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Manage your account and access all employer information on our employer service page.

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Submit / View a Claim

Dental PPO

Follow these steps to submit a claim:

By mail:

  1. Click here to download a claim form.

    Please note: The form is in Adobe® PDF format. If you to not have Adobe® Acrobat Reader®, Click here to download a free copy.

  2. Complete and print the form, and be sure to sign it.
  3. Mail the completed, signed form, along with a copy of the receipt for the services you received, to:

    PO Box 7805
    London, KY 40742

Participating providers have agreed to submit claims on your behalf. Many non-participating providers will also submit claims for you, or they will help you with the process.

Employers, members, and providers can view claim status and claim payments on a secure Web site 24 hours a day, seven days a week.

View claim status & payments

You may also contact a representative Monday through Friday, 6:30 a.m. to 5:00 p.m at 1-866-498-7912.

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