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ComplyRight 2024 ADA Dental Claim Forms, 100 Forms/Pack (20241100)
$16.39
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  • Forms conform to the Health Insurance Portability and Accountability Act (HIPAA)
  • Forms provide a common format for reporting dental services to a patient's dental benefit plan
  • ADA policy promotes use and acceptance latest version ADA Dental Claim Forms by dentists and payers
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ComplyRight 2024 ADA Dental Claim Forms, 100 Forms/Pack (20241100)

Item #: 24602229Model #: 20241100
Final price is $16.39

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  • About this product

    ComplyRight Dental Claim Forms allow healthcare providers to bill a patient's insurance company for reimbursement of dental claims.

    Starting January 1, 2024, providers and dental industry partners will see crucial updates designed to streamline dental claims processing. Developed in conjunction with all the governing agencies, including the National Uniform Claim Committee (NUCC), the National Uniform Billing Committee (NUBC), the CMS Centers for Medicare and Medicaid Services, the Health and Human Services Agency, and the American Hospital Association. Forms adhere to strict printing standards that govern the layout, paper and ink. 100% compliant to meet ADA guidelines. The following materials are prepared by ADA Practice Institute staff with contributions from the ADA Council on Dental Benefit Programs and other internal and external knowledge experts. The 2024 version provides new spaces for reporting data that can expedite timely and accurate claim reimbursement. It is now possible to clearly identify claims for services delivered by a “locum tenens” dentist, one who is standing in for another who is away from the practice for a short time. The form also supports reporting an identifier, known as Payer ID, that when available uniquely identifies the third-party payer receiving the claim.

    • Forms conform to the Health Insurance Portability and Accountability Act (HIPAA)
    • Forms provide a common format for reporting dental services to a patient's dental benefit plan
    • ADA policy promotes use and acceptance latest version ADA Dental Claim Forms by dentists and payers

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    Product specifications table
    Attributes ComplyRight 2024 ADA Dental Claim Forms, 100 Forms/Pack (20241100) Adams Health Insurance Claims (CMS1500CV) ComplyRight 2024 ADA Dental Claim Forms, 500 Forms/Pack (20241500) ComplyRight 2024 ADA Dental Claim Forms, 2,500 Forms/Pack (20241) ComplyRight 2024 ADA Dental Claim Forms, 1,000 Forms/Pack (202411)
    Your product
    Price is $16.39
    Adams Health Insurance Claims (CMS1500CV)
    Reviews
    No reviews yet
    4.4
    9
    No reviews yet
    No reviews yet
    No reviews yet
    Delivery Information
    Delivery by Fri, Jun 13
    Pick up in 1 hour
    Free delivery by Fri, Jun 13
    Free delivery by Fri, Jun 13
    Free delivery by Fri, Jun 13
    Available in my store
    No
    Yes
    No
    No
    No
    Width in Inches
    8.5
    9.5
    8.5
    8.5
    8.5
    Length in Inches
    11
    11
    11
    11
    11
    Medical Form Pack Size
    100
    100
    500
    2500
    1000
    Medical Form Type
    Dental Claims
    Health Insurance Claims
    Dental Claims
    Dental Claims
    Dental Claims
    Form Size
    8-1 / 2" X 11"
    9 1 / 2" x 11"
    8-1 / 2" x 11"
    8-1 / 2" x 11"
    8-1 / 2" x 11"
    True Color
    White
    White
    White
    White
    White
    Print Type
    Laser
    Data not available
    Laser
    Laser
    Laser
    Number of Parts
    1
    Data not available
    1
    1
    1
    Acid Free
    Acid Free
    Data not available
    Acid Free
    Acid Free
    Acid Free
    Price Per Unit
    Data not available
    Data not available
    Data not available
    Data not available
    Data not available
    Add To Cart
    Add To Cart
    Add To Cart
    Add To Cart