Get the free Cigna Dental Claim Form - HSHS benefits - Hospital Sisters Health ...

Dental Claim Form Cagney Insured and/or Administered by Connecticut General Life Insurance Company and Cagney Health and Life Insurance Company For mailing address, call Customer Service at 18002446224

How to fill out cigna dental claim form

How to fill out a Cigna dental claim form:

1. Begin by obtaining the Cigna dental claim form. You can usually find this form on the Cigna website or by contacting their customer service.
2. Fill in your personal information, including your full name, date of birth, address, and contact information. Make sure to provide accurate details to ensure the claim is processed correctly.
3. Provide your Cigna dental insurance policy information, such as your policy number and group number. This information can typically be found on your insurance card or in the policy documentation.
4. Indicate the type of dental service you are claiming by checking the appropriate box on the form. Common services include preventive, restorative, orthodontic, or cosmetic procedures.
5. Specify the date of service for each dental procedure you are claiming. Include the name and contact information of the dental provider who performed the service.
6. Provide detailed information about the dental procedure performed, including the specific tooth or area treated and the diagnosis or reason for the procedure.
7. Include any supporting documentation, such as receipts, invoices, or treatment plans, that may be required for the claim. Follow the instructions provided by Cigna regarding any documentation needed.
8. Finally, review the completed claim form to ensure all information is accurate and legible. Sign and date the form before submitting it to Cigna for processing.

Who needs a Cigna dental claim form?

1. Individuals who have a Cigna dental insurance plan and have received dental treatment from a participating provider.
2. Those who wish to seek reimbursement from Cigna for dental services rendered.
3. Anyone who wants to claim dental expenses for eligible procedures covered under their Cigna dental insurance policy. The claim form is necessary to initiate the reimbursement process.

For pdfFiller’s FAQs

What is cigna dental claim form?

Cigna dental claim form is a document used to request reimbursement for dental services rendered.

Who is required to file cigna dental claim form?

Any Cigna dental insurance policyholder who has received dental services and is seeking reimbursement.

How to fill out cigna dental claim form?

Fill out the form with accurate information about the dental services received, including provider details and costs incurred.

What is the purpose of cigna dental claim form?

The purpose of the form is to request reimbursement for dental services covered under Cigna dental insurance policy.

What information must be reported on cigna dental claim form?

Information such as date of service, type of service, provider details, costs incurred, and policyholder information.

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