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 Online Advantage 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.

SLPC 28147 03/17 (exp. 03/19)