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Appeal Request Form 

Delta Dental created an interactive appeals form that dentists can download from the forms section of the secured Dentist Connection.  Dentists who wish to file a formal appeal to a claim benefit determination must complete the Appeal Request Form.  Please follow the instructions outlined on the form to submit the Appeal.

 

Interested in Increasing Your Patient Base?

Delta Dental of Iowa is always recruiting new providers to serve our members.  If you are interested in becoming a Delta Dental Premier or PPO network dentist, please contact our Provider Services Team

We are the Iowa Oral Health Leader

As a non-profit organization, it's our mission to improve oral health throughout Iowa. Our Foundation supports projects that improve access to oral care for our neighbors. Learn more about our Public Benefit Programs.

 
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