International Plan - Dental Benefits

The myCigna mobile app allows you to: 

• Submit Claims and follow its status 
• See what is covered under your plan 
• Locate health providers near you or schedule a virtual doctor visit 
• Access your ID Card 

Download the app on your phone or tablet to ease access to services:  Apple iOS / Google Android 

Please read these documents:

• Table of Covered Dental Services
• Definition of Covered Dental Services

• For U.S. providers, please explore the myCigna App or my.cigna.com 
• Outside the U.S., all providers are considered in-network for International Plan members. To receive dental care, you will be required to pay for the services received and then file a claim for reimbursement. Please request an itemized bill or detailed receipt from the provider before you file a claim. 

If you go out-of-network in the U.S. or Puerto Rico or receive dental services outside the U.S. or Puerto Rico for which you had to pay out-of-pocket, there are several ways to submit your reimbursement claims to Cigna Healthcare: by e-mail, by fax or through postal mail. This is the Dental Claim Form. In-network claims are automatically sent by the provider.

To help the claim and reimbursement process go smoothly:

• When you pay for your procedure at a U.S. provider, always be sure ask for a “Superbill” as your receipt for payment. This document typically contains the detailed provider information necessary for Cigna Healthcare to process your claim. When a “Superbill” is not available (providers outside the U.S. may not use this type of invoice document), be sure to get an invoice/receipt that shows the details listed below. 
• For e-mail submissions, you must submit scanned copies of any supporting documentation with your claim form. For fax and postal mail submissions, you must submit paper copies of any supporting documentation with your claim form.
• Be sure to keep copies of your itemized bills, detailed receipts, and other claim-supporting documents in case they are needed for verification purposes
• Include your member ID number on each document submitted with your claim.
• Check to make sure that the documentation from your provider includes all of the following information, or include it yourself when completing the claim process via e-mail; or when completing a paper claim to fax or mail. Make sure to provide all necessary supporting documents, including original, scanned, or photographed itemized bills or detailed receipts, certificates, and medical reports as applicable.

 For dental services in the U.S. or Puerto Rico, you must include:
 

1.   The primary member name, including Cigna ID number 
2.   Please be sure the detailed invoice/receipt you are submitting includes: 

• Date of service (mm/dd/yyyy) 
• Patient name
• Procedure code
• Charge amount for each service 
• Health care professional name/credentials
• Health care professional address
• Health care professional Tax ID number
• Tooth number (If applicable, for a procedure performed on a specific tooth)
• Any clinical information provided by the dental provider

3.   Proof of payment (e.g., credit card or other receipt) if the invoice from the provider does not show “amount paid” with a zero balance.

For dental services outside the U.S. and Puerto Rico, you must include:
 

1.   Cigna Healthcare recommends that claims for outside the U.S. and Puerto Rico to be e-mailed to IADBForeignClaims@cignahealthcare.com with the information noted below:

2.   The primary member name, including Cigna ID number

3.   Please be sure the detailed invoice/receipt you are submitting includes:

• Date of service (mm/dd/yyyy) 
• Patient name
• Description of services provided
• Charge amount for each service 
• Tooth number (If applicable, for a procedure performed on a specific tooth)
• Any clinical information provided by the dental provider
   

4.   Proof of payment (e.g., credit card or other receipt) if the invoice from the provider does not show “amount paid” with a zero balance.

How to Submit a Claim through the Dedicated E-Mail: IADBForeignClaims@cignahealthcare.com

You need to attach to the e-mail:
•    A legible copy of the invoice from the provider
•    A copy of your proof of payment
•    Completed Claim Form 

PLEASE NOTE: Hard-copy sample claim forms were sent with the Cigna Healthcare welcome package. You may photocopy this form and complete by hand, or on myCigna under the Forms Center, you may click on “Mail or Fax a PDF Claim Form” to open a fillable PDF claim form that you can complete and save to attach to your e-mail or print and send by fax.

How to Submit a Claim through Postal Mail

You need to include:
•    A legible copy of the invoice from the provider
•    A copy of your proof of payment
•    Completed Claim Form 

Mail your claim and supporting documentation to: P.O. Box 188037, Chattanooga, TN, 37422-8037
 

How to Submit a Claim through Fax

You need to include in your fax:
•    A legible copy of the invoice from the provider
•    A copy of your proof of payment
•    Completed Claim Form
 

Send your claim form and supporting documentation to: Fax number: (866) 370-8574
 

Please read these documents:

• Table of Covered Dental Services
• Definition of Covered Dental Services

To receive dental care, you will be required to pay for the services received and then file a claim for reimbursement. Please request an itemized bill or detailed receipt from the provider before you file a claim. 

You can submit a claim for services you paid out of pocket through the Cigna Health Benefits website or mobile app or by postal mail. Claims cannot be filed via email. This is the claim form. Cigna Global uses the same form for all types of claims.

Please note that Cigna Global has provided a U.S. address to mail your claim documents:
Cigna Claim Processing
P.O. Box 451989
Sunrise, Florida 33345

You may also submit claims to the Belgium address on the claim form.
Cigna Claim Processing
P.O. Box 69, 
2140 Antwerpen, Belgium

To help the claim and reimbursement process go smoothly:

• Make sure to provide all necessary supporting documents, including original, scanned, or photographed itemized bills or detailed receipts, certificates, medical reports, and prescriptions as applicable
• Keep copies of your itemized bills, detailed receipts, and other claim-supporting documents in case they are needed for verification purposes
• Include your member ID number on each document submitted with your claim form
• Provide complete details on the description of the service and the reason for the visit
• Indicate the country and currency you would like to be reimbursed in. You may elect to be reimbursed in U.S. dollars or the currency of the country where you currently reside. No other options will be approved for IDB Group members. You can select your currency choices in your Cigna Health Benefits profile, so you do not have to enter this information with each claim.

How to Submit a Claim through the Cigna Global Website

1. Log in to the Cigna Health Benefits website (www.cignahealthbenefits.com)
2. Click “Claims” in the menu bar
3. Click the “Submit a claim” button
4. Select the member who received care in the drop-down menu and identify whether that member is covered by other insurance and whether the claim is related to an accident
5. Click the “Next Step” button
6. Add the invoice date, amount, type of care, and country in which care was given
7. Click the “Next Step” button
8. Use the “Choose files” button to add your claim documents (make sure you also add any supporting documents, such as prescription, proof of payment, etc., if required)
9. When you are finished adding documents, click “Save this invoice”
10. On the next screen, review the summary of your claim information to ensure it is correct and then click “Submit claim”

Visit the following documents for more information:

• How to File a Claim online
• Example of an EOB