Do I need to bring a claim form?
In most instances you do not need to bring a claim form with you. If the dental office submits insurance claims for you, they already have claim forms. However, if the dental office requires that you file your own claim(s) with insurance, please make sure the dental provider gives you a statement. Complete only the top portion (Part 1) of a claim form with the patient and member information, attach a copy of the provider statement and submit to us at:
PO Box 82520
Lincoln, NE 68501