Employer instructions for filing group life insurance claims. Dental services transition from tricare to metlife effective may 1, 2012 metropolitan life insurance company, inc. Other dental insurancecoordinating benefits with the tdp. Fedvip eligibility to certain tricareeligible individuals.
You may enroll in a dental plan or a vision plan, or both. Learn more about the capabilities that will make the process faster and easier for you here. Your sponsors social security number or dod benefits number. Dental insurance fraud is a crime that costs honest consumers and businesses money. Federal government programs dental office handboo dear doctor and staff. To enroll, submit this form and mail it along with your initial monthly premium payment check, money order or credit card to united concordia. Participating dentists will fill out and submit your dental claims for you. The patient, if 18 or older, must sign the claim form in item 37.
For the most recent information, contact metlife at 18556388371 conus. Participating dentists will usually file claims for you. Just log in to your account, go to profile and click communication preferences to update your preferences. The tricare dental program tdp minimizes your outofpocket costs for dental care. Weve been in the program as active duty military and as national guard. Government, the department of defense or the department of the air force.
Take the time to familiarize yourself with the metlife tricare dental plan and your coverage by visiting their website, liking them on facebook and twitter. Variable insurance products are distributed by metlife investors distribution company mlidc member finra or brighthouse securities, llc member finra and offered through retail broker. Call if you need assistance completing the form or email your questions to email tbd. But, if youre authorized to visit a nonnetwork dentist, you may have to submit your own claims. Individual insurance forms for members humana customer support. Sign, fax and printable from pc, ipad, tablet or mobile with pdffiller instantly no software. Keeping your personal information secure is a top priority of metlife. Provides information for how to submit dental claims. The subscribers pension recipients full name and address. Opers health care metlife dental plan patients will save, some docs will flee new tricare. Metlife federal dental plan metlife fedvip contact us. Individual insurance forms for members humana customer. This brochure describes the benefits of the metlife federal dental plan under metropolitan life insurance company metlife contract opm01. In either case, a dental explanation of benefits paid will be sent to you.
It is important to remember that tricare policies and benefits are governed by public law and federal regulations. Fraud occurs when an individual, by means of deception, receives insurance payments after filing a false claim, inflating costs of services performed on claims, or billing for services not actually delivered. The tdp will also coordinate with another supplemental dental insurance carrier, but its always a good idea to compare other plans with the tdp. The ub04 claim form and npi the ub04 claim form includes several fields that accommodate the use of your npi. Air force, under exclusive written contract with nellis air force base, nev. Metlife fillable tricare claim form fill online, printable. Metlife dental plan 20200424 opers health care metlife dental plan. Use this form to make claim for inpatient or outpatient treatments. For enrollment and eligibility questions, contact benefeds. Complete this form to receive reimbursement or to pay. Tricare claim process overview to assist you in the claimstiling process. Tricare dental program claims submission document conus service area tricare dental program participating dentists will file claims on your behalf, but if you need to submit a dental claim, mail or fax the completed dental expense claim submission document to united concordia. If you have obtained your npis and submitted them to us. You can select from several nationwide, and in some areas, regional dental preferred provider organization ppo or health maintenance organization hmo plans, and high and standard coverage options.
This consent will be valid for as long as the patient is entitled to coverage under a dental plan. Metlife now administering dental benefits for tricare. Fill metlife fillable tricare claim form, download blank or editable online. Mail or fax the completed dental expense claim submission document to. To avoid any delays in the processing of your claim, please ensure. I participated in an ambassador program on behalf of influence central for the metlife tricare dental program. Metlife federal dental benefit line can help you answer questions on your existing metlife plan, what services are covered and more. Commercial payers blue cross blue shield payers delta dental payers medicaid payers payer id 06126. To better serve you, metlife is launching an improved interactive voice response ivr experience for our dental providers this summer. What you need to know about the metlife tricare dental plan.
To the extent permitted by law, i consent to your use and disclosure of my protected health. Although the form accommodates the npi, you may continue to report your current provider identification numbers in the appropriate areas of the form until otherwise notified. Ada policy promotes use and acceptance of the most current version of the ada dental claim form by dentists and payers. Ada dental claim form the ada dental claim form provides a common format for reporting dental services to a patients dental benefit plan. You can arrange for metlife to make payment directly to the dentist by completing item 22.
Customer service for tricare dental program metlife. Ask the doc desert lightning news nelliscreech afb. Workplace voluntary benefits and financial protection products have moved to and is serviced by manhattan life. Employers statement and one death certificate is needed for processing the claim. For benefits and services questions, contact metlife. Simply dial 1877metdds9 18776383379, and select option 1. Our family has been in the tricare dental program for years and years. If enrolled in a tricare health plan, tricare eligible individuals may. Tricare dental program network dentists can complete the dental exam form dd 28 for you at no cost. Metlife dental expense claim university of delaware.
Process for continued coverage for full time students who are on medical leave of absence. Vadip offers costeffective dental coverage with three plan options designed to meet the various needs of va. Your dentist bill or statement of charges, if it isnt on your. As a retired uniform service member, you will be able to select fep bluedental to provide dental benefits for you and your family. Filing claims participating network dentists will file claims for you, but you may need to file a dental claim if you see a nonnetwork dentist. Veterans affairs dental insurance program vadip is offered by delta dental through the department of veterans affairs and is administered by the federal government programs division, located in sacramento, california. Metlife federal dental benefit line can help you answer questions on your existing. Detach and mail the completed dental expense claim form to. It is an advantageous, easy and cost effective dental coverage and. Tricare prime health care plans are available in certain areas across the world. Take advantage of your metlife tricare dental program benefits. Fedvip has expanded eligibility to include certain tricare eligible individuals.
Any person who knowingly files a statement of claim. Opm has contracted with dental and vision insurers to offer an array of choices to federal employees and annuitants. You can also select from several nationwide vision plans. Metlife tricare dental program and the military child.
Log in to your metlife account, access claim forms, or access information if. Nonavailability and referral form, a completed tdp oconus claim submission document, and the providers bill for total orthodontic services to the following address. Keeping your personal information secure is a top priority. Those who were previously eligible for the trdp are now eligible to enroll in a fedvip dental plan. Metlife is the officially partnered organization providing dental services under the tricare dental program. If you seek services from a nonparticipating dentist, you or someone in the dental office must fill out the following member information on the claim form. Phishing is a fraudulent attempt to obtain an individuals personal information, often through a misleading email. Claims filed more than a year after the date of service will be denied. Metlife tricare dental monthly premium changes for 2016. The following when charged by the dentist on a separate basis. Metlife dental insurance login make a payment tdp oconus claim form tricare dental program metlife inc form 8k ex10. The ub04 claim form accommodates the national provider identifier npi and has incorporated other important changes.
United concordias network dentists will file claims for you. If you wish benefits to be paid directly to yourself, do not complete item 21 and receipt for services rendered must accompany the claim form at time of submission. Changes to tricare programs are continually made as public law andor federal regulations are amended. Learn more about the preferred dentist program and metlife dental health maintenance organization.
General form used to submit pharmacy benefits claims. Use this eclaim payer id for those insurance companies that are not on the eclaim payer list. These benefits include enhanced dental coverage at a lower monthly premium and access to. All federal employees, annuitants, and certain tricare beneficiaries in the united states and overseas who are eligible to enroll in the federal employees dental and vision insurance program. If you wish to receive payment directly, do not complete item 38. Veterans affairs dental insurance program vadip plan. Learn about dental insurance and discover the benefits metlife dental can offer you. We are pleased to present the dental office handbook for dental programs administered by the federal government programs fgp division of delta dental of california. Metlife began administering dental benefits for the tricare dental program tdp may 1, 2012. Explains availability and coverage under the tricare dental program. If you have questions about your dental insurance, please contact.
If you are looking for greater flexibility in choosing your own health care provider, you may. Service form 1095 from your pay center each january listing the coverage you. Send the claim form and supporting documentation to. If you need to submit a dental claim, mail or fax the claim form and. Submit the following to the metlife group life claims office for processing. Delta dental of california today announced a new preventive treatment service through virtudent, inc. Form narf, tricare dental program oconus claim form, and the providers bill for total orthodontic services. If you are enrolled in the metlife tricare dental program tdp, some changes have been made to your premium and will take effect on february 1, 2016.
Military appreciation month and the metlife tricare dental. If you wish benefits to be paid directly to yourself, do not complete. If you receive metlife dental insurance benefits through your employer, you can view and manage them online. You can contact your regional tricare office at 18004445445. Check out the metlife tdp premium changes chartsee photo below metlife tricare dental program varies based on the sponsors military status. In order to determine whether you are eligible for receiving tricare prime coverage, you can use your zip code to see if the area you reside in is a prime service area. Top sites metlife dental claim appeal form 2019 latest. If you are a dental provider supporting one of tricares dental programs or if youd like to join one of the networks, please call the appropriate. Mail, email or fax the completed tricare dental program oconus nonavailability and referral form narf, tricare dental program oconus claim form, and the providers bill for total. If you have a new address or phone number, use this form to let us know so we can keep you informed about the status. Contents of the desert lightning news are not necessarily the official views of, or endorsed by, the u. See if my claims have been processed and what i owe. Metlife has become aware of a recent phishing attack against some of our customers.
You can arrange for the tricare dental program tdp contractor to make payment directly to the dentist by completing item 38. Opers health care metlife dental plan patients will save, some docs will flee new tricare dental. As a participating fedvip dental plan, the blue cross blue shield association is honored to offer you fep bluedental. Phishing is a fraudulent attempt to obtain an individuals personal information, often through a misleading email, text or other online communication. It is important that you respond to verifpoint to ensure your continued relationship with metlife. Invoice metlife directly for its share of the bill complete and submit the members claim submission provide any information needed by metlife to make coverage and payment determinations upon request, complete the department of defense active dutyreserve forces dental examination form dd form 28 for national guard and. You must be logged in to your account to view your claims. J430 same as ada dental claim form j431, j432, j433, j434, j430d to reorder call 800.
Complete your section of the claim submission document items 1 through 20 in full to assure positive identification and prompt payment. Section 715 of the national defense authorization act for fiscal year 2017 fy 2017. Cigna dental health 10050 n claim status inquiry cdo technologies 87065 y n claims. This form is used to file a claim with metlife dental for expenses or for your dentist to file to receive payment. The tricare retired dental program trdp will no longer be available after december 31, 2018. Metlife will become the dental carrier for the tricare dental program tdp.
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