Submitting Dental Claims

In-network dentists will submit dental claims directly to Delta Dental on behalf of Benefit Trust Fund participants. Some out-of-network dentists submit claims directly to Delta Dental, but others may require participants to submit their own claims.

When visiting an out-of-network dentist, take a Benefit Trust Fund Dental Claim Form
(PDF)
to the dental appointment. Ask the dentist to fill out the provider section of the form. You will have to complete the employee/patient section. Once the form is complete, you can submit it directly to Delta Dental. You must submit a claim within one year after the dental expense is incurred in order for the claim to be processed.

Submit completed dental claim forms to the following address:

Delta Dental Insurance Company
P.O. Box 1809
Alpharetta, GA  30023-1809

For questions regarding claims, you can contact Delta Dental of Georgia at 1-800-616-3631.

Complete information on how to file a claim for dental benefits is in your Summary Plan Description.

 

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Bring the Dental Claim Form when visiting an Out-of-Network dentist.

Frequently Asked Question (FAQ)

How many different plans does the Fund offer?

The Fund offers multiple Medical, Dental, and Vision plans. Short-Term Disability and Life and Accidental Death & Dismemberment benefits are also available.

How do I notify the Fund of my address change?

If you move, please notify the Fund of your new address. To change your address,
fill out a new Enrollment Form and mail or fax it to the Fund using the mailing address or fax number found on the form. Always complete a new Enrollment Form when you have a change in personal information.

Who processes health care plan claims?

Medical claims are processed by CIGNA Healthcare. Dental claims are processed by Delta Dental Insurance Company, and Vision claims are processed by Fund Office staff.

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