Aflac Dental Claim Form clearly states that this kind of claim form covers everything under an oral health that is needed by the insurance or policy holder. It is a 3 paged form wherein instructions and fillable pages are included. The last page of the form includes an agreement between the holder and Aflac. There also some requirements that policyholder must have in order to obtain this form, these requirements are given into a policyholder during the application or upon the application for the assurance company.
When filling up an Aflac Dental Claim Form, a policyholder must be able to provide all the needed information truthfully for if it will be lacking of information, it may cause such delay. So here is a step by step procedure on filling up this form:
Step1
Read the first page regarding the instruction. Now this would easily help the holder obtain the essential information first before proceeding to filling the form up. In this way preparedness will be obtained.
Step2
On page 2, from box 1 to 5 is not literally including the holder’s details but the Dentist’s assessment on the policyholder. As well as some informations about the assurance company of the right side.
Step3
Starting from box 8 to 18 is the part wherein the holder or patient needs to supply his or her information generously in each space provided. This includes some personal information such as social security number, address, gender, birthdates and contact information. If the one filling up the form is not the patient himself, it can be stated on box 17.
Step4
The next part is the Subscriber/Employee box wherein it is needed to be filled out if applicable. On the other side is more on stating if the holder has any other policies covered by.
Step5
Next is the box wherein the Billing Dentists information is needed. It is more on giving personal information about the attending Dentist, fill this part generously for it would help on the identification of the said service provider.
Step6
The last box is more of an explanation on what is the procedure that is decoded for the policy holder or the examination and treatment that is assessed for the mentioned patient. This can be done by the attending Dental Hygienist.
Step7
The last page is for the policyholder to fill, wherein his or her identification name and numbers are written as what are accordingly enlisted. Fill the spaces respectively.
Step8
Lastly sign the form to indicate authorization and formality.
1
Every spaces and required information is needed so make sure not to skip any of them or make sure not to submit it with blank answers.
2
State all the information needed clearly for it will help the form to be granted right away. If proven that the form lacks of information it will be rejected back to the holder.
3
Indicate in the form if the patient is below the age that the company is validating for which is 19 years old. There is a proper space provided for this kind of information.
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