What matters most
- The clinician who performed the service and the entity submitting the claim may be the same or different.
- If a practice has multiple offices, verify the service location used for the claim rather than defaulting to the billing office address.
- Do not copy one NPI, license, taxonomy, or other identifier into every provider-related field without confirming what the field requests and what the payer expects.
Treating versus billing information
The clinician who performed the service and the entity submitting the claim may be the same or different. Review names, identifiers, and addresses according to the office structure and payer enrollment information.
Location matters
If a practice has multiple offices, verify the service location used for the claim rather than defaulting to the billing office address. The location information should be consistent with the treatment record.
Identifiers should match the role
Do not copy one NPI, license, taxonomy, or other identifier into every provider-related field without confirming what the field requests and what the payer expects.
Dental-claim review
- Separate billing dentist/entity data from treating-dentist information.
- Verify NPI, license, specialty, address, and other identifiers in the appropriate fields.
- For 2024-form workflows, account for the locum-tenens fields when applicable.
Sources and verification
Use the ADA source below for the current 2024 Dental Claim Form and completion guidance, together with the dental plan’s requirements.
Related guides
- Patient Information on the ADA Dental Claim Form
- What Is the 2024 ADA Dental Claim Form?
- Understanding the Main Sections of the ADA Dental Claim Form
Try the software
MedClaimSoftware’s ADA Dental Claim program is designed for the current 2024 form and can save/retrieve claim data and print from Windows. A limited-use trial is available without a credit card. ADA Dental Claim software.