What Information Do You Need to Fill Out a Dental Claim Form?


Quick Answer

When filling dental claims forms, the required information includes the patient's identification details, the dentist’s identification details and a description of the services, including procedure codes and fees, explains Delta Dental.

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Full Answer

The details needed to identify the patient and his dentist include names, physical addresses and phone numbers. Other required details on the dentist include his National Provider Identifier, tax identification number, state license number and specialty code, according to Delta Dental.

The statement of treatment or any other similar document issued by the dentist’s office may not contain all the required information to enable the processing of dental claims. Therefore, patients should be sure to get the information about the dentist or the treatment procedures from any of the dental office’s staff members and enter it on the claims form, as Delta Dental advises. After entering all the required information, the patient should make a copy for his personal records.

If the patient is a Delta Dental Plan member, however, its dentists can handle all paperwork, including the filling of dental claims, notes Delta Dental. Once the patient or dentist has submitted the completed forms, claims processing takes two weeks, unless there are any other additional details needed from the patient or his dentist.

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