Submit a Claim by mail.
1.Click here to download a claim form.
The claim form is in Adobe® PDF format. If you do not have Adobe® Acrobat Reader®, which will enable you to view and print the claim form, click here to download a free copy.
2. Complete the form and be sure to sign it.
3. Mail your completed, signed form to:

Coventry Dental
P.O. Box 7402
London, KY 40742

Dentists can submit electronic claims using Emdeon Payor IS:CX049



***Coventry Health Care Advantage Member click here.

Last Updated 10/12/2016

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