To enrol in the Dental NIHB Program:
1. Download the Dental Provider Enrolment Form:
Sample Copy of a completed Dental Provider Enrolment Form:
2. Complete the Dental Provider Enrolment Form fully for all required sections.
Did you know…
Electronic Funds Transfer (EFT) is free and secure!
Sign up by completing the Payment Information section of the Dental Provider Enrolment Form and eliminate mail delivery delays of lost, misplaced, or stolen cheques! Receive your claim payments directly into your designated bank account on the day the payment is issued and still continue to receive mailed statements for reconciliation!
Electronic Data Interchange (EDI) is a point of service, claim submission method to submit Dental claims electronically in real time!
Purchasing a software compliant with CDAnet Electronic Claim Standard, Denturists Association of Canada (DACnet) or Réseau ACDQ (Association des chirurgiens dentistes du Québec) will expedite your claim submissions. Why not consider it today! For more information, contact your association to be advised of the list of certified software vendors.
3. Sign the Dental Provider Enrolment Form (where indicated).
4. Fax all pages (including a photo copy of a VOID cheque or official bank letter for EFT payments) of the Dental Provider Enrolment Form to Express Scripts Canada at fax number 1 (855) 622-0669.
Claims, Pre-Determinations and Post-Determinations
For clients of the BC First Nations Health Authority (First Nations residing in BC), please click here for the appropriate forms: fnha.ca/benefits/dental.
Claims Submission Kit
Dental Hygienist Provider Enrolment Form
Provider Information Changes
Dental Quick Reference Sheets
Express Scripts Canada Provider Claims Processing Call Centre
Extended Hours of Operation:
Monday to Friday
6:30 a.m. - 8:30 p.m. ET, excluding Statutory Holidays
1 (888) 511-4666
Mail dental claims to:
Express Scripts Canada
NIHB Dental Claims
3080 Yonge St., Suite 3002
Toronto, ON M4N 3N1
Fax dental claims to:
Toll Free Fax No.: 1 (888) 249-6098
For all other correspondence, mail to:
Express Scripts Canada
5770 Hurontario St., 10th Floor
Mississauga, ON L5R 3G5
Indigenous Services Canada
Click Indigenous Services Canada to view all the NIHB Program contact numbers.