![]() ![]() ![]() The grace period for non-ACA Individual and group plans is 31 days. For individual Affordable Care Act (ACA) plans, we allow a three-month grace period to pay each premium after the initial premium. If you are enrolled in an individual BlueDental Choice or BlueDental Copayment Q or QF plan, and do not pay your premium on or before the due date, you are entitled to a grace period. Send your claim to Florida Combined Life, P.O. Statements that you prepare, cash register receipts, receipt of payment notices, or balance due notices will not be accepted. ![]() Description of each service using the correct Common Dental Terminology code (CDT)Ī claim without a provider statement will be denied.The provider statement must include all of the following: Information about other dental coverage you may haveĮnclose an itemized statement of services received from your dentist in English or a statement in a foreign language with an English translation on the provider’s stationery.Your BlueDental member ID number (the number is printed on your member card).You must file your claim within one year after the last day you received services claims filed after one year aren’t eligible for payment.Įnclose a signed letter with your claim that includes the following: How do I submit a claim?Ĭomplete a separate claim form for each covered member who received services and each provider. Please check with your dentist for clarification, as out-of-network providers are not required to submit claims on your behalf. BlueDental participating dental providers and some out-of-network providers will file claims for you, but you may be required to submit a claim form for services received from an out-of-network dentist. ![]()
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