Out-of-Country Claims
As a Delta Dental member, you can visit any licensed dentist anywhere in the world for your dental care. Even if you’re out of the country when you receive dental treatment, you have peace of mind when you have Delta Dental coverage.
Please note that in these situations, out-of-network coverages apply.
When you see a dentist outside of the U.S., you are responsible for obtaining the necessary documentation for services provided, filing a claim form with Delta Dental, and paying the dentist at the time services are performed. When you submit your claim and accompanying documentation, please include a valid phone number or email address so that we may contact you if necessary to prevent delays in processing your claim.
Please review the additional information below and follow the instructions carefully:
In order to submit an out-of-country claim for dental services including diagnostic and preventive, restorative, and major, please follow these instructions carefully:
- Complete all required fields on the form. If you require any help, please contact our customer service team at customerservice@deltadentalnm.com or toll-free at (877) 395-9420 or local at (505) 855-7111
- Ensure the claim form or the itemized statement includes the following information:
- Procedure Date
- Area of Oral Cavity
- Tooth System
- Tooth Number(s) or Letter(s)
- Tooth Surface
- Procedure Code
- Description
- Fee
- Fill out and sign an authorization form verifying that you received the services on the claim form. You can scan and email the authorization form to customerservice@deltadentalnm.com, fax it to (505) 883-7444, or mail it to us (see address below).
- Ensure you meet the other requirements listed in the section below, "Other Requirements and Information."
- Submit your claim form and other required documents to:
Delta Dental of New Mexico
100 Sun Avenue NE, Suite 400
Albuquerque, NM 87109
Please include these additional documents, if applicable, with your claim form.
- For out-of-country claims, Delta Dental requires an itemized receipt indicating the country’s currency. Delta Dental will calculate foreign currency benefit payments based on published currency conversion tables that correspond to the date of service.
Prior to any major treatment being started, the dentist must take a radiographic image of the treatment area. Please submit a copy of the image with your claim.
- You are responsible for payments to the dentist at the time of service. The reimbursement check will be sent to your address on file. Delta Dental does not allow dedication of payment for out-of-country claims.