How To File a Claim for Connection Dental Plus
To request Connection Dental Plus® benefits:
- File your claim.
Claims may be submitted by either you or the provider and should be submitted on an American Dental Association (ADA) dental claim form.
- Include itemized bills and receipts.
Itemized bills should show:
- Name of patient and relationship to member
- Member identification number
- Name, degree and address of provider
- Dates that services or treatments were received
- Description in English of each service or treatment
- Tooth number(s) and tooth surface(s), quadrant, arch when applicable
- American Dental Association (ADA) procedure codes
- Charge for each service or treatment
- Include a copy of the EOB (explanation of benefits).
Remember to include a copy of the EOB if any other insurance provides dental coverage.
- Keep a copy for your records.
- Mail claims and supporting documents to:
Connection Dental Plus
Attn: Claims Department
PO Box 400
Independence, MO 64051-0400
The dental plan does not require predetermination of benefits. However, to avoid unexpected costs, we recommend that you ask your dentist to preauthorize any extensive treatment. We will respond to a request to preauthorize services with an estimate of covered services.
- Other dental coverage.
Remember that Connection Dental Plus is a supplemental dental benefit plan that pays last after any other coverage. If you have any other insurance that covers dental expenses, submit your claim to that insurance first. Then submit your claim along with the other insurance explanation of benefits or denial to Connection Dental Plus.