Find and download any Aflac claim form you may need.
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Please request a copy of the policyholder's identification card contained within their policy. The identification card will contain the policy number and specific website address that should be used by our Dental providers. This will ensure that we provide accurate and up-to-date benefit information to expedite the claim process.
This Aflac Dental policy does not coordinate with other insurance and we pay a flat benefit amount, regardless of what the patient is billed. Any payment received, exceeding the amount of the bill, should be provided to the patient. Aflac's dental plans are designed to allow for an easier claim payment process, allowing us to maintain fast turnaround times for claim payments. There is no pre-certification required.
Aflac currently has two methods available for submitting dental claims.
You may submit the claim electronically to Emdeon. Make sure that Aflac's payor number (58066) is included on each claim submitted (inquiries regarding software to handle electronic filing should be directed to your state ADA office).
Submit the typed claim form directly to:
Aflac Worldwide Headquarters
Attention: Claims Department
1932 Wynnton Road
Columbus, GA 31999-7251
- The policyholder's dental policy number (available on their ID card and enclosed in their policy)
- The policyholder's complete name as it is printed on their Dental Plan ID card
- The patient's full name, sex, date of birth, and relationship to the insured
- The treatment date, specific tooth number, surface or oral cavity area, ADA code and charge for each procedure
- The patient's Social Security number (to speed up claim processing)
- If the patient is a full-time student and over age 19, please indicate this on the form.
If you have questions, please call our toll-free number 1-800-99-Aflac (1-800-992-3522)