Claims Coding and Submission Guidelines
ADA Dental Claim Form 2019 Version (1064 KB)
Claims Submission CMS UB-04 (35 KB)
Claims Submission CMS1500 (37 KB)
Claims News & Updates
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EFT and ERA are fast, secure and more accurate than paper checks.
- Electronic Funds Transfer (EFT) sends claims payments directly to your bank account
- Electronic Remittance Advice (ERA) makes it easier to access and reconcile payment information
Contact firstname.lastname@example.org with any questions.