How to File a Claim
To request GEHA Connection Dental Federal® benefits:
- File your claim (download Dental Claim Form). Either you or the provider may submit claims.
- Include itemized bills and receipts. Itemized bills should show:
- Name of patient and relationship to member
- Member identification number
- Name, degree and address of provider
- Dates services or treatments were received
- Description in English of each service or treatment
- Tooth number(s) and tooth surface(s), quadrant, arch when applicable
- American Dental Association (ADA) procedure codes, if applicable
- Charge for each service or treatment
- Include a copy of the EOB (explanation of benefits). Remember to include a copy of the EOB if any other insurance provides dental coverage.
- Keep a copy for your records.
- Mail claims and supporting documents to:
GEHA Connection Dental Federal
Attn: Claims Department
P.O. Box 2336
Independence, MO 64051-2336
- Preauthorization. The dental plan does not require predetermination of benefits. However, to avoid unexpected costs, we recommend that you ask your dentist to preauthorize any extensive treatment. We will respond to a request to preauthorize services with an estimate of covered services.
- Other dental coverage:
- FEHB plan coverage
Your Connection Dental Federal coverage is a supplemental dental benefit to your FEHB medical plan. Many FEHB medical plans cover some dental services. You should submit your dental claim to your FEHB medical plan first. Then submit your dental claim along with your FEHB plan's explanation of benefits or denial to GEHA Connection Dental Federal.
If we get your claim without the primary FEHB plan's explanation of benefit statement, we will estimate their payment and, in some cases, forward the claim to your FEHB plan for processing. Please be sure you have indicated your GEHA plan ID number as well as your FEHB medical plan ID number.
- Other group coverage
If you or a covered family member has coverage under another dental plan or group health plan, this is called "double coverage." When you have double coverage, one plan normally pays its benefits in full as the primary payor and the other plan pays a reduced benefit as the secondary payer. We, like other insurers, determine which coverage is primary according to the National Association of Insurance Commissioners' guidelines. The exception is your FEHB medical plan as described above.
For example, assume your spouse also has group dental coverage. For your spouse's expenses, his or her group coverage would pay first, your FEHB medical plan would pay second and this plan would pay last.
When you have any other insurance that covers dental expenses before this plan, submit your claim to that insurance first. Then, submit your claim and the other insurance explanation of benefits to your FEHB medical plan. Finally, submit your claim and the other insurance explanation of benefits and your FEHB medical plan's explanation of benefits to GEHA Connection Dental Federal.
- Medicare coverage
Medicare normally will not cover your dental expenses. However, when you have Medicare, their rules may change which coverage pays first between your FEHB medical plan and other group health plan coverage.