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First Commonwealth, Inc., 550 West Jackson Blvd., Suite 800, Chicago, Illinois 60661 First Commonwealth is an Illinois domiciled Limited Health Services Organization licensed in accordance with the
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This dental plan includes coverage for preventive services, basic procedures, major procedures, and orthodontics, depending on the specific plan.
Individuals enrolled in the dental plan are required to file the necessary claims for benefits covered under the plan.
To fill out this dental plan, complete the required forms with personal information, provider details, and treatment descriptions, then submit them as instructed.
The purpose of this dental plan is to provide financial coverage for dental services, ensuring access to necessary oral health care.
The information that must be reported includes patient details, provider information, descriptions of services rendered, and any applicable fees.
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