HOW TO SUBMIT A CLAIM. i. Claims for Benefits must be filed on a standard Claim Form that is available in most dental offices. PPO and Premier Providers will fill out and submit your claims paperwork for you. Some Non-Delta Dental Providers may also provide this service upon your request. If you receive services from a Non-Delta Dental Provider who does not provide this service, you can submit your own claim directly to the dental plan. Please refer to the section titled “Dental Claim Form” for more information. ii. Your dental office should be able to assist you in filling out the Claim Form. Fill out the Claim Form completely and send it to: Delta Dental P.O. Box 1809 Alpharetta, GA ▇▇▇▇▇-▇▇▇▇ ▇▇▇-▇▇▇-▇▇▇▇ fax
Appears in 2 contracts
Sources: Medical and Hospital Service Contract, Medical and Hospital Service Contract