often pass the cost of access fees on to your self-funded clients by withholding claims savings. These fees can also differ from network to network.

We never charge access fees, so you can be sure your clients will get the full savings they’re entitled to.

Network size questions

Carriers that lease networks may claim that their network is “large.” But for these carriers, exactly how large can be a tough question to answer. Why? Carriers who lease networks usually have no direct contact with dentists. And since they may lease multiple networks, keeping track of dentists who leave a network, retire or fail credentialing can be a challenge. 

We update our dentist directory daily, so you know it’s accurate. And since we have relationships with our dentists, turnover is low.

Network lease timing

When your clients choose a carrier, they’re locked in for the term of their plan contract. But that contract may not correspond to the carrier network’s lease agreements. Carrier-to-carrier leasing contracts are negotiable and can be terminated at any time. This means your clients and their employees might find the dentists they chose and depend on are suddenly no longer in their network. A leased network could lose thousands of dentists overnight.

Since we don’t lease networks, your clients can be confident knowing they can visit the dentists they know and trust.

Increased costs

When leasing contracts change, members’ expenses can increase. With renegotiated fees under a new lease, members may not realize their out-of-pocket costs are higher than expected until claims are processed. And these changes can happen at any time.

Inconsistent fees and billing

When a carrier leases several different dental networks, it can result in several different fee schedules, which can lead to inconsistent costs. Dentists may also be confused about how to bill enrollees, which could potentially increase the time it takes to process claims or even lead to incorrect billing. And since the leased networks are owned by different carriers, resolving any billing disputes may be difficult.

Our networks offer predictable, consistent fees and uniform billing and processing.

Quality concerns

Quality of care matters to patients and employers. But when a carrier leases multiple networks, this is difficult to guarantee. Since carriers have no relationship with the dentists in the networks they lease and contractual obligations around quality standards vary, they may not be able to confirm that these dentists’ treatment plans, safety measures and office cleanliness meet acceptable standards, nor can they guarantee that these dentists are properly credentialed.

At Delta Dental, we contract directly, maintain strong relationships and hold our dentists to high standards.


The promise of a carrier with a leased network may seem appealing, but that promise doesn’t hold up to scrutiny. With Delta Dental, you can be sure that you’ll get the network, quality and consistency that you — and your clients — can count on.

How Delta Dental networks ensure quality care

With Delta Dental, your clients can rely on comprehensive, high-quality oral health care. Why? One of the reasons is that we’ve built the largest dentist network in the country to ensure that your clients can always find a quality dentist they trust while enjoying substantial in-network savings. But that’s not the only advantage our network offers your clients.

Objective ratings help your clients select a dentist

For your clients to take full advantage of their dental benefits, they need to feel confident in choosing a dentist who meets their unique needs. To help, we’ve tried to take the guesswork out of finding great dental care.

That’s why our online dentist directory features quality ratings for Delta Dental PPO™, Delta Dental Premier® and select DeltaCare® USA dentists within our 15 enterprise states and the District of Columbia. Developed by a neutral third party, DentaQual ratings evaluate dentists on these criteria:

  • Procedure success rate measures treatment success rate, including the likelihood of repeat procedures and post-treatment problems.
  • Commitment to best practices evaluates how well a dentist follows established standards and treatment methods.
  • Value compares the type and number of prescribed treatments and the average cost per patient.
  • Patient retention compares the degree of patient retention and loyalty.
  • Treatment recommendations compares how a dentist recommends treatment in comparison to dentists in their geographic area and specialty.

DentaQual compares each dentist’s scores to the average scores of their peers to generate an overall rating. And DentaQual automatically refreshes scores each month, so your clients will know that their dentist’s rating is always current.

Member input makes our network stronger

Our members’ opinions matter to us. That’s why we pair DentaQual ratings with Yelp ratings from actual patients to give members an extra level of confidence when choosing a dentist. We even ask our members to recommend great dentists who aren’t in our network so that we can ask them to join. 

Member satisfaction was our main objective in creating our network. In fact, in 2020, 98% of our members said they were satisfied with their dentist and the quality of the care they received.

A proprietary dentist networks offers your clients unique advantages

Unlike some other carriers who lease their networks, we’ve built our own. Of course, you might ask yourself why the network matters as long as your clients have access to dental care. It’s because your clients will enjoy several distinct advantages with Delta Dental’s networks versus a leased network:

  • Quality. We have direct contracts and relationships with our dentists and hold each to consistently high standards. In a leased network, carriers may not have relationship with dentists, and dentist credentialing may be inconsistent.
  • Size. You can count on our network size to be accurate ― we update our directory daily ― and since we have relationships with our dentists, turnover is low. Carriers with leased networks may not know exactly how many dentists their networks contain, and if the carrier’s network lease ends before your contract does, some of your clients could find themselves without an in-network dentist.
  • Value. Our networks offer predictable, consistent fees. Leased networks may not be able to make that promise. And we never charge for network access, unlike some carriers with leased networks that withhold claims saving to cover access fees.

The largest network in the nation means your clients save

A large network means it’s easy for your clients to stay in network, which translates to lower costs. And when it comes to a large network, we lead the competition. Our Delta Dental Premier network is the largest in the nation, based on total unique dentists, according to Zelis Network360’s September 2021 report.

Why is counting unique dentists important? Because it sets us apart from carriers that count access points instead. Access points represent the number of network dentists at each dental office where patients are treated. This means a single dentist who treats patients at several offices could be counted multiple times, which may not represent the actual number of individual dentists in the network. 


With Delta Dental, you can rest assured that your clients will receive quality care. Delta Dental’s robust, nationwide networks offer quality assurance, savings, simplicity and choice.

Effective discount: Understanding a plan’s true savings

When your group clients consider a PPO dental plan, certainly one of the deciding factors is savings — during a dental visit, how much will this plan save my employees?

Traditionally, a good way to judge this has been to consider the plan’s PPO network discount, or the discount offered on dental services when visiting a dentist within the plan’s PPO network. After factoring in the fees, the greater the discount, the better the plan, right?

Not exactly. While PPO network discount is one chapter of savings, it’s not the whole story. A more accurate way to gauge a plan’s true savings is to consider the plan’s effective discount. The effective discount considers the average savings enrollees receive when visiting any dentist, either in network or out of network.

It’s here where Delta Dental offers a unique advantage: the Delta Dental PPO™ plan with the Delta Dental Premier® network.

With most PPO plans, the PPO network is absolute — you’re in or you’re out. And if you visit an out-of-network dentist, you’re responsible for the full cost of dental services provided by that dentist. The Premier network offers a secondary network that acts as a “safety net” if a PPO enrollee can’t find, or chooses not to visit, a dentist within the PPO network.

While the Premier network provides a smaller discount than the PPO network, the combined size of the two networks — more than 155,000 unique dentists as of 2020 — ensures that most people covered under a PPO plan can visit a Delta Dental dentist and save. This large network enables Delta Dental to deliver a national network utilization rate of 94%, compared to an average PPO utilization of 65% for competitor networks.

And it’s this safety net that often makes a Delta Dental PPO plan a better value than one from another company.

For example, let’s look at a theoretical example in which there are two group PPO plans with identical fees: one from Delta Dental and one from a carrier without a secondary network. In each scenario, 10 people are insured. Five visit PPO dentists and receive a discount, and five visit non-PPO dentists. The Delta Dental plan provides a 35% discount at PPO dentists. The other plan provides a 36% discount at PPO dentists.

Given the otherwise identical scenarios, it might at first seem that the plan with the higher PPO network discount offers the better value. However, in the Delta Dental plan, four people can visit a Premier dentist for a 19% discount. Because only one person visits a non–Delta Dental dentist, the group receives a total effective discount of 25%. Contrast this with the other plan. Because half receive no discount at all, the effective discount is only 18%.

It’s not surprising then that Delta Dental offers groups the best effective discount in the country, averaging 29.4% nationally in 2019, according to a July 2020 study by Dental Actuarial Analytics. This equals more than $8.2B in savings for enrollees annually when compared to dentists’ average charges for services.

So, remember when speaking with your group clients: Savings is more than PPO discounts. When you consider effective discount, you offer a complete story. One with an ending your clients should like.

New videos help explain Delta Dental’s networks and online tools

With a new series of educational videos, it’s easy to help your clients make the most of their plans. Whether your clients offer Delta Dental PPO™, DeltaCare® USA or both, you’ll find useful resources to showcase Delta Dental’s networks and online tools.

Get to know Delta Dental’s online tools

Encourage members to sign up for an online account. This video walks members through the robust online tools Delta Dental offers, including plan details, claim history, personalized cost estimates, the online dentist directory and a wealth of wellness resources.

What if your client’s plan doesn’t include the Cost Estimator? No worries. This shorter version of the same video touches on the same helpful features, minus the personalized cost estimate.

Understand the Delta Dental networks

A PPO plan offers savings, quality assurance and simplicity. This video explains the advantages of this plan and how your clients’ enrollees can find a PPO dentist online.

Want to include the Delta Dental Premier® network to offer a wider selection of dentists? This video introduces both the PPO and Premier networks and explain how to search for both in our dentist directory.

For clients that offer a DeltaCare USA plan, this video covers the basics of this prepaid plan and shows how to select a primary care dentist.

Ensure accessibility

These videos were designed with accessibility in mind. While the vibrant visuals support the narration, all key messages are conveyed in the audio, which can also be accessed through closed captioning.

Share the videos easily

To share these videos on your website or intranet, just click on the videos to navigate to YouTube. Below the video you wish to share, click on Share > Embed. Then copy and paste the code into your webpage or intranet site.

What to ask about leased dentist networks

Cars, houses, clothing, even dogs — the list of items Americans lease today continues to grow. The world of dental benefits is no exception to the trend. Oftentimes, to expand network size, a dental carrier will lease a dentist network from a third party (either another carrier or a company that aggregates dental networks). While the potential for more dentist access is tempting, it’s important to know if a leased network can truly deliver more value.

If you’re recommending a carrier who leases its dentist networks, ask these questions to see how it could impact your client.

1. Who holds the contract with the leased network dentist? The primary carrier or a third party?

Why it matters: In many cases, when a carrier leases a dentist network, there is no direct contract or relationship with the leased dentists. This may create difficulties in resolving disputes through a third party, which could mean unhappy enrollees. It may also cause confusion about which claims guidelines and processing policies apply. This could leave enrollees waiting longer for a claim to process or even cause an enrollee to be billed incorrectly.

2. Are leased network dentists held to the same credentialing and quality standards as non-leased dentists? Are they continually monitored by the primary carrier?

Why it matters: When portions of a dentist network are leased, there’s a possibility that their equipment, office cleanliness, treatment plans, safety measures and/or patient history have not been vetted as thoroughly as a carrier’s direct-contracted dentists. Furthermore, if the primary carrier is not involved in monitoring the leased network dentists, there may be no guarantee that these dentists are re-credentialed every three years or that they are credentialed to National Committee for Quality Assurance (NCQA) criteria.

3. How much of a carrier’s dentist network is leased?

Why it matters: Dentist turnover might be higher if a carrier leases dentists. Why? Because a leased dentist’s network agreement could end before a group’s benefits contract. This means, if a large part of a carrier’s dentist network is leased, there could be a greater chance enrollees will find their dentist is suddenly no longer in network.

4. Which fee schedule takes precedence when an enrollee visits a leased network dentist?

Why it matters: When a carrier leases a dental network from multiple companies or carriers, the same dentist could end up in more than one leased portion of the network. If this is the case, a group may end up with multiple fee schedules, which is known as stacking. This could cause inconsistent costs for the group if different fee schedules are applied across the network. Dentists may also be confused about how to bill enrollees, which could potentially increase claims costs depending on which fee schedule they apply.

5. How does the carrier ensure the accuracy of its leased dentist directory?

Why it matters: If a carrier does not hold a direct contract with its leased network dentists, it may be hard to ensure the accuracy of the dentist directory. This could create an unpleasant surprise for an enrollee if they’re billed for an out-of-network visit when they thought the dentist was in network. It could also lead to overstatement of network size.

6. How much is the network access fee when an enrollee visits a leased network dentist?

Why it matters: A bigger network does not always mean bigger savings for the group. If a carrier leases dentist networks to increase their network numbers, groups need to consider how much they’re being charged for access to the additional dentists. These fees may differ between portions of the network.


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5 dentists your clients won’t find in our networks

At Delta Dental, we don’t lease any of our dental networks. In fact, our Professional Relations department specializes in developing close relationships with our providers to ensure quality care for enrollees. This Halloween season, we’re showing you what not to expect in our networks — and that dental visits might not be so scary after all.

Mother and daughter carving pumpkin

Here are some doctors enrollees won’t find in our networks:

  1. Philip Sherman, Finding Nemo

Okay, so P. Sherman might not be your run-of-the-mill villain, but why would anyone want to visit a man who lets his niece torture adorable sea creatures? Plus, enrollees can find a credentialed network provider easier than getting “just keep swimming” stuck in their heads with our Find a Dentist tool.

  1. Stuart Price, The Hangover

While Stu seems like a stand-up guy, enrollees probably don’t want to look up from the chair and see a dentist with a missing tooth, a knot on his head and point-blank taser wounds on his neck. Ouch.

  1. Wilbur Wonka, Charlie and the Chocolate Factory

Unlike Willy Wonka’s father Wilbur, we don’t believe that “lollipops ought to be called cavities on a stick.” While our dentists want patients in great oral health, they don’t use scare tactics to achieve wellness. Instead, our dentists encourage regular preventive care and good oral hygiene to combat plaque and decay. (For wellness tips that your clients can share with enrollees, check out our SmileWay Wellness Program.)

  1. Orin Scrivello, Little Shop of Horrors

Arguably the most evil dentist character ever played, Orin is the exact opposite of what you’ll find in our networks. In fact, we have a whole team of dental consultants on staff dedicated to reviewing claims and preventing fraud, waste and abuse.

  1. Mindbender, G.I. Joe 

There’s no mind bending or brain scrambling here — thanks to our enrollee Online Services! Enrollees can log in at deltadentalins.com to view their benefits, check claims status and even look up average submitted fees for common services with our Fee Finder tool.

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