Claim submission tips

  • Verify claims address or Electronic Payer ID

    • Claims Address:
    Sun Life Financial
    PO Box 2940
    Clinton, IA 52733

    Electronic Payer ID:
    70408

  • Review Claim Documentation Guidelines

    •

    Claim attachments are not always necessary. Review the Guidelines to determine which attachments, if any, are required.

  • Double check identification information

    • Certain information is needed to identify your patient. The following fields should be completed on your claim form:

    Employee Name
    Employee Date of Birth
    ID Number

    Patient Name�
    Patient Date of Birth

    Group Name
    Group ID Number

  • Submit attachments electronically

    • You can submit attachments to us electronically through National Electronic Attachment (NEA). For more information, visit www.nea-fast.com.

  • Clearly label all submitted x-rays

    • The label on the x-ray should include the patient's name, date the x-ray was taken, tooth number(s) and the complete name and address of the treating dentist or dental practice.

  • Make sure x-rays are of good diagnostic quality

    • Duplicate x-rays must be of good diagnostic quality. Dental consultants, during professional claim review process, have difficulty in making an accurate benefit determination with duplicate x-rays of poor diagnostic quality.

  • Send only one claim

    • There is no need to submit a claim more than once. Whether you submitted your original claim electronically or through the mail, you can check the status 24 hours a day, 7 days a week. Visit your Sun Life account to view the online services available to you.

  • Use appropriate CDT Codes

    • Please use the appropriate CDT codes. Invalid or incorrect codes may cause a delay in your claim payment. Use the most current American Dental Association (ADA) publication.

  • Include tooth number

    • Include tooth number for the teeth involved in the procedure. When submitting a claim for a periodontal procedure that does not include a full quadrant, include specific tooth numbers. Also, remember to include the number(s) of other missing teeth in the same arch when submitting claims for Prosthodontics.

  • Include tooth surfaces

    • Include tooth surfaces for all restorative treatment. Make sure that tooth surfaces correspond with submitted CDT code.

  • Submit initial and replacement detail

    • When submitting claims for Prosthodontics or Crowns, indicate if treatment is initial placement or a replacement. If a replacement, include the date the original prosthetic or crown was placed.

  • Include full-time student information

    • Include full-time student information if your patient has exceeded the standard dependent age limit. Members may also call us with this information.

  • Include primary carrier's payment amount

    • When Sun Life is the secondary payer, please provide the primary carrier's payment amount.

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