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Policy #: INSTRUCTIONS FOR FILING DENTAL CLAIMS PLEASE DO NOT SUBMIT THIS FORM FOR PRECERTIFICATION. AFLAC NEW YORK DOES NOT REQUIRE PRECERTIFICATIONS AND WILL NOT COMPLETE THE FORM FOR PRECERTIFICATION.

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While crisis injuries can occur, there are a laundry list of common injuries that need attention too. Aflac also helps cover fractures, broken teeth, eye injuries, and pain management, like epidurals.

Submit the typed claim form directly to Aflac at: Aflac Worldwide Headquarters. Attention: Claims Department. 1932 Wynnton Road. Columbus, GA 31999-7254. Fax: 1.877.44.AFLAC (1.877.442.3522) Attn: Dental Claims.

The policyholder's complete name as it is printed on the Dental Plan ID card. The patient's full name, sex, date of birth and relationship to the insured. The treatment date, tooth or surface, oral cavity and if initial placement, ADA code and charge for each procedure. The patient's Social Security number.

Claims for all other benefits covered under this policy must be filed separately using the claim forms available at aflac.com or by calling 1-800-99-AFLAC (1-800-992-3522).

We help cover what health insurance doesn't so you can focus on recovery. Accident. Get help with high deductible for covered hospital stays. Cancer. Get help coping with the financial and emotional effects of cancer. Critical Illness. ... Final Expense. ... Life. ... Pet Insurance. ... Dental. ... Supplemental Dental.

It will depend on the type of claim filed whether you'll receive lump sum payment or payments throughout treatment. Either way, if filing online and assuming all necessary documentation is present, payment turnaround should be 24-48 hrs. If filing via fax or mail, it will be longer.

Coverage is available for you, your spouse, and dependent children. Fast claims payment. Most claims are processed in about four business days. Amount payable was generated based on benefit amounts for: Crown-Full Cast Noble Metal ($325), and Molar (excluding final restoration), and Root Canal ($325).

Coverage. Aflac offers dental coverage for individuals, families and businesses. We also offer supplemental dental insurance to help cover anything missing by your primary dental plan. Most plans offer coverage in one or all of the following areas: preventative, basic and major coverage.

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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
Content Takedown Policy
Bug Bounty Program
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:
+1 833 426 79 33
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