Get the free Automatic Orthodontia Request - Voya Financial
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RESET FORMAUTOMATIC ORTHODONTIA REIMBURSEMENT REQUEST Goya Benefits Company, LLC A member of the Goya family of companies Customer Service: PO Box 929, Manchester, NH 03105 Phone: 8332324673; Fax:
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How to fill out automatic orthodontia request
How to fill out automatic orthodontia request
01
Gather all necessary information such as patient's personal details, dental history, and insurance information.
02
Contact the orthodontist's office to request the automatic orthodontia request form.
03
Fill out the form accurately and completely, double-checking all information before submission.
04
Include any additional documents or records requested by the orthodontist, such as dental x-rays or previous treatment plans.
05
Submit the completed form and any additional documents to the orthodontist's office either in person, by mail, or through their online portal.
Who needs automatic orthodontia request?
01
Any individual who requires orthodontic treatment and is seeking approval from their insurance provider to cover the cost of the treatment.
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What is automatic orthodontia request?
Automatic orthodontia request is a form submitted to request orthodontic treatment coverage automatically.
Who is required to file automatic orthodontia request?
The policyholder or the insured individual is required to file the automatic orthodontia request.
How to fill out automatic orthodontia request?
The automatic orthodontia request can be filled out by providing all relevant information such as personal details, treatment plan, and orthodontist information.
What is the purpose of automatic orthodontia request?
The purpose of the automatic orthodontia request is to request coverage for orthodontic treatment in a seamless and automatic manner.
What information must be reported on automatic orthodontia request?
The automatic orthodontia request must include details such as the policyholder's name, policy number, orthodontist's information, treatment plan, and estimated costs.
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