01. Edit your cdha login online
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Cdha claim form 2026
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- Click ‘Get Form’ to open the cdha claim form in the editor.
- Begin with Part 1, where you will enter the Registered Dental Hygienist's details. Fill in the CDHA UIN #, last name, first name, address, city, province, postal code, and telephone number.
- Next, provide the Date of Service and CDHA Service Code. If applicable, indicate if preauthorization is required and detail the dental hygienist’s fee along with a description of services provided.
- In Part 2, input your Employee/Plan Member/Subscriber information including Group Policy/Plan No., date of birth, and gender. Ensure all fields are accurately filled.
- Proceed to Part 3 for Client/Patient Information. If different from the claimant, provide their relationship to you and any relevant details regarding other insurance plans or accidents.
- Finally, review all entries for accuracy before signing at the bottom of each section. Once completed, submit your claim as instructed.
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