PLANNED FEATURE 01
Enter patient and member details
Work from an on-screen form instead of handwriting repeated member information.
CALIFORNIA • MEDI-CAL DENTAL
Software in development / interest surveyDC-217 Denti-Cal TAR / Claim Printing Software
A simpler way to prepare information for California Medi-Cal Dental paper claims and Treatment Authorization Requests (TARs) on original DC-217 laser-printer forms.
Not yet available: We are evaluating demand for a standalone Windows printing utility. There is currently no installer, pricing, online purchase or license to order.
PREPRINTED CLAIM FORM • ALIGNMENT CONCEPT
Medi-Cal Dental TAR / Claim
Patient and member details
Provider and service location
Dental procedures and fees
Illustration only — not an official claim form or a screenshot of finished software.
ABOUT THE GOVERNMENT FORM
What is the DC-217 form?
The DC-217 is California Medi-Cal Dental’s single-sheet, laser-printer version of the Treatment Authorization Request (TAR)/Claim form. Dentists can use the official form to request authorization for planned covered dental treatment or submit eligible dental services for payment, according to program rules.
Unlike the nationwide ADA Dental Claim Form, DC-217 is a California Medi-Cal Dental-specific form. It carries member and provider identification, procedure and treatment information, fees and applicable attachments. The DC-202 and DC-209 serve related paper workflows, but DC-217 is the version intended for laser printers.
THE PRINTING PROBLEM
Print on original red-ink forms without handwriting every field
Official Medi-Cal Dental DC-217 paper stock is produced with red ink for scanning. The proposed software would place readable black text into the correct boxes on original, preprinted DC-217 sheets—without printing a replacement red background. Precise printer positioning is the central problem we aim to solve.
Instead of positioning text in a word processor or repeatedly retyping a form, the proposed utility would use a dedicated data-entry workspace and printable field layout. An alignment control would help compensate for different printers and paper feeds. For DC-217, California also recommends plain 10-point fonts, uppercase printing and six-digit dates without separators.
What the software is planned to do
These are proposed capabilities, not currently shipping features. The program would be a focused paper-claim preparation tool rather than a full medical or dental practice-management system.
PLANNED FEATURE 02
Reuse provider information
Save common billing provider, service office and identifier fields for future claims.
PLANNED FEATURE 03
Prepare TARs and claims
Choose the intended request type and review procedures, tooth details, service lines and amounts.
PLANNED FEATURE 04
Adjust laser-printer alignment
Use horizontal and vertical offsets and a test-print workflow to help place black data into preprinted fields.
PLANNED FEATURE 05
Save and reopen drafts
Keep local copies for editing and later reprinting rather than retyping the entire request.
PLANNED FEATURE 06
Review before printing
Check for commonly omitted fields and prompt the user to verify attachments and signatures.
TAR approval requirements and covered services depend on current Medi-Cal Dental policy. The envisioned program would prepare and print forms only; it would not issue authorizations, submit claims electronically, or guarantee acceptance or payment.
PROPOSED WORKFLOW
How printing would work
Get official DC-217 paper
Use the California Medi-Cal Dental forms reorder process for genuine laser-printer stock.
Enter the claim or authorization
Fill in member, provider, dental procedure and fee information in the planned Windows interface.
Align and print
Check printer settings, test positioning, and print the entered text on the original red-ink sheet.
Complete submission requirements
Add any required supporting documents or signatures and follow the current Medi-Cal Dental submission instructions.
The linked government resources describe the official form and submission rules. MedClaimSoftware is an independent software company and is not affiliated with or endorsed by the California or New York Medicaid programs.
COMMON QUESTIONS
DC-217 printing FAQ
What does DC-217 stand for?
DC-217 is the California Medi-Cal Dental single-sheet TAR/Claim form designed for laser printers. TAR means Treatment Authorization Request.
Is DC-217 the same as the ADA Dental Claim Form?
No. DC-217 is a California Medi-Cal Dental-specific paper form. The ADA Dental Claim Form is a different dental insurance claim form used by other payers.
Would the software print the red form itself?
The planned software is intended to print black entries onto official preprinted DC-217 red-ink forms, not to create substitute form stock.
Can I download or buy this program now?
Not yet. This product is being evaluated. There is no available installer, purchase item or license at this time.
Could I submit a DC-217 electronically with this program?
No electronic filing capability is planned for this standalone paper-form printing utility. Providers should check currently accepted electronic options with Medi-Cal Dental.
Would a standalone DC-217 printing program help your office?
Tell us you are interested and what printing problem you need solved. We are assessing demand before releasing the software. Please do not share patient information.
Also evaluating: New York eMedNY-150003 paper claim software. Explore all MedClaimSoftware products.