Updated essential health benefit orthodontic forms
Q2 Word of Mouth newsletter 2023
We recently updated the essential health benefit (EHB) orthodontic forms and have redesigned our provider portal to make it easier for you to find them. You can find the EHB forms by visiting the Claims and Pre-Treatment Estimates page and clicking the EHB Orthodontic forms under the Claims Resources.
To avoid delays in processing your EHB orthodontic claims, complete the following steps:
Select the appropriate state form specific to the subscriber’s group state of issue and plan name shown on the member’s ID card
Fill out the applicable form in full
Attach required documentation
Submit with completed dental claim form for review of medical necessity