Predetermination Request Form
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Predetermination Request Form - BCBST
www.bcbst.comA request for predetermination is not necessary for urgent or emergency medical treatment. (If a medical review is being requested, please allow up to 15 days for a determination to be made.) Predetermination requests are never required and are offered as a courtesy review to check for possible pre-existing conditions,
Delta Dental's Federal Employees Dental Program
feds.deltadentalins.com855-410-3255 (TDD 866-847-1264) to request a list of participating providers in your area. Continued participation of any specific provider cannot be guaranteed. Thus, you should choose your plan based on the benefits provided and not for a specific provider’s participation.
ADA Dental Claim Form Instructions
www.va.govPage 1 of 1 Fact Sheet. U.S. Department of Veterans Affairs. Veterans Health Administration. Office of Community Care . IB-10-1368—COMMUNITY CARE Created Date: September 26, 2019