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Get your claim started by submitting one of the standard forms that relates to your needs.
Coordination of Benefits Questionnaire
Use this form when coordinating dental benefits with another dental coverage provider (e.g., your spouse's coverage).
Standard Claim Form (US)
Use this form to file a claim for services performed in the United States.
Out of the Country Claim Form
Use this form to file a claim for services performed outside the United States.
HIPAA Authorization Form
Use this form to view overage dependents information or if you're having custody issues.
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