Aetna - Dental Claim Form & Instructions ... 'dwh (&)

You are now leaving the Aetna Dental Web site and linking to ClaimConnect*. Aetna Dental works with ClaimConnect TM offered by EDI Health Group (EHG) to provide easy access to check patient eligibility, file a claim, check claim status, view patient rosters and …

Title: Dental Claim Form.pdf Author: Darrell Created Date: 10/10/2015 5:51:29 PM

2025年1月17日 · If you paid for a fitness item or service in 2025, use this 2025 form: English 2025 | Español 2025; This form is supported on desktop and mobile devices. It takes about 10 minutes to complete. You’ll need your Aetna® member ID and a clear image of your receipt(s) to upload. Fill out both fields to start.

You are now leaving the Aetna Dental Web site and linking to ClaimConnect*. Aetna Dental works with ClaimConnect TM offered by EDI Health Group (EHG) to provide easy access to check patient eligibility, file a claim, check claim status, view patient rosters and …

† To submit expenses covered by your underlying dental plan and fund, please use the “Dental Benefits Request" form. This is labeled as "Claim-Dental” on Aetna Navigator's Forms Library. You may submit a claim at any time during the year, but it is recommended that you accumulate a minimum of $50.00 in eligible expenses prior to

You are now leaving the Aetna Dental Web site and linking to ClaimConnect*. Aetna Dental works with ClaimConnect TM offered by EDI Health Group (EHG) to provide easy access to check patient eligibility, file a claim, check claim status, view patient rosters and …

2023年10月3日 · How to File a Dental Claim Form with Aetna Steps to File a Dental Claim Form: Complete the Aetna Dental Claim Form. English version; Spanish version; Attach any requested documentation, such as. Copy of the itemized bill/receipt(s) Copy of the EOB (Explanation of Benefits) Submit all documentation via mail to the address on the Claim Form.

note: incomplete claim forms will be returned to you for missing information. this will delay the processing of the claim. for faster, easier submission of claims, the provider may contact the aetna claim processing center for information regarding electronic claim submissions. to the employee – use black ink only 1. complete blocks 1–22 in ...

If you need the five-digit payer ID number to show the destination of the claim, use 60054 for Aetna claims, and 68246 for Aetna encounters. Use current CDT codes (five-position codes starting with the letter “D”) for each procedure. The claim may require other information. This varies according to the submitted claim.