Close Icon Dismiss modal Close Icon Dismiss modal External Icon Link to an external resource Gear Icon Display options X Icon X Icon Plus Icon Minus Icon Arrow Right Arrow Left Arrow Up Arrow Down Calendar Edit Refresh First Last Question Info Block PDF PDF Document Word Word Document Excel Excel Document Powerpoint Powerpoint Document Active Checkbox Checked checkbox Active Radio Selected radio button Checkmark Error Warning Visibile Hidden

Forms and documents Oregon

Get the forms and documents you need to get work done for your clients.

Oregon forms and documents


Claims and payments

Find out how to file fees and submit claims electronically

  • Claims form - Advise your patients to log in to their Member Dashboard to access the ADA claim form
  • ERA form - Enroll to receive Electronic Remittance Advice (ERA)
  • Refund submission form - Request refunds for overpayment
  • Sample EOPs - See what an explanation of payment (EOP) looks like
  • Sample EOBs - See what an explanation of benefits (EOB) looks like


Oregon credentialing


Contact us

Dental Customer Service: 888-217-2365
Dental Professional Relations: 888-873-1393

Get more contact details.