Submit a Claim
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
2. Complete the form and be sure to sign it.
3. Mail your completed, signed form, along with a copy
of the receipt for the dental services you are claiming,
Denex Dental Claims
P.O. Box 7402
London, KY 40742