Updated October 2026
Quick answer: Humana's Dental Provider Manual says the proof-of-loss period "is not always the same for all products." On most fully insured commercial dental products, claims must be submitted within 15 months of the date of service. Medicare dental claims must be submitted within 12 months of the date of service (Humana Dental Provider Manual). Self-funded (ASO) groups, individual plans and FEDVIP can differ, so verify in your agreement or portal, or with Humana at 800-833-2223, before you rely on a deadline.
For Humana dental CDT rules, coverage and documentation, see our Humana dental policy hub.
Humana dental filing limits by plan type
| Plan type | Filing limit | How to submit | Source |
|---|---|---|---|
| Fully insured commercial (most products) | 15 months from date of service | Payer ID 73288 (Group, On-Exchange) or CX021 (CompBenefits individual products) | Dental Provider Manual |
| Medicare Advantage dental | 12 months from date of service | Payer ID 73288 | Dental Provider Manual |
| Self-funded / other commercial products | Not publicly stated; the manual says the limit varies by product | Confirm with Humana Customer Care or the plan document | Dental Provider Manual |
| FEDVIP (Humana Dental federal plans) | Brochure: one year from date of service for emergency and international claims. It also says "the date of loss is 12 months on fully insured commercial plans plus 90 days after the date of loss to give proof" | Federal claims use the Humana Dental claims office | 2026 Humana Dental FEDVIP brochure (OPM) |
| DHMO | Routine services are paid by capitation with no claim. A claim is required to receive supplemental payments; no separate DHMO limit is published | Same claim channels | Dental Provider Manual |
The FEDVIP brochure's wording is member-facing and is not phrased the same way as the provider manual. For federal patients, confirm the deadline with Humana's FEDVIP line (877-692-2468) before relying on it.
Wrong-carrier rule: If a claim was submitted in error to another carrier or agency, Humana's timely filing period begins on the date the provider was notified of the error (manual). Keep that notice.
Where to send Humana dental claims
- Electronic: Use payer ID 73288 for Medicare Advantage, Group Dental and On-Exchange products (9-digit member IDs). Use CX021 for CompBenefits individual products such as Complete Dental and Preventive Value (13-digit member IDs). Claims can also be keyed in Availity under Humana Dental. Pre-estimates and attachments cannot currently be submitted through the Availity portal.
- Paper (Humana): Humana Dental Claims Office, P.O. Box 14611, Lexington, KY 40512-4611. This address includes federal claims.
- Paper (CompBenefits): CompBenefits Claims Office, P.O. Box 14283, Lexington, KY 40512-4283.
- Attachments: Send through Vyne FastAttach or DentalXChange.
- Two plans for one patient: If a patient has both a Medicare Advantage and an individual Humana dental plan, submit separately to Humana Dental and to CompBenefits. The plans process independently.
All of the above is from the Humana Dental Provider Manual.
Step-by-step: filing and protecting a Humana dental claim
- Read the ID card. It shows whether the claim goes to Humana or CompBenefits, which sets the payer ID and address.
- Identify the product type (fully insured commercial, Medicare Advantage, individual, DHMO or FEDVIP) and calendar the matching deadline from the date of service.
- Complete the claim. Include the NPI, current TIN, and your provider name as it appears on your Humana contract. Missing NPIs can cause denials or delays.
- Attach clinical documentation. For crowns, perio and prosthetics, follow the manual's examples: diagnostic pre-op X-rays, narratives, perio charting, and extraction dates for prosthodontics.
- Save acceptance reports from your clearinghouse as proof of timely submission.
- Check status in Availity under Claims & Payments > Claims Status.
Disputes, reconsiderations and appeals
- Claims dispute: Call 800-833-2223 and note the reference number. If the issue is referred, Humana says to expect a response within 30–45 days. If it remains unresolved, request reconsideration by secure email to DentalService@humana.com.
- Appeal on the member's behalf: You can appeal with the member's authorization. Follow the time limits in the member's dental policy, and state in the request that you are appealing on the member's behalf. The provider or the member may appeal, but not both.
- Appeal on your own behalf: Some states let providers appeal on their own behalf. The deadline is set by state law.
- Appeal forms and addresses: Humana publishes separate grievance and appeal forms for Medicare, individual/family and employer group plans. Mail Humana appeals to Grievance and Appeals, P.O. Box 14638, Lexington, KY 40512-4638. Mail CompBenefits appeals to P.O. Box 14729, Lexington, KY 40512-4729.
All of the above is from the Humana Dental Provider Manual.
FEDVIP disputes follow the brochure:
- Send a written reconsideration request within one year to P.O. Box 14638. Humana has 60 days to decide.
- A Grievance Panel review can be requested within 60 days of that decision.
- After that, an independent third party mutually agreed by Humana and OPM can review the case. Its decision is binding.
- OPM does not review FEDVIP disputed claims (2026 brochure).
Pretreatment estimates
Humana recommends a pretreatment estimate for procedures over $300, or when coverage is unclear. Submit:
- the planned services with CDT codes
- a written description of the proposed treatment
- pretreatment X-rays
- an itemized cost
- any other diagnostics Humana requests
All of this is from the manual. Need help with the codes? See our CDT code reference.
Documentation checklist
- Correct payer ID (73288 or CX021) and claims address for the product
- NPI, TIN, and contracted provider name
- Date of service and product-specific filing deadline on your calendar
- Clearinghouse acceptance report, or the other carrier's misdirected-claim notice
- X-rays, narrative, perio charting or prosthetic history per Humana's attachment guidelines
- For appeals: copy of the original claim
- For appeals: the remittance showing the denial
- For appeals: supporting clinical records
- For appeals: an appointment of representative (AOR) form signed on or after the denial date, when appealing for the member. An assignment of benefits is not enough.
FAQ
What is Humana's dental timely filing limit?
For most fully insured commercial products, it is 15 months from the date of service. For Medicare, it is 12 months. Other products can differ, so verify by product.
Is the Humana dental limit the same as Humana's medical limit?
Don't assume so. Use the Dental Provider Manual and your dental agreement for dental claims, not Humana's medical claims guidance.
Can I submit a Humana dental pre-estimate in Availity?
Not currently. Humana's manual says pre-estimates and attachments can't be submitted through the portal. Use your clearinghouse or paper.
Who can file a Humana dental appeal?
The member, or the provider acting with the member's written authorization. Some states also allow providers to appeal on their own behalf.
Sources
- Humana Dental Provider Manual (12-25 edition): https://assets.humana.com/is/content/humana/Dental%20Provider%20Manual%2012-25pdf-1
- Humana Dental 2026 FEDVIP brochure (OPM): https://www.opm.gov/healthcare-insurance/healthcare/plan-information/plans/BrochureJson?brochureNumber=02AP-10&year=2026
Compare other carriers' filing rules on our payer directory and the BCBS dental timely filing guide.