Toll Free 800.632.3334

Online Claims Processing Form

 

 

1.  Review the procedure for submitting a claim.

2.  Select the appropriate office for your region.

3.  Choose your submission method and click the appropriate link.

4.  Fill out the secure form and submit to NADENT via fax or email.

 

NADENT South & East

 

Option 1: Print + Fax

 

A.  Printable Form - Print page, fill out by hand and fax to 970-206-9958

B.  Printable Online Form -  Type in info online, print, and fax to 970-206-9958

 

Option 2:  Email

 

Click here to submit Claims Form to Nadent/South and East by email.

 

*All email claim requests will be acknowledged. If you have not received

a response from us in a couple of days, please give us a call.

 

 

NADENT West

 

Option 1: Print + Fax

 

A.  Printable Form - Print page, fill out by hand and fax to 970-226-0249

B.  Printable Online Form -  Type in info online, print, and fax to 970-226-0249

 

 

Option 2:  Email

 

Click here to submit Claims Form to Nadent West by email.

 

*All email claim requests will be acknowledged. If you have not received

a response from us in a couple of days, please give us a call.

 

 

Dental Links

 

SERVING THE USA

CANADA & MEXICO

800.632.3334

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Health Data Services (HDS) handles medical claims for NADENT-HDS. (More...)