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Dental Treatment Authorization Request 2355 E. Camelback Rd #300 Phoenix, AZ 85016 pH. 602.778.1800 x8313 Fax: 602.778.1838 Emergent Urgent Member Information: Member Name: AHC CCS Member Routine
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Fill in your personal information, including your name, address, and contact details.
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Care 1st dentist refers to a dental care provider that is part of the Care 1st Health Plan network.
Dental care providers who are contracted with Care 1st Health Plan are required to file care 1st dentist.
To fill out care 1st dentist, dental care providers need to submit the necessary claim forms and documentation to Care 1st Health Plan.
The purpose of care 1st dentist is to ensure that dental care services provided by contracted providers are properly documented and billed for.
The information that must be reported on care 1st dentist includes the patient's information, treatment provided, dates of service, and any relevant supporting documentation.
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