Delta-Dental-Claim-Form 2025

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We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.
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When you submit claims as soon as possible after treatment is completed, you help us process claims more efficiently, using the patients most current eligibility and benefits to determine payment. Generally, claims received more than 12 months after the date of treatment may not be paid.
How do I submit a claim myself? Download a claim form from your secure member portal. Fill out the claim form. You will need the ADA Procedure codes (provided by your dentists office), along with your providers information and TIN (tax identification number).
To fill out the claim form, you will need the American Dental Association procedure codes (provided by your dentists office), along with your dentists information and tax identification number (TIN). If available, please attach a copy of your bill as well. Fax your completed claim form to 617-886-1199.
If you get your dental insurance through your employer: Please use the information on the back of your ID card to call customer service or to mail a claim. If you do not have an ID card, call us at 1- 800-448-3815 (TTY 711). Lines are open from 7 a.m.-7 p.m. central.
You may submit your dental claim electronically or use a paper form to receive payment for services. You are encouraged to directly submit your claims and pre-treatment estimates online through the provider portal or through a clearinghouse.
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For any claims or eligibility questions, email customer.care@deltadentalma.com or call 800-872-0500.

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