Submit Electronic Claims and Dental Claim Forms

Switch to:

Submit Electronic Claims and Dental Claim Forms

Submitting claims online

For faster claims processing and reimbursement, send your claims and claim attachments electronically.

  • To submit electronic claimssign in to our secure provider Web site or register to start an account. Our Electronic Payer ID is 13551.
  • To submit claim attachments, such as X-rays, we recommend using FastAttach, a system of National Electronic Attachment (NEA). To set up your FastAttach account, contact NEA at 1-800-782-5150, ext. 2 or by e-mail.

To learn more, call our Electronic Data Interchange (EDI) Help Desk at 1-212-615-4362.

Submitting claim forms manually

Paper claims are still required for procedures that need coordination of benefits statements from a primary carrier.

Both network and out-of-network dentists should submit the current ADA claim form. Please mail completed form to:

Dental Claims
P.O. Box 2838
New York, NY 10116-2838