Dental Services

• Final dated stamped itemized invoice mentioning the tooth number, date, name, and cost of each performed service. Copy of performed radiology results is requested.

General Notes:

• Claims should be submitted/completed within 120 days from the date of service. Any claims submitted after 120 days will not be refundable.

• Claims refund will be for final eligible treatment costs only, and not for deposits, advance payments, registration, or administration fees charged by the service provider.

• Specialty of the treating doctor should be relevant to the performed services.

• Please note that claim evaluation will be done at the time of processing after receiving the full supporting documents.

• Claims are subject to further requirements, if needed.