Before you start
- Confirm the subscriber name, relationship, plan or group information, and other payer-requested identifiers from the current coverage record.
- When another dental or medical plan is involved, the order of benefits and supporting information can affect what is sent with the claim.
- Group numbers, employers, plan names, and subscriber details can change.
Identify the correct coverage record
Confirm the subscriber name, relationship, plan or group information, and other payer-requested identifiers from the current coverage record. If more than one plan is involved, keep primary and secondary coverage information distinct.
Coordination of benefits
When another dental or medical plan is involved, the order of benefits and supporting information can affect what is sent with the claim. Do not infer coordination rules from a prior patient's claim; verify the applicable plan instructions.
Avoid stale insurance templates
Group numbers, employers, plan names, and subscriber details can change. Saved insurance data should be reviewed at the point of claim preparation, not only during patient intake.
Dental-claim review
- Verify the subscriber/policyholder identity and plan identifiers from the current benefit record.
- When another coverage exists, keep primary and secondary plan information in the correct sections.
- Recheck subscriber information when employment or coverage changes.
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
- Diagnosis Information on Dental Claims
- Procedure Dates and Tooth Information on Dental Claims
- Patient Information on 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.