Hf004 2025

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The document provides detailed instructions for filing dental claims with Aflac New York. It specifies that claims must be submitted on a typed ADA claim form, outlines the necessary information required from the dentist's office, and clarifies that precertification is not needed. It also includes guidelines for submitting claims electronically, addresses specific conditions such as orthodontic benefits, and provides contact information for claim submission.

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Click ‘Get Form’ to open hf004 in the editor.
Begin by entering the policyholder’s dental policy number and their complete name as printed on the Dental Plan ID card.
Fill in the patient’s full name, sex, date of birth, and relationship to the insured. Ensure all fields are completed to avoid delays.
Provide details about the treatment date, tooth or surface involved, ADA code, and charges for each procedure performed.
If applicable, indicate if the patient is a full-time student over age 19 and ensure that Aflac New York’s payer number (52080) is included if your dentist submits electronically.
Review all entries for accuracy before submitting. Once completed, submit the form directly to Aflac New York via fax or mail as instructed.

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How long does it take Aflac to process a claim?

Aflac Aflac cannot process claims until they have the employee's statement, physician's statement, employer statement and the authorization page. Claims approval process takes 5 days to process and pay out claims.

How do I get in touch with Aflac?

Customer Service What are your hours of operation? The Aflac Customer Solutions Center is open 8 a.m. - 7 p.m. ET, Monday thru Friday. ... What is your phone number? Aflac Customer Solutions Center: 800.992.3522. ... What is your fax number? Claims: 877.442.3522 (fax)

Does Aflac cover oral surgery?

Major Services: Aflac provides dental insurance that covers implants. We also help cover periodontics, endodontics, oral surgery, dentures, and anesthesia.

Does Aflac cover a chipped tooth?

Injuries and Emergency Services Covered Aflac also helps cover fractures, broken teeth, eye injuries, and pain management, like epidurals.

Where do I send my Aflac dental claim?

5. Fax this form to 1-877-442-3522 or return the form to Aflac, Attn: Claims Department, Worldwide Headquarters, 1932 Wynnton Road, Columbus, GA 31999, as soon as possible in order to expedite claim review.

How do I upload documents to Aflac?

1If all documentation is not available upon initial claim filing, you may upload the documents later by clicking \u201cUpload Documents\u201d on the mobile app or \u201cMyClaims\u201d on desktop. Register or Log in: Go to aflac.com/myaflac or download the Aflac SmartClaim Mobile app from the App Store or Google Play Store. One Day Pay*.

How do I send an email to Aflac?

If you need assistance from customer service, please use the CSCMail@aflac.com email.

Hf004 2025

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