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  • Healthscope Benefits Dental Claim Form 2015

Get Healthscope Benefits Dental Claim Form 2015-2025

Tatement Check one: Dentist s pretreatment estimate Dentist s statement of actual services (This area is HSB Records Center Use Only) P A T I E N T 1. Patient s Name (first, middle initial, last) 2. Relationship to Employee Self child Spouse other 3. Sex M F 6. Employee Name and Mailing Address 7. Employee s identification No. or Social Security No. 8. Employee s S E C T I O N 11. Is Patient Covered By Another Benefit Plan? Dental Medical 12a. Name and Address of other Carr.

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UNITEDHEALTH GROUP I Sternlieb of Kirkland & Ellis LLP acted as a legal advisor to ABRY Partners. UnitedHealth Group Incorporated (NYSE:UNH) completed the acquisition of HealthSCOPE Benefits, Inc.

with this completed claim form to: HealthSCOPE Benefits, Inc. P.O. Box 99006. Lubbock, TX 79490-9006.

Dental claims processing includes all aspects of giving care to patients, from the moment a patient is registered with your practice until the explanation of benefits (EOB) and payments are finished. Dental insurance claims can be submitted via paper and electronically.

If you have questions, you may visit our website at .healthscopebenefits.com or contact Customer Services at 877-385- 8775. You may fax this claim form to 877-240-0135.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232