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  • Cigna Dental Oral Health Integration Program Reimbursement Form

Get Cigna Dental Oral Health Integration Program Reimbursement Form

Cigna Dental Oral Health Integration Program Reimbursement Form Proof of Payment Dental Explanation of Benefits (EOB) OR Itemized Receipt from Dentist OR, Completed Claim Form (primary and secondary if applicable) Cigna Dental P.O. Box 188044 Chattanooga, TN 37422-8044 A. INSURED/SUBSCRIBER INFORMATION INSURED/SUBSCRIBER NAME: (Last, First, Middle Initial) (State) (City) ADDRESS: (Street) TELEPHONE NUMBER: EMPLOYER NAME: E-MAIL ADDRESS: OTHER DENTAL OR MEDICAL COVERAGE? Yes SSN OR CIGN.

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For more information about your coverage, or to get a copy of the complete terms of coverage, call 1-866-494-2111 or visit us at https://.cigna.com/individuals-families/policy.

Most in-network preventive dental care, like cleanings, routine exams, and routine X-rays, is covered at 100%. You may be required to pay a copay at the time of your visit and share costs with your plan for any care that goes beyond preventive.

An EOB (Explanation of Benefits) is a claim statement that Cigna sends to you after a health care visit or procedure to show you how your claim was paid. An EOB is not a bill.

Your EOB is now online at myCigna.com. You can choose to go paperless, continue getting paper EOBs by mail or opt for both. a paper copy. The Summary page gives an overview of the ways your benefits are working for you – quickly see what was submitted, what's been paid and what you owe.

The following services are excluded from coverage regardless of clinical indications; â–ª Macromastia or Gynecomastia Surgeries; â–ª Surgical treatment of varicose veins; â–ª â–ª Rhinoplasty; â–ª Blepharoplasty; â–ª Redundant skin surgery; â–ª Removal of skin tags; â–ª Acupressure; â–ª Craniosacral/cranial therapy; â–ª Dance therapy, ...

Your EOB is not a bill. It's a summary of your benefits applied to your claims. Do not send payment to your provider unless you receive a bill directly from your provider. Always compare your provider bill with your EOB to confirm that services you received and charges listed are correct.

To submit a medical, dental, or mental health claim: Download and print the appropriate claim form (depending on the type of claim) Follow the instructions included on the form to complete it. Mail your completed claim to the address shown on the form.

If you're not yet registered for the Cigna for Health Care Professionals website, go to CignaforHCP.com and register now. Easily track claim status with multiple payers through an EDI vendor. Look up a claim using the patient's name or Cigna ID number, or the claim or reference number.

After you receive a health care service, you get: A medical bill from your provider. If you have no health insurance, this is the amount that you pay. If you're insured, you will likely pay less than the provider has billed you for.

What is an Explanation of Benefits? Each time your insurer pays for a service you use, they send you an Explanation of Benefits (EOB). The EOB is your insurance company's written explanation for that claim, showing the name of the provider that covered the service and date(s) of service.

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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
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
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