Your dentist will usually complete the claim form for you.
If your dental office gives you a receipt instead, submit it along with a claim form.
It is important to make sure that all the pertinent information is on the claim form.
Incomplete forms will cause payment delays.
Click here for a dental claim form.
Pacific Blue Cross requires this information on each claim:
- Patient's full name
- The member's policy and ID numbers
- Patient's dependent number and birth date
- If PBC is to reimburse the member, we also need the member's mailing
We also need all the information about the dental services that were performed.
- Procedure code
- Date of service
- Fee charged
- Tooth numbers and surfaces, if applicable
- The dentist's signature or authorization (or attach a receipt)
- The dentist's name and PBC ID number
- A note indicating if PBC should reimburse the member or the dentist
(for example, write "pay member")
If the patient has dental coverage under more than one plan, please
see our information on duplicate coverage.
Mail your claim to Pacific Blue Cross, PO Box 7000, Vancouver,
BC, V6B 4E1 or drop off your claim personally at 4250 Canada Way, Burnaby (we're at the corner of Canada Way and Gilmore).
Please note: We suggest that you submit your claims
promptly. Pacific Blue Cross can only pay claims we receive, with correct
and complete information, within one year of the service