CONUS Claims

United Concordia will accept claims filed on any standard dental claim form of the American Dental Association (ADA) or on the TRICARE Dental Program (TDP) Claim form. For your convenience, this form can be filled out online, printed and mailed to United Concordia. A separate claim form must be submitted for each enrollee receiving services.

Whether or not you file a TDP claim depends on the type of dentist - participating or nonparticipating - you are seeing for treatment.

TDP Participating Dentists  - If your dentist is a participating dentist, his or her office will handle all of the paperwork, including filing claims. United Concordia will reimburse your dentist directly for covered services, less the amount you paid for your cost-share.

TDP Nonparticipating Dentists  - If you seek treatment from a nonparticipating dentist, you may be required to file your own claim. United Concordia will reimburse you for the claim, less the amount you paid for your cost-share. United Concordia will pay a nonparticipating dentist directly only if you designate on the claim form that the dentist is to receive the payment.

Additionally, any part of the dentist's fee exceeding United Concordia's allowance is your responsibility.

Submitting a Claim
When submitting a claim to United Concordia, it is important that all of the appropriate information is provided. Failure to provide the necessary information will result in a claim payment being denied.

If you have to file your own claim(s), be sure to include the following information on your claim form:

• Date(s) of service
• Specific problem encountered
• Procedure Code(s)
• Specific tooth/teeth treated for each service performed
• Total charges
• A complete description of the service performed, including applicable tooth/ teeth numbers, if a procedure code is not provided

You'll also need to include a dentist's bill or statement of charges if the specific service(s) provided are not found on the claim form.

Deadline for Filing Claims
Claim forms should be submitted to United Concordia as soon as possible after the service, preferably within 60 days. Claims submitted more than 12 months after the month in which the service was provided will be denied. Prompt submission is especially important for claims involving an orthodontic treatment plan, because the banding date is used to determine timely filing.