Automatic Orthodontia Reimbursement Process
Group Dynamic, Inc. offers two options for requesting reimbursement for ongoing orthodontia expenses.
You may follow standard reimbursement request procedures for services that have been received:
- Obtain a receipt or statement from the orthodontist that includes the orthodontist’s name, address, date of service, service provided and fee charged for the service.
- Complete a Flexible Spending Account Reimbursement Request form.
- Mail, fax or scan &
the Reimbursement Request form and receipt or statement to the Reimbursement Team at GDI.
You may request to have automatic reimbursement for orthodontia services during the plan year, thus eliminating the need to submit a request for reimbursement each month.
To enroll in this process:
If you have any questions, please call Tisha Campbell on our Reimbursement Team at 1-800-626-3539 or 207-781-8800.
- Obtain a copy of the orthodontist's contract or "Truth in Lending Statement". This documentation must contain the orthodontist’s name, address, dates of service (from the beginning of treatment through the anticipated end of treatment), a breakdown of the deposits, fees and payment schedule.
- Complete a Flexible Spending Account Reimbursement Request form, being sure to include the dates of service and charges incurred within the plan year. Please write “auto generation” on your Reimbursement Request form.
- Upon receipt of the items listed above, your orthodontia reimbursements will be automatically processed during the first full week of each month during the plan year.