If you do need to file a claim form: Download the claim form for your Delta Dental plan: Delta Dental PPO TM, DPO and Delta Dental Premier ® DeltaCare USA ® Delta Dental of Delaware (See Delta Dental of . How to file a dental claim. Custom Benefit Administrators 39170 Delta Dental Plan of Vermont (Northeast) 02027 Custom Design Benefits (Cincinnati, OH) 82056 Delta Dental Plan of Virginia 54084 ... Delta Dental Plan of Arkansas 00001 Dental Benefit Providers 52133 (+)/(ID) = Additional special enrollment required for payer Dental Payer List Information For any questions please contact eServices Support at 800.475.5036. Box 242810 Louisville, KY 40224-2810 800-955-2030 deltadentalky.com Payer #CDKY1 Maine, New Hampshire, Vermont Northeast Delta Dental P.O. Delta Dental of Colorado . You can search by payor ID or Payor Name for payers that accept electronic claims and attachments, or that provide electronic insurance eligibility verification. 800-610-0201 . Payer #77777 . Search by carrier or state in one easy step to locate the correct payer id code, neccessary to route EDI transactions to the correct payer. You can search by payer ID or Payer Name for payers that accept electronic claims and attachments, or that provide electronic insurance eligibility verification. Box 173803 . Delta Dental of Connecticut (See Delta Dental of New Jersey) Payer #22189 . Box 9000 Johnston, IA 50131-9000 800-544-0718 www.deltadentalia.com Payer #CDIAl Delta Dental of Kansas 1619 N. Waterfront Parkway Payer List Includes (20 pgs): Commercial Payers Blue Cross Blue Shield Payers Delta Dental Payers Medicaid Payers Payer ID 06126: Use this eClaim payer id for those insurance companies that are not on the eClaim Payer List deltadentalco.com . Payer #84056 . Payer ID Payer Name Type 02027 Delta Dental of Maine (Northeast) Benefit 23166 Delta Dental of Maryland(Mechanicsburg, PA) Benefit 04614 Delta Dental of Massachusetts (Boston, MA, Milwaukee, Benefit CDMI0 Delta Dental of Michigan(Farmington Hills, MI) CDMN1 Delta Dental of Minnesota(Minneapolis, MN) Benefit Eclaims.com provides a searchable payer id code list, spanning all states for BCBS, MDCR and MDCD. Payer ID Payer Name CDIA1 Delta Dental of Iowa (Ankeny, IA) CDKS1 Delta Dental of Kansas(Whichita, KS) 94276 Delta Dental of Louisiana(Irving, TX) 02027 Delta Dental of Maine (Northeast) 23166 Delta Dental of Maryland(Mechanicsburg, PA) 04614 Delta Dental of Massachusetts (Boston, MA, Milwaukee, WI) CDMN1 Delta Dental of Minnesota(Minneapolis, MN) Delta Dental of Delaware, Inc. Payer #51022 See Delta Dental of Pennsylvania Kentucky Delta Dental of Kentucky P.O. EIN verification service allows to find EIN (Employer Identification Number) is also known as a Federal Tax Identification Number) using organization name, address, or other entity attributes. Pennsylvania) Payer #51022 . Delta Dental dentists will handle all claims and paperwork for you. Delta Dental CA - Tricare Retirees 039003 Doral Dental USA 006001 Delta Dental CA (Commercial) 019001 Eastern Life and Health 047002 ... Electronic Attachment Dental Payer List March 2010 Payer Name NEA Payer IDPayer Name NEA Health Care Systems, Inc. 017012 Medicaid FL - … However, if you visit a non-Delta Dental dentist, you may need to file the claim yourself. P.O. Payer ID: WDENC Delta Dental of Indiana P.O. DENTAL PAYER LIST Commercial Advantage by Peach State Health Plan Medicare Advantica AETNA ... BCI SNP ID- Medicare Benefits Inc. (Alan Sturm) Blue Advantage ... Northeast Delta Dental (NEDD) PMI DeltaCare USA TruAssure Insurance Co. Denver, CO 80217-3803 . Box 9085 Farmington Hills, Ml 48333-9085 800-524-0149 www.deltadentalin.com Payer #DDPIN Delta Dental of Iowa P.O.